Spectral dependence of glandular tissue dose in screen-film mammography

The average glandular tissue dose in mammography is generally determined from published tables with knowledge of the breast entrance skin exposure, x-ray tube target material, beam quality (half-value layer [HVL]), breast thickness, and breast composition. Using a carefully designed and experimentally validated Monte Carlo simulation, the authors found that average glandular dose also depends on x-ray tube voltage and, to a lesser extent, on x-ray tube voltage waveform. For currently employed molybdenum target-molybdenum filter source assemblies, a difference in dose of 10% or more is possible in estimating the average glandular dose obtained with different x-ray tube voltages but with the same HVL. Presented are normalized average glandular tissue doses in units of radiation absorbed dose per unit entrance skin exposure for different tube voltages and tube voltage waveforms as well as for different breast thicknesses and compositions and beam filtrations.