Spectrometric characterization of x-ray attenuation in silicone-gel and saline breast implants under mammography and CT conditions.
Lefèvre Jérémie J, Kerfa Jade J, Bony Mathis M, Plagnard Johann J et al.
Breast implants alter x-ray beam attenuation, but quantitative energy-resolved data for commercial prostheses are largely missing from the literature. Current dosimetric protocols lack specific correction factors for implant materials. To measure the x-ray attenuation properties of silicone-gel (PDMS) and saline breast implants under mammography and computed tomography (CT) conditions. We performed transmission spectrometry on six breast implants (three PDMS, three saline-filled) from a single manufacturer, using a cadmium telluride (CdTe) detector in narrow-beam geometry. Energy-dependent linear attenuation coefficients, effective attenuation coefficients ( μ eff ), half-value layers, and bulk densities were determined for mammography (25-49 kV) and CT (80-120 kV) beam qualities. Combined uncertainties were 3%-5%. Under mammographic conditions, PDMS attenuates more than saline: μ eff values are roughly 1.5-2 times higher, because of enhanced photoelectric absorption linked to a higher effective atomic number ( Z eff = 11.7 vs. 7.5). Saline implants behave much like water and soft breast tissues. The monoenergetic attenuation curves of the two materials converge above ∼ 60 keV as Compton scattering comes to dominate, but the spectrum-weighted effective attenuation still differs by ∼ 40% at a representative 80 kV Al CT tube potential (0.48 vs. 0.34 cm - 1 ), narrowing to ∼ 10% only with harder filtration and higher tube potential combined (120 kV AlCu). We provide log-log polynomial fits suitable for dosimetric codes. These measurements supply energy-resolved attenuation data for silicone-gel and saline implants across the diagnostic range. PDMS and saline differ substantially at mammographic energies. Their monoenergetic attenuation converges in the Compton regime, but spectrum-weighted differences persist at 80 kV and should be accounted for in breast CT dosimetry. The results are consistent with recent phantom findings on AEC response and dose variations in the presence of silicone implants.