A guide to the fundamental principles of medical imaging physics, radiation protection and radiation biology, with complex topics presented in the clear and concise manner and style for which these authors are known.

A tungsten anode spectral model using interpolating polynomials (TASMIP) was used to compute x-ray spectra at 1 keV intervals over the range from 30 kV to 140 kV. The TASMIP is not semi-empirical and uses no physical assumptions regarding x-ray production, but rather interpolates measured constant potential x-ray spectra published by Fewell et al. [Handbook of Computed Tomography X-ray Spectra (U.S. Government Printing Office, Washington, D.C., 1981)]. X-ray output measurements (mR/mAs measured at 1 m) were made on a calibrated constant potential generator in our laboratory from 50 kV to 124 kV, and with 0-5 mm added aluminum filtration. The Fewell spectra were slightly modified (numerically hardened) and normalized based on the attenuation and output characteristics of a constant potential generator and metal-insert x-ray tube in our laboratory. Then, using the modified Fewell spectra of different kVs, the photon fluence phi at each 1 keV energy bin (E) over energies from 10 keV to 140 keV was characterized using polynomial functions of the form phi (E) = a0[E] + a1[E] kV + a2[E] kV2 + ... + a(n)[E] kVn. A total of 131 polynomial functions were used to calculate accurate x-ray spectra, each function requiring between two and four terms. The resulting TASMIP algorithm produced x-ray spectra that match both the quality and quantity characteristics of the x-ray system in our laboratory. For photon fluences above 10% of the peak fluence in the spectrum, the average percent difference (and standard deviation) between the modified Fewell spectra and the TASMIP photon fluence was -1.43% (3.8%) for the 50 kV spectrum, -0.89% (1.37%) for the 70 kV spectrum, and for the 80, 90, 100, 110, 120, 130 and 140 kV spectra, the mean differences between spectra were all less than 0.20% and the standard deviations were less than approximately 1.1%. The model was also extended to include the effects of generator-induced kV ripple. Finally, the x-ray photon fluence in the units of photons/mm2 per mR was calculated as a function of HVL, kV, and ripple factor, for various (water-equivalent) patient thicknesses (0, 10, 20, and 30 cm). These values may be useful for computing the detective quantum efficiency, DQE(f), of x-ray detector systems. The TASMIP algorithm and ancillary data are made available on line at http:/(/)www.aip.org/epaps/epaps.html.

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.

Computer simulation is a convenient and frequently used tool in the study of x-ray mammography, for the design of novel detector systems, the evaluation of dose deposition, x-ray technique optimization, and other applications. An important component in the simulation process is the accurate computer-generation of x-ray spectra. A computer model for the generation of x-ray spectra in the mammographic energy range from 18 kV to 40 kV has been developed. The proposed model requires no assumptions concerning the physics of x-ray production in an x-ray tube, but rather makes use of x-ray spectra recently measured experimentally in the laboratories of the Center for Devices and Radiological Health. Using x-ray spectra measured for molybdenum, rhodium, and tungsten anode x-ray tubes at 13 different kV's (18, 20, 22, ..., 42 kV), a spectral model using interpolating polynomials was developed. At each energy in the spectrum, the x-ray photon fluence was fit using 2, 3, or 4 term (depending on the energy) polynomials as a function of the applied tube voltage (kV). Using the polynomial fit coefficients determined at each 0.5 keV interval in the x-ray spectrum, accurate x-ray spectra can be generated for any arbitrary kV between 18 and 40 kV. Each anode material (Mo, Rh, W) uses a different set of polynomial coefficients. The molybdenum anode spectral model using interpolating polynomials is given the acronym MASMIP, and the rhodium and tungsten spectral models are called RASMIP and TASMIP, respectively. It is shown that the mean differences in photon fluence calculated over the energy channels and over the kV range from 20 to 40 kV were -0.073% (sigma = 1.58%) for MASMIP, -0.145% (sigma = 1.263%) for RASMIP, and 0.611% (sigma = 2.07%) for TASMIP. The polynomial coefficients for all three models are given in an Appendix. A short C subroutine which uses the polynomial coefficients and generates x-ray spectra based on the proposed model is available on the World Wide Web at http:/(/)www.aip.org/epaps/epaps.html.

The tables and graphs may be useful for optimizing mammographic procedures. The higher energy data may be useful for investigations of the potential of dual-energy mammography or for calculation of dose in general diagnostic or computed tomographic procedures.