O estudo e a determinação das propriedades de atenuação de tecidos mamários são fundamentais para o entendimento e para a quantificação do contraste e da dose absorvida em um exame mamográfico. A proposta deste trabalho é determinar experimentalmente os coeficientes de atenuação de tecidos mamários e, posteriormente, incorporar esses resultados a um modelo teórico-analítico que possibilite o estudo da influência de diversos parâmetros no contraste de objetos e na dose em mamografia. Dentre os fatores de estudo, destacam-se as características da mama (geometria e composição), a técnica radiográfica, a combinação ânodo-filtro e o receptor de imagem. Os coeficientes de atenuação foram medidos usando geometria de feixe estreito, no intervalo de energia entre 8 e 30 keV, utilizando um difratômetro de raios-X 4-círculos P3 Nicolet-Siemens e um monocromador de Si (111). Para essas medidas foram utilizadas 63 amostras de tecidos mamários (classificadas previamente como tecidos normais, fibroadenomas e/ou diferentes tipos de carcinomas). Os coeficientes de atenuação medidos foram comparados com predições teóricas, obtidas usando a regra das misturas, e com dados experimentais previamente publicados. O modelo desenvolvido para o contraste objeto leva em conta as contribuições primária e secundária na radiação transmitida. A dose média absorvida foi estimada através de duas aproximações, que permitem predizer os limites superior e inferior, e de uma aproximação mais completa, que inclui as componentes espalhadas simples e duplas. O modelo desenvolvido neste trabalho permite a obtenção de resultados de forma simples e rápida, com valores similares aos obtidos por simulação Monte Carlo, bem como definir limites de detecção de massas tumorais. / The study and determination of attenuation properties of breast tissues are fundamental to understand and quantify contrast and absorbed dose in the mammographic examination. The purpose of this work is to experimentally determine the attenuation coefficient of breast tissues, and then to include these results into a theoretical analytical model, in order to study the influence of several parameters on subject contrast and dose in mammography. Among the parameters studied, one can emphasize the breast characteristics (geometry and composition), the radiographic technique, the target-filter combination and the image receptor. The attenuation coefficients were measured using narrow beam geometry, within the energy range of 8-30 keV, using an x-ray diffractometer 4-circle P3 Nicolet-Siemens and a monocromator of Si (111). For these measurements were analyzed 63 breast tissue samples (previously classified as normal tissues, fibroadenomas and several types of carcinomas). The linear attenuation coefficients measured were compared with theoretical predictions obtained from the mixture rule, and with experimental data previously published. The developed model to the subject contrast takes into account the primary and scattered contribution of the transmitted radiation. The average absorbed dose was estimated considering two simplified approaches, which allowed to predict upper and lower limit values, and a more complete approach, which included the contribution of single and double scattered radiation. The analytical model developed in this work provided results in a fast and simple way, with a good agreement with those reported by others authors who had used Monte Carlo simulation, as well it allowed to define limit values for detection of tumor masses.

O estudo e a determinação das propriedades de atenuação de tecidos mamários são fundamentais para o entendimento e para a quantificação do contraste e da dose absorvida em um exame mamográfico. A proposta deste trabalho é determinar experimentalmente os coeficientes de atenuação de tecidos mamários e, posteriormente, incorporar esses resultados a um modelo teórico-analítico que possibilite o estudo da influência de diversos parâmetros no contraste de objetos e na dose em mamografia. Dentre os fatores de estudo, destacam-se as características da mama (geometria e composição), a técnica radiográfica, a combinação ânodo-filtro e o receptor de imagem. Os coeficientes de atenuação foram medidos usando geometria de feixe estreito, no intervalo de energia entre 8 e 30 keV, utilizando um difratômetro de raios-X 4-círculos P3 Nicolet-Siemens e um monocromador de Si (111). Para essas medidas foram utilizadas 63 amostras de tecidos mamários (classificadas previamente como tecidos normais, fibroadenomas e/ou diferentes tipos de carcinomas). Os coeficientes de atenuação medidos foram comparados com predições teóricas, obtidas usando a regra das misturas, e com dados experimentais previamente publicados. O modelo desenvolvido para o contraste objeto leva em conta as contribuições primária e secundária na radiação transmitida. A dose média absorvida foi estimada através de duas aproximações, que permitem predizer os limites superior e inferior, e de uma aproximação mais completa, que inclui as componentes espalhadas simples e duplas. O modelo desenvolvido neste trabalho permite a obtenção de resultados de forma simples e rápida, com valores similares aos obtidos por simulação Monte Carlo, bem como definir limites de detecção de massas tumorais. / The study and determination of attenuation properties of breast tissues are fundamental to understand and quantify contrast and absorbed dose in the mammographic examination. The purpose of this work is to experimentally determine the attenuation coefficient of breast tissues, and then to include these results into a theoretical analytical model, in order to study the influence of several parameters on subject contrast and dose in mammography. Among the parameters studied, one can emphasize the breast characteristics (geometry and composition), the radiographic technique, the target-filter combination and the image receptor. The attenuation coefficients were measured using narrow beam geometry, within the energy range of 8-30 keV, using an x-ray diffractometer 4-circle P3 Nicolet-Siemens and a monocromator of Si (111). For these measurements were analyzed 63 breast tissue samples (previously classified as normal tissues, fibroadenomas and several types of carcinomas). The linear attenuation coefficients measured were compared with theoretical predictions obtained from the mixture rule, and with experimental data previously published. The developed model to the subject contrast takes into account the primary and scattered contribution of the transmitted radiation. The average absorbed dose was estimated considering two simplified approaches, which allowed to predict upper and lower limit values, and a more complete approach, which included the contribution of single and double scattered radiation. The analytical model developed in this work provided results in a fast and simple way, with a good agreement with those reported by others authors who had used Monte Carlo simulation, as well it allowed to define limit values for detection of tumor masses.

