Analysis of Average Glandular Dose (AGD) and Associated Parameters for Conventional and Digital X-Ray Mammography

Suliman, I.I.; Mohamed, Sawsan; Mahadi, Alaa; Bashier, Einas; Farah, Andrew; Hassan, Nada; Ahmed, Nada A.; Eisa, Mohamed; El-Khayatt, A.M.; Sassi, Salem

doi:10.21203/rs.3.rs-799884/v1

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…The national DRL in the current study was comparable with those in Malaysia [19]. However, most countries set their DRLs for a single narrow CBT range as in Malta which was set at a CBT range of 50-70mm, while Sudan [30], and Ireland [31] set their DRLs at 55-65mm CBT range The comparison of DRLs with those of other countries is therefore challenging due to the lack of a standard CBT range used for setting the DRLs.…”

Section: Discussionmentioning

confidence: 61%

National diagnostic reference levels for digital diagnostic and screening mammography in Uganda

Odongo,

Musisi,

Okello

et al. 2023

Preprint

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IntroductionScreening and diagnostic mammography are associated with some risk of radiation-induced breast cancer. This study was conducted to establish the National Diagnostic Reference Levels (NDRLs) for digital diagnostic and screening mammography in Uganda to achieve breast radiation dose optimization.MethodsA cross-sectional study was conducted among female participants recruited by a consecutive sampling from three selected Hospitals with digital mammography in Uganda. The study variables extracted from the mammography machines were exposure factors, compressed breast thickness (CBT), and Average Glandular Dose (AGD) of two standard mammogram views. The stratified National DRL was derived by calculating 75thpercentile of the AGD across all the samples at various CBT ranges for both screening and diagnostic mammography in craniocaudal (CC) and mediolateral oblique (MLO) views.ResultsWe included 300 participants with mean ages of 50.28±9.32 and 47.45±13.45 years for the screening and diagnostic mammography, respectively. There were statistically significant positive correlations between AGD and exposures factors (mAs, kVp) (all p-values<0.0001). For screening mammography, mAs demonstrated a strong positive correlation (r = 0.8369 in CC, 0.8133 in MLO), whereas kVp showed positive correlation with relatively lower coefficients (r = 0.3700 in CC, 0.3080 in MLO). In diagnostic mammography, mAs exhibited an even stronger positive correlation (r = 0.8987 in CC, 0.8762 in MLO), and kVp maintained a positive correlation with somewhat lower coefficients (r = 0.4954 in CC, 0.3597 in MLO). In screening mammography, for CBT within the range of (7-39)mm, the NDRLs were (1.5mGy, 1.66mGy) in CC) and MLO views. For CBT in the range of (40-59)mm, the NDRLs were (1.78mGy, 1.87mGy), and for CBT in the range of (60-99)mm, the NDRLs were (2.18mGy, 2.22mGy). For diagnostic mammography, the NDRLs were established as (1.7mGy, 1.91mGy), (2.00mGy, 2.09mGy), and (2.63mGy, 2.81mGy) for CBT ranges of (7-39)mm, (40-59)mm, and (60-99)mm, respectively.ConclusionThe NDRLs for digital screening and diagnostic mammography in Uganda have been proposed for the first time. The NDRL values in mammography should be specific to CBT ranges and mammographic views for both diagnostic and screening mammography.

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Section: Discussionmentioning

confidence: 61%

National diagnostic reference levels for digital diagnostic and screening mammography in Uganda

Odongo,

Musisi,

Okello

et al. 2023

Preprint

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National diagnostic reference levels for digital diagnostic and screening mammography in Uganda

