Mean Glandular Dose Measurement in Three Mammography Centers in Kashan: An approach to Provide a Local DRL
-
Akbar Aliasgharzadeh
,
Habiballah Moradi
,
Tamara Talakesh
,
Elham Motallebzadeh
,
Gholamreza Ataei
,
Meysam Haghighi Borujeni
,
Bagher Farhood
Abstract
Purpose: Mammography is the most important diagnostic modality for early detection of breast cancer, however, concerns related to the side effects induced by ionizing radiation are still present. In the current study, the Mean Glandular Dose (MGD) values for mammography examinations as well as a local Diagnostic Reference Level (DRL) were obtained for mammography centers in Kashan, Iran.
Materials and Methods: Three mammography devices from three radiology centers were selected to obtain the MGD values of mammography examinations. To assess the MGD values, the technical parameters for patients’ imaging at these three radiology centers were extracted. Then, the incident air kerma (in mGy) value received by each patient was measured by a UNIDOS E electrometer (PTW, Germany) along with a SFD mammography ionization chamber (PTW, Germany). Finally, the incident air kerma values were converted to the MGD values by specific conversion factors. Based on the obtained MGD values, a local DRL was also established for mammography examinations.
Results: Mean MGD values per exposure were obtained 2.39 ± 1.46 mGy for Right Craniocaudal (RCC), 2.64 ± 1.67 mGy for Left Craniocaudal (LCC), 2.82 ± 1.89 mGy for Right Mediolateral Oblique (RMLO), and 3.09 ± 1.90 mGy for left mediolateral oblique views. Moreover, a local DRL obtained from mammography examinations, which was established as the overall median of MGD value, was 1.72 mGy (1.91 mGy for digital and 1.32 mGy for analog mammography).
Conclusion: The MGD values for different views obtained in this study are in the range of previously reported values. Considering the European guidelines for quality assurance in breast cancer screening and diagnosis, it can be mentioned that the obtained DRL was less than the recommended dose level (2.0 mGy).
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3- Taghavi A, Fazeli Z, Vahedi M, Baghestani AR, Pourhoseingholi A, Barzegar F, et al. "Increased trend of breast cancer mortality in Iran." Asian Pacific Journal of Cancer Prevention;13(1):367-70, 2012.
4- Sharifian A, Pourhoseingholi MA, Emadedin M, Nejad MR, Ashtari S, Hajizadeh N, et al. "Burden of breast cancer in Iranian women is increasing." Asian Pacific Journal of Cancer Prevention;16(12):5049-52, 2015.
5- Keyghobadi N, Rafiemanesh H, Mohammadian-Hafshejani A, Enayatrad M, Salehiniya H. "Epidemiology and trend of cancers in the province of Kerman: southeast of Iran." Asian Pacific Journal of Cancer Prevention 2015;16(4):1409-13.
6- Noroozi A, Jomand T, Tahmasebi R. "Determinants of breast self-examination performance among Iranian women: an application of the health belief model." Journal of Cancer Education;26(2):365-74, 2011.
7- Parwaie W, Farhood B, Ardekani MA, Safari H. "Evaluating the frequency of breast cancer risk factors in women referred to mammography center for breast cancer screening: A report from south part of Iran." Journal of cancer policy; 16:33-8, 2018.
8- Iranmakani S, Mortezazadeh T, Sajadian F, Ghaziani MF, Ghafari A, Khezerloo D, et al. "A review of various modalities in breast imaging: technical aspects and clinical outcomes." Egyptian Journal of Radiology and Nuclear Medicine; 51:1-22, 2020.
9- Ng K-H, Jamal N, DeWerd L. "Global quality control perspective for the physical and technical aspects of screen-film mammography—image quality and radiation dose." Radiation protection dosimetry;121(4):445-51, 2006.
10- Jerome-D'Emilia B, Dunphy Suplee P, Akincigil A, editors. "Validation of the Spanish Version of the Mammography-Specific Self-Efficacy Scale." Oncology nursing forum; 2015.
11- Karnan M, Thangavel K. "Automatic detection of the breast border and nipple position on digital mammograms using genetic algorithm for asymmetry approach to detection of microcalcifications." Computer methods and programs in biomedicine;87(1):12-20, 2007.
