(Monday, 4/9/2018) 8:00 AM - 10:00 AM
Room: Marquis Ballroom 1-4
Part 1:
The American College of Radiology released its Digital Mammography QC Manual in 2017 and it became effective July 2017. Adoption of the new QC manual has been slow due to the fact that it does not cover Digital Breast Tomosynthesis (DBT), meaning that facilities with DBT or planning on adding it soon must continue using the manufacturer’s QC manual. The ACR’s Quality Assurance in Mammography Subcommittee has developed a DBT supplement to the DM QC Manual. Once approved by FDA, this supplement, along with the DM QC Manual, will be an alternative standard, allowing facilities to elect to use it in place of the manufacturer-mandated QC programs. This talk will introduce attendees to the proposed supplement, detailing the testing protocols involved. The steps for gaining approval for the supplement will be outlined and an update on the current status will be provided.
Learning Objectives:
1. Understand the intent of the Digital Breast Tomosynthesis supplement to the ACR Digital Mammography QC Manual.
2. Understand the differences between the proposed QC test protocols and the current manufacturers’ protocols for DBT QC.
3. Learn the anticipated timetable for implementation of the ACR DBT Supplement.
Part 2:
Mammography based on projection x-ray imaging is the current gold standard for breast cancer screening, even as the technology has changed dramatically over the years, including the migration from screen-film to digital mammography using detector systems based on 2D-breast imaging and later, 3D- breast imaging or Tomosynthesis. Concurrently, with the advent of truly three-dimensional breast imaging modalities such as MRI and breast CT, previous assumptions regarding breast geometry and composition have changed as well. Knowledge of the 3D breast anatomy gained from these new modalities has informed the dosimetry assumptions of 2D breast imaging. This presentation will discuss past and present breast dosimetry modeling, and how 3D breast anatomy learned from breast CT has changed assumptions about skin thickness, breast density, and breast density distribution. This session will also address details associated with the newly adopted Dance method by the ACR; and describe the similarities and differences in comparison to prior ACR methods for the estimation of the mean glandular dose in mammography.
Learning Objectives:
1. Be able to describe how breast dose is impacted by changes in target/filter combinations, kV, and breast thickness/composition.
2. Understand the differences (and similarities) between the Dance method and the prior ACR method.
3. Understand how to implement the Dance method in terms of look up tables, assumptions made, etc.
4. Be able to discuss how the simple breast dosimetry model fails to accurately reflect actual patient dose and give reasons for this failure.
5. Gain insight on future directions in dosimetry modeling and estimation techniques.
Handouts
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