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In many countries, there is an interest in determining the location of the women with the highest breast density. This investigation is important for optimize screening for breast cancer for women with dense breasts as other imaging modalities since 2D mammography is not very efficient on this type of breast. The objective of this study was to evaluate the variations in breast density in Brazilian women of different regions of Brazil. The mammographic images were taken from four regions of Brazil. The images, in the cranial caudal (CC) projection, were separated into intervals of compressed breast thickness (CBT) and patient age and were analysed by the software VolparaDensity, where volumetric breast density (VBD) calculations were performed. For each interval, null hypothesis tests for the mean difference between the VBD from the four regions of Brazil were performed. The paired tests indicated that there was a significant difference in the VBD of the women in the different regions of Brazil, with variations from 11.05% to 36.73%. Higher VBD was observed for women living in the Southeast region, followed by the Midwest, Northeast, and North regions. The Brazilian IBGE data show that the most urbanised region in Brazil is the Southeast, which coincides with the second highest rate of breast cancer in Brazil, according to the Brazilian National Cancer Institute (INCA). It is also known that breast cancer is strongly related to breast density; therefore, the results of this work support the data presented by federal agencies demonstrating that women living in the most urbanised region of Brazil (e.g., Southeast) present the highest breast density.

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OBJECTIVE:: To evaluate the exposure parameters, radiation protection, absorbed dose and radiographic image quality of the DIOX® intraoral portable radiography device. METHODS:: The exposure parameters were measured using the Xi UNFORS detector. Operator exposure to secondary radiation was measured using the 1800cc ionization chamber coupled to the electrometer. The absorbed dose (D) in the patient was calculated using TLD-100H positioned in the Alderson RANDO anthropomorphic simulator. The quality of the radiographic digital image was assessed by comparing radiographic images obtained from two conventional devices (CS 2200®, Carestream Health; Heliodent plus®, Sirona Dental Systems GMbH) with the radiological simulator of the upper molar region RMI (Radiation Measurements Instruments), using three acquisition sensors: Kodak RVG 5000® and Kodak PSP®, Eastman Kodak Company, Rochester, NY; EVO Micro Image®, Brazil. RESULTS:: The DIOX intraoral portable radiographic device demonstrated reliability in relation to the performance of the standard evaluated parameters, except for the diameter of the radiation field (5.8 mm) less or greater. No evidence of device head radiation was detected. The Pb lead protection of the apparatus attenuates the secondary radiation, thus protecting the operator. However, it was observed that the region of the operator's gonads was the most exposed during the measurements. In the Alderson RANDO anthropomorphic simulator, the highest value of D was in the region corresponding to the submandibular and lingual glands of the left side (0.568 mGy). The image quality of the DIOX portable radiographic apparatus presented quality standards equivalent to those produced by the two conventional radiographic devices. CONCLUSION:: The DIOX intraoral portable radiography device demonstrated reliability in relation to the quality control and radioprotection criteria, according to international standards. Results obtained demonstrated the safe use of the DIOX intraoral portable radiography device and indicated the need for debate and change in international sanitary oversight standards regarding the use of portable XR devices in dentistry.

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This study determined the interaction of radiation parameters of four biomaterials as attenuators to measure the transmitted X-rays spectra, the mass attenuation coefficient and the effective atomic number by spectrometric system comprising the CdTe detector. The biomaterial BioOss® presented smaller mean energy than the other biomaterials. The µ/ρ and Zeff of the biomaterials showed their dependence on photon energy. The data obtained from analytical methods of x-ray spectra, µ/ρ and Zeff, using biomaterials as attenuators, demonstrated that these materials could be used as substitutes for dentin, enamel and bone. Further, they are determinants for the characterization of the radiation in tissues or equivalent materials.

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Abstract Objective: Derive filtered tungsten X-ray spectra used in digital mammography systems by means of Monte Carlo simulations. Materials and Methods: Filtered spectra for rhodium filter were obtained for tube potentials between 26 and 32 kV. The half-value layer (HVL) of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F & MAM Detector Platinum and 8201023-C Xi Base unit Platinum Plus w mAs in a Hologic Selenia Dimensions system using a direct radiography mode. Results: Calculated HVL values showed good agreement as compared with those obtained experimentally. The greatest relative difference between the Monte Carlo calculated HVL values and experimental HVL values was 4%. Conclusion: The results show that the filtered tungsten anode X-ray spectra and the EGSnrc Monte Carlo code can be used for mean glandular dose determination in mammography.