12- Ciraj-Bjelac O, Beciric S, Arandjic D, Kosutic D, Kovacevic M. "Mammography radiation dose: initial results from Serbia based on mean glandular dose assessment for phantoms and patients." Radiation protection dosimetry;140(1):75-80, 2010.
13- Faj D, Posedel D, Štimac D, Ivezić Z, Kasabašić M, Ivković A, et al. "Survey of mammography practice in Croatia: equipment performance, image quality and dose." Radiation protection dosimetry;131(4):535-40, 2008.
14- Lessick J, Abadi S, Agmon Y, Keidar Z, Carasso S, Aronson D, et al. "Multidetector computed tomography predictors of late ventricular remodeling and function after acute myocardial infarction." European journal of radiology;81(10):2648-57, 2012.
15- Faulkner K, Wallis M, Neilson F, Whitaker C. "Evaluation of the population dose to the UK population from the National Health Service Breast Screening Programme." Radiation protection dosimetry;129(1-3):184-90, 2008.
16- Bloomquist A, Bosmans H, Burch A, Chevalier M, Daros K, Gennaro G. "IAEA Human Health Series No. 17: Quality Assurance Programme for Digital Mammography." Vienna: International Atomic Energy Agency, 2011.
17- Dance D, Skinner C, Young K, Beckett J, Kotre C. "Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol." Physics in medicine & biology;45(11):3225, 2000.
18- Michielsen K, Jacobs J, Lemmens K, Nens J, Zoetelief J, Faulkner K, et al. "Results of a European dose survey for mammography." Radiation protection dosimetry;129(1-3):199-203, 2008.
19- Jamal N, Ng K, McLean D. "A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it." The British journal of radiology;76(904):238-45, 2003.
20- Tsapaki V, Tsalafoutas I, Poga V, Louizi A, Kottou S, Koulentianos E. "Investigation of breast dose in five screening mammography centres in Greece." Journal of Radiological Protection;28(3):337, 2008.
21- Bahreyni Toossi M, Zare H, Bayani Roodi S, Hashemi M, Akbari F, Malekzadeh M. "Towards proposition of a diagnostic reference level for mammographic examination in the greater Khorasan Province, Iran." Radiation protection dosimetry; 155(1):96-9, 2013.
22- Alizadeh Riabi H, Mehnati P, Mesbahi A. "Evaluation of mean glandular dose in a full-field digital mammography unit in Tabriz, Iran." Radiation protection dosimetry;142(2-4):222-7, 2010.
23- Bouzarjomehri F, Mostaar A, Ghasemi A, Ehramposh M, Khosravi H. "The study of mean glandular dose in mammography in Yazd and the factors affecting it." Iranian Journal of Radiology;4(1):29-35, 2006.
24- Dance D, Young K, Van Engen R. "Estimation of mean glandular dose for breast tomosynthesis: factors for use with the UK, European and IAEA breast dosimetry protocols." Physics in Medicine & Biology;56(2):453, 2010.
25- Dance D, Young K, Van Engen R. Further factors for the estimation of mean glandular dose using the United Kingdom, European and IAEA breast dosimetry protocols. Physics in Medicine & Biology. 2009;54(14):4361.
26- Mullenders L, Atkinson M, Paretzke H, Sabatier L, Bouffler SJNRC. "Assessing cancer risks of low-dose radiation.";9(8):596-604, 2009.
27- Aliasgharzadeh A, Mohseni M, Salimian M, Farhood B, Najafi M, Safari H, et al. "Cumulative effective dose caused by diagnostic imaging and its associated risk for cancer development in trauma patients referred to the emergency department.";40(2):51-8, 2020.
28- Azadbakht J, Khoramian D, Lajevardi ZS, Elikaii F, Aflatoonian AH, Farhood B, et al. "A review on chest CT scanning parameters implemented in COVID-19 patients: bringing low-dose CT protocols into play." Egyptian Journal of Radiology and Nuclear Medicine;52(1):1-10, 2021.
29- Hendrick RE, Pisano ED, Averbukh A, Moran C, Berns EA, Yaffe MJ, et al. "Comparison of acquisition parameters and breast dose in digital mammography and screen-film mammography in the American College of Radiology Imaging Network digital mammographic imaging screening trial." AJR American journal of roentgenology;194(2):362-9, 2010.
