PHYSICAL & TECHNICAL ASPECT OF MAMMOGRAPHY

By Dr. A. O Adeyinka Presented at the Physics Update Course at LUTH February 14th 18th 2005

OBJECTIVES OF MAMMOGRAPHY
Obtain Information about differences in Type & Structure of Tissues of the Breast Optimize Information Content of Mammography Describe how this Image is Generated within the framework of Physical, Technical & Radiation Protection criteria, Inorder to render Diagnostic opinion

MAMMOGRAPHY IMAGING CHAIN Pathway of X-Rays in Tube to Interpretation

X-RAY TUBE ASSEMBLY Anode Material Filter Tube Voltage
RADIOGRAPHIC DEVICE Focal Spot Geometrical Configuration Scattered Radiation

IMAGE QUALITY Radiation Exposure

IMAGE RECEPTOR Sensitivity Contrast Resolution Noise

BREAST Thickness Tissue Composition

DEDICATED MAMMO - EQIUPMENT

Composition (Film-Screen Mammo) Special Focal Spot Target & Filter Materials Low Kilovoltage Compression Device designed to optinize the Mammographic Image at Low Radiation Dose

STEP 1- GENERATION OF THE X-RAYS

Factors that Determine Transparency of Breast Tisue in Displayed Image Tube Voltage Anode Materials Type & Thickness of Added Filter

TUBE MATERIALS (MOLYBDENUM & TUNGSTEN) Molybdenum:

Uses 0.03mm Molybdenum Filteration

Produces Low Kilo-electron Volt X-Rays

Xteristic Peak Volt 17.9 & 19.5 Kev which provides high Contrast Breast Image of average thickness
>20Kev Photons are suppressed by Filters Kvp settings = 25-28Kvp

TUNGSTEN TARGET:
Uses a Beryllium Window and Aluminum Filter At Low Kvp, Tungsten produces High Energy Photons with Low Subject Contrast Kvp settings = 22-26Kvp New Mammo-Equip Uses Tungsten Target + Berylium Window plus a Molybdenum or Rhodium K-edge Filter to produce High Contrast Images Thick/Dense Breast0.05 Rhodium Filter at high Kv

Factors that Determine the Maximum Attainable Resolution of Imaging System 1. Focal Spot Shape & Size Helps to produce high Resolution Helps to Reduce Geometrical Blurr Size should be kept Small Dist b/w Breast & Image receptor should be Smaller Maximize Object to Focal Spot Distance In Magnification Work FS size should not be greater than 0.3mm ( Range 0.1-0.2mm)

2. Geometrical Configuration of Radiographic Device Image Display achieved by Relative Absorption of X-Rays in Tissue Pathway: X-RaysBreastModulated by Absorption & ScatteringImage Receptor Radiation Image=Distribution of X-Ray Intensity at Plane of Image Receptor Radiation Image carries Information extracted from the tissue as the Distrbution of Intensity & direction of the X-Rays The Information can only be Selectively Emphasized or suppressed or Eliminated

Step 3- Image Improvement Anti-Scatter Grid

Radiation Image consist of PRIMARY (contains the entire Image Information) & SCATTERED Radiation Primary Radiation (Primary Contrast) is caused by Attenuation (Absorption & Scattering) Scattering diminishes the Intensity Differences in Primary Radiation Grid Modifies the Radiation Beam b/4 reaching Image Receptor, by absorbing the Scattered radiation to a greater degree than Primary radiation

Grid Improves Image Contrast by reducing Scatter

There is Concomitant increase in Patient Dose The Increase in Radiation Dose with Grid is about 2Times that of Non-Grid, but thjis may be Compensated by a Faster Screen-Film combination

More Useful in Thick Dense Breast

Typical Reciprocating Grid = 16micro.m lead strips separated by 300micro.m Carbon Filter Resin Interspace Dedicated Machines-Grid Ratio of 5:1