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

Area of Science:

• Medical Imaging
• Radiological Physics
• Public Health

Background:

• Screening mammography is crucial for early breast cancer detection.
• Longitudinal exposure may increase radiation-induced breast cancer risk, necessitating dose optimization.
• Current practices require robust systems for internal auditing and dose monitoring.

Purpose of the Study:

• To establish a comprehensive Diagnostic Reference Level (DRL) system for screening mammography.
• To identify healthcare centers with elevated radiation doses requiring optimization.
• To create a tool for dose notification level assessment.

Main Methods:

• Retrospective analysis of screening mammography data from 2048 women across seven centers.
• Establishment of typical DRLs based on bilateral image views (LCC, RCC, LMLO, RMLO) and compressed breast thickness (CBT) criteria.
• Classification of CBT into eight groups (e.g., <20 mm to 90-110 mm) and calculation of local DRLs per view and CBT group.

Main Results:

• A comprehensive DRL system was built using 8877 mammography images.
• Significant dose variations were found among the seven healthcare centers.
• Local DRLs for the 60-69 mm CBT group were 1.24 mGy (LCC), 1.23 mGy (RCC), 1.34 mGy (LMLO), and 1.32 mGy (RMLO).

Conclusions:

• The developed DRL system is efficient, user-friendly, and clinically effective.
• The system successfully identified at least one center needing optimization per bilateral image view and CBT group.
• Implementation of this DRL system supports radiation dose optimization in screening mammography.