Sudan Journal of Medical Sciences

ISSN: 1858-5051

High-impact research on the latest developments in medicine and healthcare across MENA and Africa

Diagnostic Reference Levels in Mammography in the Asian Context

Published date: Sep 30 2022

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 17 (2022), Issue No. 3

Pages: 401–415

DOI: 10.18502/sjms.v17i3.12128

Authors:

Chamudi Ishara RajamuniDepartment of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka

Bimali Sanjeevani Weerakoonbsw888@gmail.comDepartment of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka

Abstract:

Background: Breast cancer is the most frequent cancer among the female population globally. Therefore, early detection is helpful for effective treatments and to reduce the mortality rate. Mammography is a radiological examination done with low-energy X-rays to detect abnormalities in breast tissue. This study aims to review the literature to evaluate the techniques, protocols, and conversion factors used to determine the diagnostic reference levels (DRLs); within the Asian continent using both phantom- and patient-based data.

Methods: Related articles were systematically reviewed via Pub Med, Google scholar, and freehand search with the aid of relevant terms. Related abstracts in English were screened, and suitable articles were selected after reviewing the full-text. Four hundred and thirty abstracts were screened for relevance, and 12 articles were selected.

Results: The study comprises four phantom-based and eight patient-based studies. The studies varied between the types of test subjects, conversion factors, breast compression thickness, and dose calculation protocols. This obstructs continuing the DRLs with the updates and comparisons among countries. Establishments of DRLs in Asian countries are less than the rest of the world. DRLs should be measured continuously, and should be updated based on other clinical parameters of the patients.

Conclusion: DRLs in mammography were measured from time to time in different geographical locations in Asia by following various techniques. But when compared with the other regions of the world, there is less consideration for establishing DRLs in Asia. There should be standard protocols and updated conversion factors according to the advancements of the technology to ensure radiation protection with optimal absorbed dose with appropriate image quality.

Keywords: mammography, diagnostic reference level, mean glandular dose

References:

[1] World Health Organization. (2021). Breast cancer. WHO. https://www.who.int/newsroom/ fact-sheets/detail/breast-cancer

[2] Bray, F., McCarron, P., & Parkin, D. M. (2004). The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Research, 6(6), 229– 239. https://doi.org/10.1186/bcr932

[3] Bhoo-Pathy, N., Yip, C. H., Hartman, M., Uiterwaal, C. S., Devi, B. C., Peeters, P. H., Taib, N. A., van Gils, C. H., & Verkooijen, H. M. (2013). Breast cancer research in Asia: Adopt or adapt Western knowledge? European Journal of Cancer (Oxford, England), 49(3), 703–709. https://doi.org/10.1016/j.ejca.2012.09.014

[4] Saz-Parkinson, Z., Duffy, S. W., Canelo-Aybar, C., Gräwingholt, A., Quinn, C., Follmann, M., & Schünemann, H. J. (2012). Breast cancer screening and diagnosis. Annals of Internal Medicine, 172(12), 109–127. https://doi.org/10.7326/L20-0254

[5] Vañó, E., Miller, D. L., Martin, C. J., Rehani, M. M., Kang, K., Rosenstein, M., Ortiz- Lo´pez, P., Mattsson, S., Padovani, R., Rogers, A. (2017). ICRP Publication 135 – Diagnostic reference levels in medical imaging. Annals of the ICRP, 44(1).

[6] Dance, D. R., Skinner, C. L., & Alm Carlsson, G. (1999). Breast dosimetry. Applied Radiation and Isotopes, 50(1), 185–203. https://doi.org/10.1016/S0969- 8043(98)00047-5

[7] Dance, D. R. (1990). Monte Carlo calculation of conversion factors for the estimation of mean glandular breast dose. Physics in Medicine and Biology, 35, 1211–1219. https://doi.org/10.1088/0031-9155/35/9/002

[8] Butler, P. F., & Jensen, J. E. Breast exposure: Nationwide trends; A mammographic quality assurance program–Results to date. Radiologic Technology, 50(3), 251–257.

[9] Fitzgerald, M., White, D. R., White, E., & Young, J., (1981). Mammographic practice and dosimetry in Britain. The British Journal of Radiology, 54(639), 212–220. https://doi.org/10.1259/0007-1285-54-639-212

[10] Breslow L., & Thomas, L. B. (1977). Final reports of the National Cancer Institute ad hoc Working Groups on Mammography in Screening for Breast Cancer and a summary report of their joint findings and recommendations. Journal of the National Cancer Institute, 69, 467–541.

[11] Boag, J. W., Stacey, A. J., & Davis, R. (1976). Radiation exposure to the patient in xeroradiography. The British Journal of Radiology, 49, 253–261. https://doi.org/10.1259/0007-1285-49-579-253

[12] Karlsson, M., Nygren, K., Wickman, G., & Hettinger, G. (1976). Absorbed dose in mammary radiography. Acta Radiologica: Therapy, Physics, Biology, 15(3), 252–258. https://doi.org/10.3109/02841867609131962

[13] Fintor, L., Alciati, M. H., & Fischer, R. (1995). Legislative and regulatory mandates for mammography quality assurance. Journal of Public Health Policy, 16, 81–107. https://doi.org/10.2307/3342978

[14] Vañó, E., Miller, D. L., Martin, C. J., Rehani, M. M., Kang, K., Rosenstein, M., Ortiz- López, P., Mattsson, S., Padovani, R., Rogers, A., & the Authors on behalf of ICRP. (2017). ICRP Publication 135: Diagnostic reference levels in medical imaging. Annals of the ICRP, 46(1), 1–144. https://doi.org/10.1177/0146645317717209

[15] Tenforde, T. S. (2004). A guide to mammography and other breast imaging procedures. NCRP Report.