In the framework of this thesis, a simulation model, based on Monte Carlo techniques, was developed for the study of breast imaging using Synchrotron Radiation (SR). The basic core of the model was developed in previous dissertations of our Department for conventional mammography. The existing model was expanded to include SR physical and geometrical characteristics and test the potential of SR for further optimization in breast imaging. The SR model was validated against experimental data from SYRMEP beamline of the Elettra Synchrotron Light Facility. The alterations of the new model comparing to the one for conventional mammography mostly concerned the geometry used (source-to-slit distance 22m), the narrow gaussian almost monoenergetic beam, and the scanning of the region of interest by a uniform movement of the phantom and the detector. Besides the generation of an image, the model was enriched with dose parameters (incident air kerma, backscatter radiation, entrance surface air kerma-Ke), in order to evaluate SR for both image quality and dose. The validation showed excellent results for 16-28 keV, for both image quality (subject contrast-SC) and dose (incident air kerma and corresponding number of photons) indices. In the case of SC, Pearson's correlation R was calculated 0.996, while in the case of dose validation, R was equal to 1. Regarding the backscatter, the validation was based on published data and the deviation did not exceed 2% for 20 keV. The performance of SR was then evaluated with mathematical phantoms designed to simulate difficult imaging tasks; the first experiment concerned a 4cm-thick phantom made of adipose tissue with embedded spheres of PMMA, glandular tissue and water of increasing diameter; the second one concerned a step wedge of 0-75% glandularity in a 5cm-thick background of adipose tissue and small calcifications in each step. The first experiment was used to compare SR energies (16-25 keV) to conventional mammographic spectra (Mo/Mo, Mo/Rh, Rh/Rh, W/Mo, W/Rh, W/Nb and W/Pd at 28 kVp) in terms of SC and CNR (Contrast-to-Noise Ratio). The results demonstrate that there is an energy range where CNR maximized (18-21 keV). The image quality indices are highly affected by the size and composition of the lesion, with PMMA showing a slightly degraded CNR compared to the same size glandular tissue inhomogeneity. SR energies between 18-21 keV demonstrate improved imaging performance compared to conventional spectra. For the second experiment, a Figure of Merit (FOM=CNR^2/Ke), was used as an index of the overall perfomance. The energy on the detector was kept constant at 7μGy for SR energies 19-25 keV (for 20 keV, the corresponding Ke was 1.5mGy). The results showed that the best performance (highest FOM), is observed in higher energies. However, taking into consideration the contrast-detail visibility, the best performance was observed at 21-22 keV. Synchrotron Radiation seems promising for breast imaging, since it shows better performance in cases where conventional mammography faces limitations. However, further exhaustive performance studies, in terms of resolution and dose, are necessary in order to consider it as a reliable alternative for mammographic applications. / Στα πλαίσια της διατριβής αυτής, αναπτύχθηκε ένα μοντέλο προσομοίωσης με βάση τις τεχνικές Monte Carlo για την υπολογιστική μελέτη της εφαρμογής της Ακτινοβολίας Συγχρότρου (ΑΣ) στην απεικόνιση μαστού. Μια βάση για το σχεδιασμό