30- Moran P, Chevalier M, Ten J, Fernandez Soto J, Vano EJRpd. "A survey of patient dose and clinical factors in a full-field digital mammography system.";114(1-3):375-9, 2005.
31- Avramova-Cholakova S, Vassileva J. "Pilot study of patient and phantom breast dose measurements in Bulgaria." Polish Journal of Medical Physics And Engineering;14(1):21-32, 2008.
32- Bor D, Tükel S, Olgar T, Aydin E. "Variations in breast doses for an automatic mammography unit." Diagnostic and Interventional Radiology;14(3):122, 2008.
33- Suad K, Suada K, Samek D, Amila H, Samir K. "Analysis of application of mean glandular dose and factors on which it depends to patients aged 65 to 80." Journal of Physical Science and Application;3(6):387-91, 2013.
34- Mehnati P, Alizadeh H. "Comparison Between Film-Screen and Digital Mammography for Woman Breast Cancer Screening: Mean Glandular Dose." Acad J Cancer Res; 7:162-7, 2014.
35- Paknyat A, Samarin ER, Jeshvaghane NA, Paydar R, Fasaei B, Karamloo A, et al. "Evaluation of patient dose in some mammography centres in Iran." Radiat Prot Dosimetry;147(1-2):192-5, 2011.
36- Isoardi P, Ropolo RJTBjor. "Measurement of dose–width product in panoramic dental radiology.";76(902):129-31, 2003.
37- Aliasgharzadeh A, Khezerloo D, Farhood B, Mohseni M, Moradi H, Mortezazadeh TJOr. "Measuring the dose–width product and proposing the local diagnostic reference level in panoramic dental radiography: a multi-center study from Iran." 1-6, 2020.
38- International Commission on Radiological Protection. ICRP 1990 recommendations of the ICRP Ann ICRP Publication 60. Amsterdam: Elsevier; 1990.
39- European Commission. Guidance on diagnostic reference levels (DRLs) for medical exposures. Radiation Protection 109. Luxembourg, 1999.
40- Vañó E, Miller D, Martin C, Rehani M, Kang K, Rosenstein M, et al. "ICRP publication 135: diagnostic reference levels in medical imaging";46(1):1-144, 2017.
41- Young K, Burch A, Oduko JJTBjor. "Radiation doses received in the UK Breast Screening Programme in 2001 and 2002.";78(927):207-18, 2005.
42- Smans K, Bosmans H, Xiao M, Carton A, Marchal GJRpd. "Towards a proposition of a diagnostic (dose) reference level for mammographic acquisitions in breast screening measurements in Belgium.";117(1-3):321-6, 2005.
43- Baldelli P, McCullagh J, Phelan N, Flanagan FJRpd. "Comprehensive dose survey of breast screening in Ireland.";145(1):52-60, 2011.
2- Farhood B, Geraily G, Alizadeh A. "Incidence and mortality of various cancers in Iran and compare to other countries: a review article." Iran J Public Health;47(3):309, 2018.
3- Taghavi A, Fazeli Z, Vahedi M, Baghestani AR, Pourhoseingholi A, Barzegar F, et al. "Increased trend of breast cancer mortality in Iran." Asian Pacific Journal of Cancer Prevention;13(1):367-70, 2012.
4- Sharifian A, Pourhoseingholi MA, Emadedin M, Nejad MR, Ashtari S, Hajizadeh N, et al. "Burden of breast cancer in Iranian women is increasing." Asian Pacific Journal of Cancer Prevention;16(12):5049-52, 2015.
5- Keyghobadi N, Rafiemanesh H, Mohammadian-Hafshejani A, Enayatrad M, Salehiniya H. "Epidemiology and trend of cancers in the province of Kerman: southeast of Iran." Asian Pacific Journal of Cancer Prevention 2015;16(4):1409-13.
6- Noroozi A, Jomand T, Tahmasebi R. "Determinants of breast self-examination performance among Iranian women: an application of the health belief model." Journal of Cancer Education;26(2):365-74, 2011.
7- Parwaie W, Farhood B, Ardekani MA, Safari H. "Evaluating the frequency of breast cancer risk factors in women referred to mammography center for breast cancer screening: A report from south part of Iran." Journal of cancer policy; 16:33-8, 2018.
