A model-based method for reporting mammographic diagnostic reference levels for any compressed breast thickness: A...

Area of Science:

• Medical Imaging
• Radiological Physics
• Radiation Safety

Background:

• Mammography is vital for early breast cancer detection, but involves ionizing radiation requiring dose monitoring.
• Conventional diagnostic reference levels (DRLs) use broad compressed breast thickness (CBT) ranges, limiting precise radiation dose optimization.
• Individual variations in CBT hinder the effectiveness of current DRL reporting methods.

Purpose of the Study:

• To develop a novel equation-based method for determining diagnostic reference levels (DRLs) applicable to any compressed breast thickness (CBT).
• To enhance the precision of mammographic radiation dose optimization by addressing individual patient variations.

Main Methods:

• Utilized the 75th percentile of median average glandular dose (AGD) from 187,704 mammograms across nine centers.
• Compared three DRL estimation approaches: a simple range, DRLs per 10-mm CBT ranges, and a proposed DRL equation derived from curve fitting.
• Assessed the reliability and differences in DRL estimations across the evaluated methods.

Main Results:

• A bi-exponential equation with high reliability (R² > 0.98) was established for DRL estimation based on CBT.
• The equation approach yields continuous DRL values for any specific CBT.
• Significant discrepancies were observed, with the equation approach showing potential dose differences exceeding 35% and 175% compared to range-based methods.

Conclusions:

• The proposed DRL equation approach offers superior precision for any CBT compared to conventional range-based methods.
• This equation-based DRL system can automate mammographic dose optimization when integrated by vendors.
• The findings support a more individualized and effective approach to radiation safety in mammography.