Resumo Objetivo: Derivar espectros filtrados de raios X de tungstênio utilizados em sistemas de mamografia digital por meio de simulações Monte Carlo. Materiais e Métodos: Espectros filtrados por filtro de ródio foram obtidos para potenciais do tubo entre 26 e 32 kV. Os valores de camada semirredutora (CSR) dos espectros filtrados simulados foram comparados aos valores obtidos experimentalmente com um detector de estado sólido Unfors modelo 8202031-H Xi R/F & MAM Detector Platinum e unidade base 8201023-C Xi Platinum Plus w mAs em um sistema Hologic Selenia Dimensions utilizado no modo radiografia direta. Resultados: Os valores de CSR calculados mostraram boa concordância quando comparados com os valores obtidos experimentalmente. A maior diferença relativa entre os valores de CSR calculados com Monte Carlo e os valores de CSR experimentais foi 4%. Conclusão: Os resultados demonstram que os espectros filtrados de raios X de ânodo de tungstênio e o código de Monte Carlo EGSnrc podem ser utilizados para determinar a dose glandular média em mamografia.

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The purpose of this paper was to estimate mean glandular dose levels (DG) in six digital mammography systems in Santiago, Chile, and to propose preliminary reference levels to execute mammography in Chile. The study was carried out assessing two direct digital systems and four computer-based radiography (CR) systems. Estimates of DG were calculated for different thicknesses of polymethyl methacrylate according to the quality control protocol in digital mammography of the Spanish Society of Medical Physics and NHSBSP Equipment Report 0604 Version 3. DG values ranged between 0.64 and 7.26 mGy for a range of 20- to 70-mm thickness, respectively. Thirty-six per cent of DG was higher than the acceptable dose level and 100 % of DG was higher than the desirable level. It is therefore necessary to optimise doses. The initial proposal to establish dose reference levels for DG would range between 0.90 and 6.40 mGy for a thickness range of 20 to 70 mm.

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Studies are needed to determine the radiation dose of patients that are undergoing Digital breast tomosynthesis (DBT) procedures. Mean glandular dose (DG) values were derived from the incident air kerma (Ki) measurements and tabulated conversion coefficients. Ki values were obtained through an ionization chamber positioned in a Hologic Selenia Dimensions system using appropriate exposure parameters. This work contributes to determine the reliable radiation dose received by the patients and compare DG values provided by this DBT system images.

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OBJECTIVE: Derive filtered tungsten X-ray spectra used in digital mammography systems by means of Monte Carlo simulations. MATERIALS AND METHODS: Filtered spectra for rhodium filter were obtained for tube potentials between 26 and 32 kV. The half-value layer (HVL) of simulated filtered spectra were compared with those obtained experimentally with a solid state detector Unfors model 8202031-H Xi R/F & MAM Detector Platinum and 8201023-C Xi Base unit Platinum Plus w mAs in a Hologic Selenia Dimensions system using a direct radiography mode. RESULTS: Calculated HVL values showed good agreement as compared with those obtained experimentally. The greatest relative difference between the Monte Carlo calculated HVL values and experimental HVL values was 4%. CONCLUSION: The results show that the filtered tungsten anode X-ray spectra and the EGSnrc Monte Carlo code can be used for mean glandular dose determination in mammography.

OBJETIVO: Derivar espectros filtrados de raios X de tungstênio utilizados em sistemas de mamografia digital por meio de simulações Monte Carlo. MATERIAIS E MÉTODOS: Espectros filtrados por filtro de ródio foram obtidos para potenciais do tubo entre 26 e 32 kV. Os valores de camada semirredutora (CSR) dos espectros filtrados simulados foram comparados aos valores obtidos experimentalmente com um detector de estado sólido Unfors modelo 8202031-H Xi R/F & MAM Detector Platinum e unidade base 8201023-C Xi Platinum Plus w mAs em um sistema Hologic Selenia Dimensions utilizado no modo radiografia direta. RESULTADOS: Os valores de CSR calculados mostraram boa concordância quando comparados com os valores obtidos experimentalmente. A maior diferença relativa entre os valores de CSR calculados com Monte Carlo e os valores de CSR experimentais foi 4%. CONCLUSÃO: Os resultados demonstram que os espectros filtrados de raios X de ânodo de tungstênio e o código de Monte Carlo EGSnrc podem ser utilizados para determinar a dose glandular média em mamografia.