8- Iranmakani S, Mortezazadeh T, Sajadian F, Ghaziani MF, Ghafari A, Khezerloo D, et al. "A review of various modalities in breast imaging: technical aspects and clinical outcomes." Egyptian Journal of Radiology and Nuclear Medicine; 51:1-22, 2020.
9- Ng K-H, Jamal N, DeWerd L. "Global quality control perspective for the physical and technical aspects of screen-film mammography—image quality and radiation dose." Radiation protection dosimetry;121(4):445-51, 2006.
10- Jerome-D'Emilia B, Dunphy Suplee P, Akincigil A, editors. "Validation of the Spanish Version of the Mammography-Specific Self-Efficacy Scale." Oncology nursing forum; 2015.
11- Karnan M, Thangavel K. "Automatic detection of the breast border and nipple position on digital mammograms using genetic algorithm for asymmetry approach to detection of microcalcifications." Computer methods and programs in biomedicine;87(1):12-20, 2007.
12- Ciraj-Bjelac O, Beciric S, Arandjic D, Kosutic D, Kovacevic M. "Mammography radiation dose: initial results from Serbia based on mean glandular dose assessment for phantoms and patients." Radiation protection dosimetry;140(1):75-80, 2010.
13- Faj D, Posedel D, Štimac D, Ivezić Z, Kasabašić M, Ivković A, et al. "Survey of mammography practice in Croatia: equipment performance, image quality and dose." Radiation protection dosimetry;131(4):535-40, 2008.
14- Lessick J, Abadi S, Agmon Y, Keidar Z, Carasso S, Aronson D, et al. "Multidetector computed tomography predictors of late ventricular remodeling and function after acute myocardial infarction." European journal of radiology;81(10):2648-57, 2012.
15- Faulkner K, Wallis M, Neilson F, Whitaker C. "Evaluation of the population dose to the UK population from the National Health Service Breast Screening Programme." Radiation protection dosimetry;129(1-3):184-90, 2008.
16- Bloomquist A, Bosmans H, Burch A, Chevalier M, Daros K, Gennaro G. "IAEA Human Health Series No. 17: Quality Assurance Programme for Digital Mammography." Vienna: International Atomic Energy Agency, 2011.
17- Dance D, Skinner C, Young K, Beckett J, Kotre C. "Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol." Physics in medicine & biology;45(11):3225, 2000.
18- Michielsen K, Jacobs J, Lemmens K, Nens J, Zoetelief J, Faulkner K, et al. "Results of a European dose survey for mammography." Radiation protection dosimetry;129(1-3):199-203, 2008.
19- Jamal N, Ng K, McLean D. "A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it." The British journal of radiology;76(904):238-45, 2003.
20- Tsapaki V, Tsalafoutas I, Poga V, Louizi A, Kottou S, Koulentianos E. "Investigation of breast dose in five screening mammography centres in Greece." Journal of Radiological Protection;28(3):337, 2008.
21- Bahreyni Toossi M, Zare H, Bayani Roodi S, Hashemi M, Akbari F, Malekzadeh M. "Towards proposition of a diagnostic reference level for mammographic examination in the greater Khorasan Province, Iran." Radiation protection dosimetry; 155(1):96-9, 2013.
22- Alizadeh Riabi H, Mehnati P, Mesbahi A. "Evaluation of mean glandular dose in a full-field digital mammography unit in Tabriz, Iran." Radiation protection dosimetry;142(2-4):222-7, 2010.
23- Bouzarjomehri F, Mostaar A, Ghasemi A, Ehramposh M, Khosravi H. "The study of mean glandular dose in mammography in Yazd and the factors affecting it." Iranian Journal of Radiology;4(1):29-35, 2006.
24- Dance D, Young K, Van Engen R. "Estimation of mean glandular dose for breast tomosynthesis: factors for use with the UK, European and IAEA breast dosimetry protocols." Physics in Medicine & Biology;56(2):453, 2010.
25- Dance D, Young K, Van Engen R. Further factors for the estimation of mean glandular dose using the United Kingdom, European and IAEA breast dosimetry protocols. Physics in Medicine & Biology. 2009;54(14):4361.
26- Mullenders L, Atkinson M, Paretzke H, Sabatier L, Bouffler SJNRC. "Assessing cancer risks of low-dose radiation.";9(8):596-604, 2009.
