Normalized mean glandular dose computation from mammography using GATE: a validation study

Mean glandular dose (MGD) is the figure of merit to assess breast dose after a mammographic acquisition. The use of normalized MGD obtained from Monte Carlo computations with measured incident air kerma determines the MGD delivered to patients. The Geant4 Application for Tomographic Emission (GATE) toolkit is a modern Monte Carlo application specifically designed for medical imaging systems modelling. Although there is an increasing number of publications using GATE worldwide for a wide range of medical imaging and therapeutic applications, there is currently no means to obtain normalized MGD. In this work, the GATE toolkit is extended, through the development of two new modules, to provide normalized MGD information for compressed breast phantoms based on simple geometries. The normalized MGD values were validated against published work and provided results at half value layers lower than 0.3 and greater than 0.6 mmAl. In addition, the skin thickness and composition were considered. Normalized MGD was computed after substitution of the adipose layer surrounding the standard breast phantom with skin tissue and the relative difference is reported. Spectrum generation was facilitated by further development of previously published work by other authors. Validation of the new GATE extension showed good agreement with published data and can be used to assess breast dose from mammographic as well as more complex x-ray imaging techniques. Changing skin thickness and composition revealed substantial changes in normalized MGD specifically for compressed breast thickness different than 5 cm and a possible revision of the structure of the standard breast model may be necessary.