Dose comparison between screen/film and full-field digital mammography

The study purpose was the comparison between doses delivered by a full-field digital mammography system and a screen/film mammography unit, both using the same type of X-ray tube. Exposure parameters and breast thickness were collected for 300 screen/film (GE Senographe DMR) and 296 digital mammograms (GE Senographe 2000D). The entrance surface air kerma (ESAK) was calculated from anode/filter combination, kV(p) and mAs values and breast thickness, by simulating spectra through a program based on a catalogue of experimental X-ray spectra. The average glandular dose (AGD) was also computed. Results showed an overall reduction of average glandular dose by 27% of digital over screen/film mammography. The dose saving was about 15% for thin and thick breasts, while it was between 30% and 40% for intermediate thicknesses. Full-field digital mammography dose reduction is allowed by wider dynamic range and higher efficiency of digital detector, which can be exposed at higher energy spectra than screen/film mammography, and by the separation between acquisition and displaying processes.