27- Aliasgharzadeh A, Mohseni M, Salimian M, Farhood B, Najafi M, Safari H, et al. "Cumulative effective dose caused by diagnostic imaging and its associated risk for cancer development in trauma patients referred to the emergency department.";40(2):51-8, 2020.
28- Azadbakht J, Khoramian D, Lajevardi ZS, Elikaii F, Aflatoonian AH, Farhood B, et al. "A review on chest CT scanning parameters implemented in COVID-19 patients: bringing low-dose CT protocols into play." Egyptian Journal of Radiology and Nuclear Medicine;52(1):1-10, 2021.
29- Hendrick RE, Pisano ED, Averbukh A, Moran C, Berns EA, Yaffe MJ, et al. "Comparison of acquisition parameters and breast dose in digital mammography and screen-film mammography in the American College of Radiology Imaging Network digital mammographic imaging screening trial." AJR American journal of roentgenology;194(2):362-9, 2010.
30- Moran P, Chevalier M, Ten J, Fernandez Soto J, Vano EJRpd. "A survey of patient dose and clinical factors in a full-field digital mammography system.";114(1-3):375-9, 2005.
31- Avramova-Cholakova S, Vassileva J. "Pilot study of patient and phantom breast dose measurements in Bulgaria." Polish Journal of Medical Physics And Engineering;14(1):21-32, 2008.
32- Bor D, Tükel S, Olgar T, Aydin E. "Variations in breast doses for an automatic mammography unit." Diagnostic and Interventional Radiology;14(3):122, 2008.
33- Suad K, Suada K, Samek D, Amila H, Samir K. "Analysis of application of mean glandular dose and factors on which it depends to patients aged 65 to 80." Journal of Physical Science and Application;3(6):387-91, 2013.
34- Mehnati P, Alizadeh H. "Comparison Between Film-Screen and Digital Mammography for Woman Breast Cancer Screening: Mean Glandular Dose." Acad J Cancer Res; 7:162-7, 2014.
35- Paknyat A, Samarin ER, Jeshvaghane NA, Paydar R, Fasaei B, Karamloo A, et al. "Evaluation of patient dose in some mammography centres in Iran." Radiat Prot Dosimetry;147(1-2):192-5, 2011.
36- Isoardi P, Ropolo RJTBjor. "Measurement of dose–width product in panoramic dental radiology.";76(902):129-31, 2003.
37- Aliasgharzadeh A, Khezerloo D, Farhood B, Mohseni M, Moradi H, Mortezazadeh TJOr. "Measuring the dose–width product and proposing the local diagnostic reference level in panoramic dental radiography: a multi-center study from Iran." 1-6, 2020.
38- International Commission on Radiological Protection. ICRP 1990 recommendations of the ICRP Ann ICRP Publication 60. Amsterdam: Elsevier; 1990.
39- European Commission. Guidance on diagnostic reference levels (DRLs) for medical exposures. Radiation Protection 109. Luxembourg, 1999.
40- Vañó E, Miller D, Martin C, Rehani M, Kang K, Rosenstein M, et al. "ICRP publication 135: diagnostic reference levels in medical imaging";46(1):1-144, 2017.
41- Young K, Burch A, Oduko JJTBjor. "Radiation doses received in the UK Breast Screening Programme in 2001 and 2002.";78(927):207-18, 2005.
42- Smans K, Bosmans H, Xiao M, Carton A, Marchal GJRpd. "Towards a proposition of a diagnostic (dose) reference level for mammographic acquisitions in breast screening measurements in Belgium.";117(1-3):321-6, 2005.
43- Baldelli P, McCullagh J, Phelan N, Flanagan FJRpd. "Comprehensive dose survey of breast screening in Ireland.";145(1):52-60, 2011.
| Files | ||
| Issue | Vol 8 No 4 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v8i4.7756 | |
| Keywords | ||
| Mammography Mean Glandular Dose Diagnostic Reference Level Iran | ||
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How to Cite
1.
Aliasgharzadeh A, Moradi H, Talakesh T, Motallebzadeh E, Ataei G, Haghighi Borujeni M, Farhood B. Mean Glandular Dose Measurement in Three Mammography Centers in Kashan: An approach to Provide a Local DRL. Frontiers Biomed Technol. 2021;8(4):285-291.