Odongo,

Musisi,

Okello

et al. 2024

PLoS ONE

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Introduction Screening and diagnostic mammography are associated with some risk of radiation-induced breast cancer. This study was conducted to establish the National Diagnostic Reference Levels (NDRLs) for digital diagnostic and screening mammography in Uganda to achieve breast radiation dose optimization. Methods A cross-sectional study was conducted among female participants recruited by consecutive sampling from three selected hospitals with digital mammography in Uganda. The study variables extracted from the mammography machines were exposure factors, compressed breast thickness (CBT), and Average Glandular Dose (AGD) of two standard mammogram views. The stratified National DRL was derived by calculating the 75th percentile of the AGD across all the samples at various CBT ranges for both screening and diagnostic mammography in craniocaudal (CC) and mediolateral oblique (MLO) views. Results We included 300 participants with mean ages of 50.28±9.32 and 47.45±13.45 years for the screening and diagnostic mammography, respectively. There were statistically significant positive correlations between AGD and exposure factors (mAs, kVp) (all p-values<0.0001). For screening mammography, mAs demonstrated a strong positive correlation (r = 0.8369 in CC, 0.8133 in MLO), whereas kVp showed a positive correlation with relatively lower coefficients (r = 0.3700 in CC, 0.3080 in MLO). For diagnostic mammography, mAs exhibited an even stronger positive correlation (r = 0.8987 in CC, 0.8762 in MLO), and kVp maintained a positive correlation with somewhat lower coefficients (r = 0.4954 in CC, 0.3597 in MLO). In screening mammography, for CBT within the range of (7–39) mm, the NDRLs were (1.5mGy, 1.66mGy) in CC) and MLO views. For CBT in the range of (40–59) mm, the NDRLs were (1.78mGy, 1.87mGy), and for CBT in the range of (60–99) mm, the NDRLs were (2.18mGy, 2.22mGy). For diagnostic mammography, the NDRLs were established as (1.7mGy, 1.91mGy), (2.00mGy, 2.09mGy), and (2.63mGy, 2.81mGy) for CBT ranges of (7–39) mm, (40–59) mm, and (60–99) mm, respectively. Conclusion The NDRLs for digital screening and diagnostic mammography in Uganda have been proposed for the first time. The NDRL values in mammography should be specific to CBT ranges and mammographic views for both diagnostic and screening mammography.

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Screening Mammography Diagnostic Reference Level System According to Compressed Breast Thickness: Dubai Health

Dalah,

Alkaabi,

Al-Awadhi

et al. 2024

J. Imaging

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Screening mammography is considered to be the most effective means for the early detection of breast cancer. However, epidemiological studies suggest that longitudinal exposure to screening mammography may raise breast cancer radiation-induced risk, which begs the need for optimization and internal auditing. The present work aims to establish a comprehensive well-structured Diagnostic Reference Level (DRL) system that can be confidently used to highlight healthcare centers in need of urgent action, as well as cases exceeding the dose notification level. Screening mammographies from a total of 2048 women who underwent screening mammography at seven different healthcare centers were collected and retrospectively analyzed. The typical DRL for each healthcare center was established and defined as per (A) bilateral image view (left craniocaudal (LCC), right craniocaudal (RCC), left mediolateral oblique (LMLO), and right mediolateral oblique (RMLO)) and (B) structured compressed breast thickness (CBT) criteria. Following this, the local DRL value was established per the bilateral image views for each CBT group. Screening mammography data from a total of 8877 images were used to build this comprehensive DRL system (LCC: 2163, RCC: 2206, LMLO: 2288, and RMLO: 2220). CBTs were classified into eight groups of <20 mm, 20–29 mm, 30–39 mm, 40–49 mm, 50–59 mm, 60–69 mm, 70–79 mm, 80–89 mm, and 90–110 mm. Using the Kruskal–Wallis test, significant dose differences were observed between all seven healthcare centers offering screening mammography. The local DRL values defined per bilateral image views for the CBT group 60–69 mm were (1.24 LCC, 1.23 RCC, 1.34 LMLO, and 1.32 RMLO) mGy. The local DRL defined per bilateral image view for a specific CBT highlighted at least one healthcare center in need of optimization. Such comprehensive DRL system is efficient, easy to use, and very clinically effective.

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Analysis of Average Glandular Dose (AGD) and Associated Parameters for Conventional and Digital X-Ray Mammography

Cited by 3 publications

References 12 publications

National diagnostic reference levels for digital diagnostic and screening mammography in Uganda

National diagnostic reference levels for digital diagnostic and screening mammography in Uganda

National diagnostic reference levels for digital diagnostic and screening mammography in Uganda

Screening Mammography Diagnostic Reference Level System According to Compressed Breast Thickness: Dubai Health

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