του μοντέλου είχε διαμορφωθεί στο Εργαστήριο Ιατρικής Φυσικής για κλασική μαστογραφία. Το νέο μοντέλο σχεδιάστηκε και πιστοποιήθηκε ως προς την ακρίβεια των αποτελεσμάτων του, με βάση πειραματικές μετρήσεις που πραγματοποιήθηκαν με τη δέσμη SYRMEP του Elettra Synchrotron Light Facility στην Τεργέστη. Οι διαφορές του μοντέλου για ΑΣ σε σχέση με το προηγούμενο που είχε αναπτυχθεί για κλασική μαστογραφία παρατηρήθηκαν κυρίως στη διάταξη (απόσταση πηγής-σχισμής 22m), στη στενή gaussian μορφή της σχεδόν μονοενεργειακής δέσμης, αλλά και στην σάρωση της περιοχής ενδιαφέροντος από τη δέσμη, που πραγματοποιείται στην πράξη με την ομοιόμορφη κίνηση του συστήματος ομοίωμα-ανιχνευτής. Εκτός από τη δημιουργία εικόνας, στο μοντέλο προστέθηκαν και παράμετροι για τον υπολογισμό δοσιμετρικών στοιχείων (προσπίπτον kerma στην επιφάνεια του ομοιώματος, οπισθοσκεδαζόμενη ακτινοβολία, kerma εισόδου στην επιφάνεια του μαστού-Ke), για τη συνολική εκτίμηση της απόδοσης της ΑΣ στην απεικόνιση μαστού. Η πιστοποίηση του μοντέλου ως προς την ακρίβεια των παραγόμενων αποτελεσμάτων είχε εξαιρετικά αποτελέσματα, τόσο για την ποιότητα εικόνας (αντίθεση υποκειμένου-subject contrast), όσο και για τη δόση (προσπίπτον kerma και αντίστοιχος αριθμός φωτονίων). Ο συντελεστής συσχέτισης του Pearson, R, μεταξύ των δεικτών ποιότητας πειραματικής και προσομοιωμένης εικόνας, βρέθηκε 0.996, ενώ στην περίπτωση της επαλήθευσης της δόσης, ο συντελεστής R άγγιξε το 1. Για την οπισθοσκεδαζόμενη ακτινοβολία, η επαλήθευση πραγματοποιήθηκε με βάση βιβλιογραφικά στοιχεία και τα αποτελέσματα έδωσαν απόκλιση μικρότερη του 2% για 20 keV. Στη συνέχεια, πραγματοποιήθηκαν πειράματα προσομοίωσης για την αξιολόγηση της ΑΣ με χρήση μαθηματικών ομοιωμάτων; στο πρώτο πείραμα σχεδιάστηκε ομοίωμα πάχους 4cm από λιπώδη ιστό με σφαιρικές ανομοιογένειες τριών διαφορετικών διαμέτρων και τριών διαφορετικών πυκνοτήτων (PMMA, αδενώδης ιστός και νερό); το δεύτερο πείραμα αφορά σε ομοίωμα αδενώδους ιστού αυξανόμενου πάχους (step wedge) 0-75% glandularity μέσα σε λιπώδη ιστό πάχους 5cm και με ενσωματωμένες αποτιτάνωσεις σε κάθε βήμα. Στο πρώτο πείραμα, συγκρίθηκαν ενέργειες ΑΣ (16-25 keV) με τα συνήθη μαστογραφικά φάσματα (Mo/Mo, Mo/Rh, Rh/Rh, W/Mo, W/Rh, W/Nb and W/Pd) στα 28 kVp ως προς το Subject Contrast (SC) και το Contrast-to-Noise Ratio (CNR). Τα αποτελέσματα έδειξαν ότι υπάρχει ένα εύρος ενεργειών (18-21 keV) όπου το CNR γίνεται βέλτιστο. Οι δείκτες ποιότητας εικόνας εξαρτώνται σημαντικά από το μέγεθος και τη σύνθεση της ανομοιογένειας με το PMMA να εμφανίζει ελαφρώς υποβαθμισμένο CNR σε σχέση με το αντίστοιχο μέγεθος ανομοιογένειας από αδενώδη ιστό. Οι ενέργειες ΑΣ στο εύρος 18-21 keV παρουσίασαν καλύτερη απόδοση από τα συμβατικά φάσματα. Για το δεύτερο πείραμα, χρησιμοποιήθηκε ένας δείκτης συνολικής απόδοσης (Figure of Merit - FOM=CNR^2/Ke). Για εύρος ενεργειών 19-25 keV, διατηρήθηκε σταθερή η ενέργεια στον ανιχνευτή (7 μGy), που αντιστοιχεί σε Ke=1.5mGy για 20 keV. Τα αποτελέσματα έδειξαν ότι την καλύτερη απόδοση (υψηλότερο FOM) παρουσίασαν οι υψηλότερες ενέργειες ΑΣ. Λαμβάνοντας όμως υπόψη και την ανιχνευσιμότητα των αποτιτανώσεων, η καλύτερη απόδοση παρατηρήθηκε στα 21-22 keV. Η Ακτινοβολία Συγχρότρου φαίνεται εξαιρετικά υποσχόμενη στην απεικόνιση μαστού, καθώς έχει καλύτερη απόδοση σε περιπτώσεις όπου η συμβατική μαστογραφία παρουσιάζει περιορισμούς. Εντούτοις, πρέπει να υποβληθεί σε περισσότερες μελέτες απόδοσης, ώστε να θεωρηθεί ως αξιόπιστη εναλλακτική για τις μαστογραφικές εφαρμογές.