title: Cancer risk estimation in Digital Breast Tomosynthesis using GEANT4 Monte Carlo simulations and voxel phantoms.
abstract: The aim of this work was to estimate the risk of radiation induced cancer following the Portuguese breast screening recommendations for Digital Mammography (DM) when applied to Digital Breast Tomosynthesis (DBT) and to evaluate how the risk to induce cancer could influence the energy used in breast diagnostic exams. The organ doses were calculated by Monte Carlo simulations using a female voxel phantom and considering the acquisition of 25 projection images. Single organ cancer incidence risks were calculated in order to assess the total effective radiation induced cancer risk. The screening strategy techniques considered were: DBT in Cranio-Caudal (CC) view and two-view DM (CC and Mediolateral Oblique (MLO)). The risk of cancer incidence following the Portuguese screening guidelines (screening every two years in the age range of 50-80years) was calculated by assuming a single CC DBT acquisition view as standalone screening strategy and compared with two-view DM. The difference in the total effective risk between DBT and DM is quite low. Nevertheless in DBT an increase of risk for the lung is observed with respect to DM. The lung is also the organ that is mainly affected when non-optimal beam energy (in terms of image quality and absorbed dose) is used instead of an optimal one. The use of non-optimal energies could increase the risk of lung cancer incidence by a factor of about 2.
authors.affiliation: Centro de Ciência e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, Km 139, 7, 2695-066 Bobadela, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Ferreira
authors.affiliation: Centro de Ciência e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, Km 139, 7, 2695-066 Bobadela, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Baptista
authors.affiliation: Centro de Ciência e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, Km 139, 7, 2695-066 Bobadela, Portugal. Electronic address: salvatore@ctn.ist.utl.pt.
authors.forename: S
authors.initials: S
authors.lastname: Di Maria
authors.affiliation: Centro de Ciência e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, Km 139, 7, 2695-066 Bobadela, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Vaz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003198:Computer Simulation; D055088:Early Detection of Cancer / Q000592:standards; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000528:radiation effects; D008327:Mammography; D008875:Middle Aged; D009010:Monte Carlo Method; D058958:Organs at Risk; D019047:Phantoms, Imaging; D011174:Portugal; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods
keywords: Breast imaging; Cancer risk assessment; Dose assessment; Monte Carlo simulations; Screening mammography; Voxel phantoms