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Medical Physics |
1 From the Department of Radiology, X-ray Imaging Laboratory, University of California, Davis Medical Center, 4701 X St, Sacramento, CA 95817 (J.M.B., K.K.L., J.A.S.); and Department of Radiology, University of California, San Diego (T.R.N.). From the 2000 RSNA scientific assembly. Received January 18, 2001; revision requested March 16; revision received April 10; accepted May 14. Supported in part by grants from the U.S. Army Breast Cancer Research Program (DAMD17-98-1-8176) and the National Cancer Institute (R21 CA82077). Address correspondence to J.M.B. (e-mail: jmboone@ucdavis.edu).
PURPOSE: To evaluate the feasibility of breast computed tomography (CT) in terms of radiation dose and image quality.
MATERIALS AND METHODS: Validated Monte Carlo simulation techniques were used to estimate the average glandular dose (AGD). The calculated photon fluence at the detector for high-quality abdominal CT (120 kVp, 300 mAs, 5-mm section thickness) was the benchmark for assessing the milliampere seconds and corresponding radiation dose necessary for breast CT. Image noise was measured by using a 10-cm-diameter cylinder imaged with a clinical CT scanner at 10–300 mAs for 80, 100, and 120 kVp. A cadaveric breast was imaged in the coronal plane to approximate the acquisition geometry of a proposed breast CT scanner.
RESULTS: The AGD for 80-kVp breast CT was comparable to that for two-view mammography of 5-cm breasts (compressed breast thickness). For thicker breasts, the breast CT dose was about one-third less than that for two-view mammography. The maximum dose at mammography assessed in 1-mm3 voxels was far higher (20.0 mGy) than that at breast CT (5.4 mGy) for a typical 5-cm 50% glandular breast. CT images of an 8-cm cadaveric breast (AGD, 6.3 mGy) were subjectively superior to digital mammograms (AGD, 10.1 mGy) of the same specimen.
CONCLUSION: The potential of high signal-to-noise ratio images with low anatomic noise, which are obtainable at dose levels comparable to those for mammography, suggests that dedicated breast CT should be studied further for its potential in breast cancer screening and diagnosis.
Index terms: Breast neoplasms, CT, 00.1211 • Breast neoplasms, radiography, 00.11 • Breast radiography, radiation dose • Computed tomography (CT), radiation exposure, 00.1211
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