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Objetivo: Avaliar a dose glandular média utilizando um detector de estado sólido e a qualidade da imagem de um sistema de radiografia direta a partir de objetos simuladores. Materiais e Métodos: Irradiações foram realizadas utilizando o controle automático de exposição e placas de polimetilmetacrilato com diferentes espessuras para o cálculo da dose glandular média. A qualidade da imagem foi avaliada por meio das estruturas visualizadas nas imagens dos objetos simuladores. Resultados: Considerando a incerteza das medições, os resultados de dose glandular média estão de acordo com os valores fornecidos pelo equipamento e com os níveis de referência adotados internacionalmente. Os resultados obtidos a partir das imagens dos objetos simuladores estavam em conformidade com os valores de referência. Conclusão: Este trabalho contribui para verificar a conformidade do equipamento em relação a dose e qualidade da imagem. .

Objective: To evaluate the mean glandular dose with a solid state detector and the image quality in a direct radiography system, utilizing phantoms. Materials and Methods: Irradiations were performed with automatic exposure control and polymethyl methacrylate slabs with different thicknesses to calculate glandular dose values. The image quality was evaluated by means of the structures visualized on the images of the phantoms. Results: Considering the uncertainty of the measurements, the mean glandular dose results are in agreement with the values provided by the equipment and with internationally adopted reference levels. Results obtained from images of the phantoms were in agreement with the reference values. Conclusion: The present study contributes to verify the equipment conformity as regards dose values and image quality. .

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OBJECTIVE: To evaluate the mean glandular dose with a solid state detector and the image quality in a direct radiography system, utilizing phantoms. MATERIALS AND METHODS: Irradiations were performed with automatic exposure control and polymethyl methacrylate slabs with different thicknesses to calculate glandular dose values. The image quality was evaluated by means of the structures visualized on the images of the phantoms. RESULTS: Considering the uncertainty of the measurements, the mean glandular dose results are in agreement with the values provided by the equipment and with internationally adopted reference levels. Results obtained from images of the phantoms were in agreement with the reference values. CONCLUSION: The present study contributes to verify the equipment conformity as regards dose values and image quality.

OBJETIVO: Avaliar a dose glandular média utilizando um detector de estado sólido e a qualidade da imagem de um sistema de radiografia direta a partir de objetos simuladores. MATERIAIS E MÉTODOS: Irradiações foram realizadas utilizando o controle automático de exposição e placas de polimetilmetacrilato com diferentes espessuras para o cálculo da dose glandular média. A qualidade da imagem foi avaliada por meio das estruturas visualizadas nas imagens dos objetos simuladores. RESULTADOS: Considerando a incerteza das medições, os resultados de dose glandular média estão de acordo com os valores fornecidos pelo equipamento e com os níveis de referência adotados internacionalmente. Os resultados obtidos a partir das imagens dos objetos simuladores estavam em conformidade com os valores de referência. CONCLUSÃO: Este trabalho contribui para verificar a conformidade do equipamento em relação a dose e qualidade da imagem.

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OBJETIVO: Esta pesquisa visou a avaliar a qualidade dos serviços de mamografia do Distrito Federal e o impacto de uma intervenção de inspeção e capacitação. MATERIAIS E MÉTODOS: Foram estudados 41 serviços de mamografia no Distrito Federal no período de 2000 a 2002. A intervenção consistiu na inspeção inicial seguida de um treinamento e notificação oficial da Vigilância Sanitária. Os resultados de qualidade da imagem foram comparados "antes" e "depois" da intervenção. RESULTADOS: O estudo demonstrou que dos 36 serviços que completaram a pesquisa, nenhum estava acima de 90 por cento de conformidade antes da intervenção. Após a intervenção, dez unidades atingiram mais de 90 por cento. As principais melhorias foram em relação aos chassis, compressão da mama e visualização de microcalcificações. CONCLUSÃO: Apesar de o Distrito Federal dispor de muitos serviços, na sua maioria não eram de qualidade. A intervenção foi eficaz para a melhoria da qualidade, porém, torna-se necessária uma ação continuada para resolver os problemas restantes e aumentar o impacto.

OBJECTIVE: The present study was aimed at evaluating the quality and the impact of an intervention involving inspection and education in mammography centers of the Federal District, Brazil. MATERIALS AND METHODS: Forty one mammography centers in the Federal District were studied in the period between 2000 and 2002. The intervention involved an initial inspection followed by a training activity and notification of mammography centers by the Federal District Sanitary Vigilance authority. The imaging quality was compared before and after the intervention. RESULTS: None of the 36 centers which completed the study reached more than 90 percent compliance with the standard imaging quality prior to the interventions, whereas ten were above 90 percent afterwards. Major improvements were observed in chassis maintenance, breast compression and visualization of microcalcifications. CONCLUSION: Despite the availability of a great number of mammography centers in the Federal District, most of them did not meet the required quality standards. The intervention has shown to be effective for improving the imaging quality, however a continued action is required to solve the remaining problems and increase the impact of the program.

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