The effect of a compression paddle on energy response, calibration and measurement with mammographic dosimeters using ionization chambers and solid-state detectors.

A compression paddle is always used in mammography x-ray examinations, in order to improve image quality and reduce patient doses. Although clinical dose measurements should be performed with the paddle to interfere with the x-ray beam, calibration of mammography dosimeters is performed free in air without the presence of the paddle. The paddle hardens the x-ray beam, which has an impact on a dosimeter performance, particularly on high-energy-dependent detectors. Due to the paddle, clinical mammography x-ray systems may exhibit beams with HVL values exceeding those of the IEC 61267 RQR-M series qualities at which dosimeters are usually calibrated. In this study, the influence of the paddle in mammography dosimetry is examined, in Mo/Mo anode/filter x-ray qualities. PMMA slabs of 1, 2 and 3 mm thickness and Al foils of 0.05, 0.10 and 0.15 mm thicknesses were used to simulate the paddles, producing beams with HVL values from 0.28 up to 0.43 mmAl. In these qualities, four solid-state (ST) detectors and three ionizations chambers (IC) were calibrated in terms of Kair and N(K) and k(Q) were deduced. The results showed that all IC and two modern-type ST dosimeters have a flat energy response in the above HVL range (less than 3%), so their calibration factor at RQR-M2 quality could be safely used for clinical measurements. Two other ST dosimeters exhibit up to 20% energy response, so differences up to 15% in dose measurement may be observed if the effect of paddle on their performance is ignored. Finally, the need of additional mammographic calibration qualities to the existing IEC 61267 RQR-M series is examined and discussed.