[16] Jamal, N., Ng, K. H., & McLean, D. (2003). A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it. The British Journal of Radiology, 76, 238–245. https://doi.org/10.1259/bjr/66428508

[17] Strudley, C., Looney, P., & Young K. C. (2014). Technical evaluation of Hologic Selenia Dimensions digital breast tomosynthesis system: NHSBSP Equipment Report 1307 Version 2. NHS.

[18] Suleiman, M. E., Bernnan, P. C., & McEntee, F. M. (2014). Diagnostic reference levels in digital mammography: A systematic review. Radiation Protection Dosimetry, 167(4).

[19] Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ, 339(7716), b2535. https://doi.org/10.1136/bmj.b2535

[20] Hendrick, M. J., Bassett, L., Botsco, M., Deibel, D., Feig, S., Gray, J., Haus, A., Heinlei, R., & Kitts, E., (2018). Mammography quality control manual. American College of Radiology.

[21] Perry, N., Broeders, M., de Wolf, C., Törnberg, S., Holland, R., & von Karsa, L. (2008). European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition. Summary Document, 19(4). https://doi.org/10.1093/annonc/mdm481

[22] Wu, X., Gingold, E. L., Barnes, G. T., & Tucker, D. M. (1994). Normalized average glandular dose in molybdenum target-rhodium filter and rhodium target-rhodium filter mammography. Radiology, 193(1), 83–89. https://doi.org/10.1148/radiology.193.1.8090926

[23] Sharma, R., Sharma, S. D., Mayya, Y. S., & Chourasiya, G. (2012). Mammography dosimetry using an in-house developed polymethyl methacrylate phantom. Radiation Protection Dosimetry, 151(2), 379–385. https://doi.org/10.1093/rpd/ncr476

[24] Dance, D. R., Skinner, C. L., Young, K. C., Beckett, J. R., & Kotre, C. J. (2000). Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol. Physics in Medicine and Biology, 45(11), 3225– 3240. https://doi.org/10.1088/0031-9155/45/11/308

[25] Hwang, Y. S., Tsai, H. Y., Chen, C. C., Chia, S. H., Lin, J. H., Wan, Y. L., & Hsu, G. C. (2009). Survey of radiation dose, image quality and equipment performance of mammography units in Taiwan. Springer.

[26] Parmaksiz, A., AydinAtac, G. K., Bulur, E., Alhan, T., & Alhan, A. (2020). Average glandular doses and national diagnostic reference levels in mammography examinations in Turkey. Radiation Protection Dosimetry, 190(1), 100–107.

[27] Jamal, N., Ng, K.-H., & McLean, D. (2003). A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it. British Journal of Radiology, 76(905), 238–245. https://doi.org/10.1259/bjr/66428508

[28] Bor, D., Akyol, O., & Olgar, T. (2008). Performance measurements of mammographic systems. Radiation Protection Dosimetry, 129, 165–169. https://doi.org/10.1093/rpd/ncn141

[29] National Council on Radiation Protection and Measurements, & National Council on Radiation Protection. (2004). A guide to mammography and other breast imaging procedures. National Council on Radiation Protection.

[30] Wu, X., Barnes, G. T., & Tucker, D. M. (1991). Spectral dependence of glandular tissue dose in screen-film mammography. Radiology, 179(1), 143–148. https://doi.org/10.1148/radiology.179.1.2006265

[31] Asada, Y., Suzuki, S., Minami, K., & Shirakawa, S. (2014). Results of a 2011 national questionnaire for investigation of mean glandular dose from mammography in Japan. Journal of Radiological Protection, 34(1), 125–132. https://doi.org/10.1088/0952- 4746/34/1/125

[32] Kawaguchi, A., Matsunaga, Y., Otsuka, T., & Suzuki, S. (2014). Patient investigation of average glandular dose and incident air kerma for digital mammography. Radiological Physics and Technology, 7(1), 102–108. https://doi.org/10.1007/s12194- 013-0239-9

[33] AlNaemi, H., Aly, A., Omar, A. J., AlObadli, A., Ciraj-Bjelac, O., Kharita, M. H., & Rehani, M. M. (2020). Evaluation of radiation dose for patients undergoing mammography in Qatar. Radiation Protection Dosimetry, 189(3), 354–361.

[34] Bahreyni Toossi, M. T., Zare, H., Bayani Roodi, Sh., Hashemi, M., Akbari, F., & Malekzadeh, M. (2013). Towards proposition of a diagnostic reference level for mammographic examination in the greater Khorasan Province, Iran. Radiation Protection Dosimetry, 155, 96–99. https://doi.org/10.1093/rpd/ncs317

[35] Du, X., Wang, J., Yang, C. Y., Zhou, X. F., Chen, W., Cao, X. J., Zhou, Y. Y., Le Yu, N., & the N. L. Y. Xiang DU. (2014). Investigation of mean glandular dose in diagnostic mammography in China. Biomedical and Environmental Sciences, 27(5), 396–399.

[36] Baek, J. E., Kang, B. J., Kim, S. H., & Lee, H. S. (2017). Radiation dose affected by mammographic composition and breast size: First application of a radiation dose management system for full-field digital mammography in Korean women. World Journal of Surgical Oncology, 15, 38. https://doi.org/10.1186/s12957-017-1107-6

[37] Geeraert, N., Klausza, R., Muller, S., Bloch, I., & Bosmans, H. (2012). Breast characteristics and dosimetric data in X-ray mammography – A large sample worldwide survey. IAEA 2012 - International Conference on Radiation Protection in Medicine [Conference session]. Bonn, Germany.

Download
HTML
Cite
Share
statistics

1103 Abstract Views

546 PDF Downloads