Bruno Barufaldi BSC, MSc, Presenter: Nothing to Disclose

Tessa S. Cook MD, PhD, Abstract Co-Author: Nothing to Disclose

Marie Synnestvedt, Abstract Co-Author: Nothing to Disclose

Emily F. Conant MD, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc

Mitchell Dennis Schnall MD, PhD, Abstract Co-Author: Nothing to Disclose

Andrew D.A. Maidment PhD, Abstract Co-Author: Research support, Hologic, Inc Research support, Barco nv Spouse, Employee, Real-Time Radiography, Inc Spouse, Stockholder, Real-Time Radiography, Inc

To monitor radiation dose in a mixed breast screening and diagnostic imaging environment using an automated dose tracking system.

The tracking software consists of three components. A custom DICOM SCP accepts x-ray breast images, maps DICOM metadata into a relational database using an object relational mapper including a thumbnail of the image, and creates a disk backup. Intermediate software cleans the metadata. A client-side application (Sharepoint PowerView, Microsoft, Redmond WA) enables realtime data exploration. Various data views support different user roles (e.g., technical supervisor or medical physicist). The addition of breast glandularity is ongoing.

Radiation dose in breast imaging is a function of various factors, including: (i) compressed breast size and glandularity; (ii) image system; and (iii) phototimer programming. Dose can be extracted directly from the DICOM metadata or more accurately calculated from machine calibration data, image technique factors, breast size and glandularity. We track radiation dose by room, technologist, procedure and view. Phantom measurements fail to capture the effect of breast size and glandularity; clinical image data provide a more accurate estimate of dose. At our institution, the average breast size is 60 mm, and the average mammography and tomosynthesis doses are 1.76 and 3.78 mGy (per view).

A fully automated patient dose tracking system for breast imaging has been implemented and tested in a large multicenter institution. The system is robust and portable, allowing for widespread utilization.

There is an increased awareness of radiation utilization. Breast cancer screening requires particular scrutiny, because it involves repeated irradiation of women who are largely free of disease.

Barufaldi, B, Cook, T, Synnestvedt, M, Conant, E, Schnall, M, Maidment, A, A Radiation Dose Reporting System for Mammography and Digital Breast Tomosynthesis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010823.html