Is the implementation of tungsten x-ray anode material instead of molybdenum or rhodium in mammography justified?

Abstract

Abstract Objectives: The current systematic review explores the literature seeking for a justification for the recent replacement of Molybdenum and Rhodium anode/filter materials by tungsten. Introduction: With the late increase of breast cancer prevalence and the transition to the use of tungsten anode instead of molybdenum or rhodium in digital mammography, the importance of optimising the image quality and lowering the radiation dose is increased. Methods: The current systematic review was established using the studies that met the inclusion and exclusion criteria and found on the databases of PubMed and Web of Science. It has only included studies published in English with no specific dates were set in the search. Results: The total studies that met the pre-set criteria are only 12 studies out of 100 excluded studies. Contrast to noise ratio and signal to noise ratio values obtained by Mo/Mo, Mo/Rh or Rh/Rh are higher than those obtained using W/Rh and W/Ag. Discussion: Parameter values of automatic exposure control must be optimised to compensate the lost image quality at lower dose. Filters like Zr, Pd, Cd and Sn can increase the performance of tungsten anode. Conclusion: Tungsten anode combined with proper filter can obtain comparable image quality at lower dose. • Key words Digital mammography, target/filter material, mean glandular dose, contrast to noise ratio, systematic review.