A new method to evaluate the average absorbed dose in mammography and breast tomosynthesis

Digital mammography represents the most sensitive technique to detect and diagnose breast cancer and is hence the preferred method for clinical and screening diagnostic tests. Nevertheless, the absorbed dose in a mammographic procedure can not be neglected even due to the highly radiosensitivity of the breast. In this work we developed a practical method to assess the average absorbed dose both in digital mammography and digital breast tomosynthesis. A new dose index is here proposed as an easily evaluable dosimetric quantity according to the requests of the European Directive 2013/59 EURATOM

A study of the possibility of curing Graves' disease based on the desired reduction of thyroid mass (volume) as a consequence of 131I therapy: a speculative paper

Abstract PURPOSE: The possibility of predicting the final volume of Graves' disease thyroids submitted to 131I therapy could allow the physician to decide what activity to administer based on the desired volume reduction instead of on a fixed value of the thyroid radiation absorbed dose. In this paper the relationship between maximum uptake of 131I, fractional reduction of thyroid volume and outcome of Graves' disease is discussed. METHODS: The results are based on ultrasonography thyroid volume measurements before administration of therapy and at the moment of recovery from Graves' disease (thyroid stimulating hormone >0.3 microIU x ml(-1) in the absence of anti-thyroid drug therapy) and on measurements of 131I uptake in 40 patients. It is shown that the possibility of curing Graves' disease may be individually related to the final volume of the patient's thyroid. An equation is presented to calculate the 'optimal' final thyroid volume. RESULTS: A comparison between the traditional method, based on absorbed dose, and the final method, based on volume, has been carried out retrospectively. In the first case a median activity of 529 MBq has been administered; in the second, a median activity of 394 MBq (non-parametric Wilcoxon test, P<0.05) should be administered. The corresponding thyroid median absorbed doses are, respectively, 353 Gy and 320 Gy (non-parametric Wilcoxon test, P<0.02). CONCLUSION: A method to evaluate individually the 'optimal' final thyroid mass is presented and discussed. The method based on 'volume reduction' could probably reduce the activity and the thyroid absorbed dose compared to the method based on 'empirical' calculations, thus allowing the administration of 131I therapy to be optimized