Congress:
EuroSafe Imaging 2019
Keywords:
Action 2 - Clinical diagnostic reference levels (DRLs), Action 4 - Dose management systems, Breast, Radioprotection / Radiation dose, Mammography, Dosimetry, Technology assessment, Dosimetric comparison
Authors:
A. Viñals Muñoz, R. Fayos-Sola Capilla, P. Garcia Castañon, I. GALÁN GONZALEZ, C. Idoate Ortueta, C. Ansón Marcos, D. Hernández González, M. L. España López
DOI:
10.26044/esi2019/ESI-0097
Background/introduction
Mammography is the most effective technique for breast cancer detection,
but entails by itself cancer induction risk; therefore,
it is essential to optimize patient doses.
European directive EURATOM 2013/59 (1) emphasizes the implementation and review of Diagnostic Reference Levels (DRLs) use as an optimization tool for diagnostic radiology procedures like mammography.
According to International Commission of Radiation Protection (ICRP) recommendations,
DRLs in a single facility (2) can be established by means of the median value of a distribution for the selected dosimetric quantity.
The establishment of adequate DRLs require the acquisition of a representative patient dose sample,
which is not always easy to achieve.
In fact,
ICRP recommends to include at least 50 patients (2) to establish DRLs in mammography,
due to the great variation of the compressed breast thickness and glandularity. The development of dose management programmes (DMP),
which allow the massive data exploitation,
have nowadays facilitated the establishment and periodical review of local DRLs.
Several dose management online systems have been developed over the last decade by different manufacturers.
The information attached to the digital images in the DICOM header is extracted by those programmes,
including for each modality specific dosimetric quantities.
Generally,
for mammography,
the dosimetric quantities selected are the Entrance Surface Dose (ESD),
Entrance Surface Air Kerma (ESAK) and Average Glandular Dose (AGD).
Digital mammographic units provide,
for each exposition,
with dosimetric indices that consist of an estimation of those quantities.
These indices can be easily extracted by DMP.
The aim of this study is the evaluation of patient radiation dose monitoring online systems as a suitable tool for local DRL establishment in mammography.