Dosimetric evaluation of the mean glandular dose for mammography in Indian (North East) women.

Volume 6, Issue 3, June 2021     |     PP. 198-212      |     PDF (348 K)    |     Pub. Date: May 31, 2021
DOI: 10.54647/cm32505    91 Downloads     4793 Views  

Author(s)

Jibon Sharma, State Cancer Institute, Gauhati Medical College. Guwahati, Assam, India
Gautam Goswami, State Cancer Institute, Gauhati Medical College. Guwahati, Assam, India

Abstract
The assessment of mean glandular dose is important to reduce and control the potential risk of radiation induced carcinogenesis during mammography procedure. The quantity which describes amount of risk for glandular tissue caused by application of radiation in mammography is called mean glandular dose (MGD). The purpose of the study was to estimate patient mean glandular doses in the two standard views, cranio-caudal and mediolateral oblique for mammography procedure. The study was also aimed to identify the various factors which influence the quantity MGD and Glandularity. Material and Methods: The following clinical data were collected from 72 numbers of women, who were referred to Radiology department, in a designed format during diagnostic examination:a) Patient demographic data like age, weight and height.b) Applied clinical spectrum (Target/filter combination.)c) Digital readout of CBT (compressed breast thickness) and type of projection (CC, MLO) for each breast.d) Exposure factors: mAS and kVp. The MGD per woman was calculated by summing the MGDs for all exposures and averaging it over both breasts. The MGD values are based on measurement of entrance surface air kerma (ESAK) and HVL.The measurements were done with Magic maxx mammography detector, IBA, using appropriate conversion coefficients as per IAEA protocol. For analysis of data Origin 2018b software was used for determining the descriptive and Pearson’s correlation.Results: In this study, 72 women (18 to 78 years) were included. Mean age was (42.28±14.8) years. The mean CBT value of CC view is (4.04±1.13) c.m., which is lower than that of (4.75±1.19) c.m. for MLO views. Significant difference was found between MGD from CC (1.10±0.02mGy) and MLO (1.26±0.13 mGy) views. (p=0.0386). Significant relationships were seen between MGD per patient with respect to CBT (R²=0.152, p=0.0007) , mAs(R²=0.696,p=0.00001) and glandularity (R²=0.140,p=0.0011).It was also noted that there was a considerable significance between glandularity and CBT (R²=0.173,p=0.00028).Discussion: The significant increase of doses in MLO in regard to CC projection can be explained with the fact that pectoral muscle is involved in MLO projection, which causes an increase of thickness of compressed tissue and require a greater dose for an image of a better quality. It is known that compressed breast thickness value shows a certain tendency of growth in younger patient and a tendency of decline in older patients, it was proved as true in our study and the similar symmetry was noted in other works (Suad Kunosic et al, 2012).Conclusions: The total MGD value per woman is (2.36±0.22) mGy, which is between the limiting value of the Institute of Physical sciences in Medicine (2.0 mGy) and American College of Radiology (3.0 mGy) recommendation. These ensure that the mammography procedure performed in our centre is capable of achieving acceptable dose level for patient safety.

Keywords
Mammography, CBT, MGD, Glandularity.

Cite this paper
Jibon Sharma, Gautam Goswami, Dosimetric evaluation of the mean glandular dose for mammography in Indian (North East) women. , SCIREA Journal of Clinical Medicine. Volume 6, Issue 3, June 2021 | PP. 198-212. 10.54647/cm32505

