The UK and European protocols for mammographic dosimetry use conversion factors that relate incident air kerma to the mean glandular dose (MGD) within the breast. The conversion factors currently used were obtained by computer simulation of a model breast with a composition of 50% adipose and 50% glandular tissues by weight (50% glandularity). Relative conversion factors have been calculated which allow the extension of the protocols to breasts of varying glandularity and for a wider range of mammographic x-ray spectra. The data have also been extended to breasts of a compressed thickness of 11 cm. To facilitate the calculation of MGD in patient surveys, typical breast glandularities are tabulated for women in the age ranges 40-49 and 50-64 years, and for breasts in the thickness range 2-11 cm. In addition, tables of equivalent thickness of polymethyl methacrylate have been provided to allow the simulation for dosimetric purposes of typical breasts of various thicknesses.

The IPSM report on the commissioning and routine testing of mammographic x-ray systems recommends that breast dose be specified as the mean dose to the glandular tissues within the breast and gives the size and compositions of a standard breast phantom for the comparison of doses. The dose to this standard breast phantom can be determined by measuring the incident air kerma to a Perspex phantom and applying appropriate multiplicative conversion factors. These conversion factors have been evaluated by Monte Carlo calculations for a wide range of mammographic x-ray spectra. Some factors are provided for a range of breast thicknesses to supplement existing tabulations. Results are also given for equivalent thicknesses of Perspex and breast tissue.

The United Kingdom, European and IAEA protocols for breast dosimetry in mammography make use of s-factors which allow for the use of different target/filter combinations. To supplement the existing protocols, a Monte Carlo computer program has been used to calculate s-factors for mammography using a tungsten target with silver filters of thicknesses 50-75 microm and for the same target filtered with 0.5 mm aluminium. The dosimetry protocols use slabs of polymethyl methacrylate (PMMA) of specified thicknesses to simulate the exposure of typical breasts. The equivalent thickness of PMMA has been calculated using a simplified approach for a wider range of x-ray spectra and for breast thicknesses of 2-11 cm. The results show that for the tungsten/silver target/filter combination, a single s-factor of 1.042 can be used with the protocols, but when the tungsten target is filtered with 0.5 mm of aluminium, it is necessary to select from a tabulation of s-factors against breast thickness. The equivalent thicknesses of PMMA for a given breast thickness show some dependence on beam quality and the values obtained differ from those presently used in the dosimetry protocols by an amount which depends upon breast thickness and half value layer (HVL). For the extreme case of an 11 cm breast and an HVL of 0.62 mm Al, the use of the protocol thickness would give rise to an error of 10%, but for breast thicknesses of 6 cm or less, the error is typically 2-3%.

A formalism is proposed for the estimation of mean glandular dose for breast tomosynthesis, which is a simple extension of the UK, European and IAEA protocols for dosimetry in conventional projection mammography. The formalism introduces t-factors for the calculation of breast dose from a single projection and T-factors for a complete exposure series. Monte Carlo calculations of t-factors have been made for an imaging geometry with full-field irradiation of the breast for a wide range of x-ray spectra, breast sizes and glandularities. The t-factors show little dependence on breast glandularity and tables are provided as a function of projection angle and breast thickness, which may be used for all x-ray spectra simulated. The T-factors for this geometry depend upon the choice of projection angles and weights per projection, but various example calculations gave values in the range 0.93-1.00. T-factors are also provided for the Sectra tomosynthesis system, which employs a scanned narrow-beam imaging geometry. In this quite different configuration, the factor (denoted T(S)) shows an important dependence on breast thickness, varying between 0.98 and 0.76 for 20 and 110 mm thick breasts, respectively. Additional data are given to extend the current tabulations of g-, c- and s-factors used for dosimetry of conventional 2D mammography.