Normalized glandular dose coefficients for digital breast tomosynthesis using detailed Chinese breast models

The rise in breast cancer diagnoses among Chinese women has necessitated the use of X-ray breast screening, which carries a radiation risk. This study aimed to provide a dosimetry protocol for the Chinese female population to replace the traditional standard that utilizes simplified breast models, for the accurate estimation of the mean glandular dose of a patient undergoing digital breast tomosynthesis (DBT). The first set of detailed Chinese female breast models and representative breast parameters was constructed. Considering backscatter radiation and computational efficiency, we improved the combination of these models and the Chinese reference adult female whole-body voxel phantom. Image acquisition for four commercial DBT systems that are widely employed in China was simulated using the Monte Carlo method to obtain the normalized glandular dose coefficients of DBT \(\left( {D_{{{\text{gN}}}}^{{{\text{DBT}}}} } \right)\) $\left(D_{\text{gN}}^{\text{DBT}}\right)$ and the glandular depth dose \(\left( {D_{{\text{g}}}^{{{\text{dep}}}} \left( z \right)} \right)\) $\left(D_{\text{g}}^{\text{dep}}\left(z\right)\right)$ for different breast characteristics and X-ray spectra. We calculated a series of \(D_{{{\text{gN}}}}^{{{\text{DBT}}}}\) $D_{\text{gN}}^{\text{DBT}}$ values for breasts with different percentage mass glandularities (5%, 25%, 50%, 75%, and 100%) and compressed breast thicknesses (2, 3, 4, 5, 6, and 7 cm) at various tube potentials (25, 28, 30, 32, 35, and 49 kV) and target/filter combinations (W/Rh, W/Al, Mo/Mo, Rh/Rh, and Rh/Ag). The parameter dependence of the breast characteristics and beam conditions on \(D_{{{\text{gN}}}}^{{{\text{DBT}}}}\) $D_{\text{gN}}^{\text{DBT}}$ in detailed breast models was investigated. The \(D_{{{\text{gN}}}}^{{{\text{DBT}}}}\) $D_{\text{gN}}^{\text{DBT}}$ results were 14.6–51.0% lower than those of the traditional dosimetry standard in China. The difference in \(D_{{{\text{gN}}}}^{{{\text{DBT}}}}\) $D_{\text{gN}}^{\text{DBT}}$ was mainly due to a decrease in the depth of the main energy deposition area caused by the glandular distribution along the depth direction. The results obtained in this study may be used to improve breast dosimetry in China and provide more detailed information on risk assessment during DBT.