References

[ 1 ] Tomal A, PolettiME, Caldas LVE.Evaluation of subject contrast and normalized average glandular dose by semi-analytical models. Appl.Radiat. Isot.,2010;68:755-59.
[ 2 ] Xiang D, Ningle Y, Yimei Z, Jin W. The relationship of the mean glandular dose with compressed breast thickness in mammography. Journal of Public Health and Engineering, 2017; 1(32):1-8.
[ 3 ] Dance DR, SkinnerCL, CarlssonGA, Breastdosimetry. Appl.Radiat. Isot.,1999;50:185-203.
[ 4 ] Haus AG, Yaffe MJ, Feig SA, et al. Relationship between phantom failure rates and radiation dose in mammography accreditation. Med Phys 2001; 28:2297-2301.
[ 5 ] Salomon E, Homolka P, Semturs F, Figl M, Gruber M &Hummel J. Comparison of a personalized breast dosimetry method with standard dosimetry protocols. Scientific Reports,2019;9 :5866 (1-9) [http://doi.org/10.1038/s41598-019-42144-7.]
[ 6 ] Klein R, Aichinger H, Dierker J, Jansen JTM, Joit-Barfub S, Sabel M.Determination of average glandular dose with modern mammography units for two large groups of patients. Phys Med Biol, 1997; 42:651–71.
[ 7 ] Beckett JR, Kotre CJ, Dosimetric implications of age-related glandular changes in screening mammography. Phys Med Biol., 2000; 45:801–13.
[ 8 ] Eklund GW, Cardenosa W. The art of mammographic positioning. Radiol.Clin. North.Am, 1992; 30:21-53.
[ 9 ] Brnic Z, HebrangA. Breast compression and radiation dose in two different mammographic oblique projections: 45° and 60°.Euro. J. Radial. 2001; 40:10-15.
[ 10 ] Bouzarjomehri F, MostaarA, GhasemiA, EhramposhMH, Khosravi H.J. Radiol.,2006;4(1):
[ 11 ] Hackshaw AK, WaldNJ, MichellMJ, FieldS, Wilson ARM.An investigation into why two-view Mammography is better than one view in Breast Cancer Screening. Clinical Radiology, 2000; 55(6):454-58.
[ 12 ] Pery N., BroedersM., C. De Wolf and Tomberg Commissions of the European Communities, European Guidelines for Quality Assurance in Mammography Screening Report EUR 14821, Luxemberg,2001.
[ 13 ] Dance DR, SkinnerCL, YoungKC, Beckett JR and Kotre CJ. Additional factors for the estimation of mean glandular breast dose using the UK mammography & dosimetry protocol. PhysMed Biol,2000;45:3225-40.
[ 14 ] Dance DR, YoungKC, Van Engen RE. Further factors for the estimation of mean glandular dose using the United Kingdom, European and IAEA breast dosimetry protocols. Phys Med Biol 2009; 54:4361-72.
[ 15 ] Food and Drug Administration. The Mammography Quality Standards Act Final Regulations and Additions to Policy Guidance.[Available at: http://www.fda.gov/Radiation EmittingProducts/MammographyQualityStandardsActandProgram/DocumentArchives/ucm114207.htm. Accessed March 28, 2018.
[ 16 ] Hendrick RE, Bassett L, Botsco MA, et al. Mammography Quality Control Manual. Reston, V.: American College of Radiology; 1999.
[ 17 ] Xavier AC, Andrade MEA, Pinto BVCC, Barros VSM, et al. Research on Biomedical Engineering ,2017;33(2):138-143. [ http://dx.doi.org/10.1590/2446-4740.02117]
[ 18 ] Kawaguchi A, Matsuraga V, Otsuka T, Suzuki S. Patient investigation of average glandular dose and incident air kerma for digital mammography, Radiol.Phy.Tech.2014;7(1):102-108. [http://dx.doi.org/10.1007/s12194-013-029-9. PMid:24234736.]
[ 19 ] Suad Kunosic (2012). An analysis of application of Mean Glandular dose and factors in which it depends to patients of various age groups, Mammography-Recent advances, Dr. NachikoUchiyama (Ed)ISBN: 978-953-51-0285-4, Intech [http://www.intechopen.com/books/mammography.recentadvances/an-analysis-of application-of-mean-glandular-dose-and factors-on-which-it depends to patients-of-var.]
[ 20 ] Hendrick RE,Pisano ED,Averbukh A, Moran C,Berns EA et.al.Comparison of acquisition parameter and breast dose in digital mammography and screen film mammography in the American College of Radiology Imaging Network Digital Mammographic Imaging screening trial, AJR, 2010; 194(2):362-369. [http://dx.doi.org/10.2214/AJR.08.2004 .PMid:20093597.]
[ 21 ] Young KC, Burch A. Radiation dose received in the UK breast screening programme in 1997 and 1998.Br. J. Radiology.2000;73:278-287.