Average glandular dose conversion coefficients for segmented breast voxel models

For 8 voxel models of a compressed breast (4-7 cm thickness and two orientations for each thickness) and 14 radiation qualities commonly used in mammography (HVL 0.28-0.50 mm Al), tissue dose conversion coefficients were calculated for a focus-to-film distance of 60 cm using Monte Carlo methods. The voxel models were segmented from a high-resolution (slice thickness of 1 mm) computed tomography data set of an ablated breast specimen fixated while being compressed. The contents of glandular tissues amounted to 2.6%, and were asymmetrically distributed with regard to the midplane of the model. The calculated tissue dose conversion coefficients were compared with the recent literature values. These earlier tissue dose conversion coefficients were also calculated using Monte Carlo methods and breast models of various thickness, but these consist of homogeneous mixtures of glandular and adipose tissues embedded in 5 mm pure adipose tissue both at the entrance and exit sides. The results show that the new glandular tissue dose conversion coefficients agree well with the literature values for those cases where the glandular tissue is predominantly concentrated in the upper part of the model. In the opposite case, they were lower by up to 40%. These findings reveal a basic problem in patient dosimetry for mammography: glandular dose is not only governed by the average breast composition, which could be derived from the breast thickness, but also by the local distribution of glandular tissue within the breast, which is not known.