1. To understand the needs for personalised dosimetry.
2. To learn about existing and new methodologies used for patient dosimetry.
3. To understand the challenges for the implementation of patient-specific dosimetry.
The use of ionising radiation in medical imaging offers substantial benefits for the diagnosis and treatment of numerous medical conditions in children and adults. However, exposure to ionising radiation may be associated with harmful risks. Justification and optimisation as principles of radiation protection make radiation dosimetry fundamental. Physicians need to know the levels of exposure, and hence the risks from imaging examinations that they have to justify and operators of X-ray cases such as examinations of children and pregnant patients or screening examinations require specific organ dose estimations. Moreover, to prevent tissue reactions patient skin dose needs to be estimated during radiological interventional procedures. Patient characteristics, such as age, sex and size, should be taken into consideration for specific patient dose assessments. Each modality (radiography, fluoroscopy, mammography, computed tomography, etc.) has its specificities and demands different methods to calculate the dose. Modern imaging modalities usually display conventional dosimetry metrics, such as dose-area product, incident air-kerma or computed tomography dose index that do not represent individual patient dose. Thus, numerous sophisticated concepts and methods have been proposed to estimate patient radiation dose that includes either physical measurements with dosimeters and anthropomorphic phantoms or computational measurements using Monte Carlo simulations. All these methods progressively allow to more accurate estimations of individual patient doses.
1. To understand the current method to estimate organ dose in mammography and its limitations.
2. To understand breast dosimetry in emerging modalities.
3. To learn about upcoming approaches in breast dosimetry.
Mammographic dosimetry is a subject of intense interest due to the use of this imaging modality for population-based screening. However, established breast dosimetry methods do not result in patient-specific dose estimates. Rather, our current methods provide estimates of dose to a model breast, even if the actual technique used for a specific acquisition is taken into account. New insights into breast anatomy have provided us, for the first time, with estimates of how current dose predictions can differ from actual patient-specific doses. During this talk, the current method and model for breast dosimetry in mammography and digital breast tomosynthesis will be reviewed, and its capabilities and limitations discussed. How patient-specific breast dosimetry could be achieved and the current progress towards this goal will be presented, and what its potential applications could be will be discussed.