Ciraj-Bjelac Olivera, Beciric Snezana, Arandjic Danijela, Kosutic Dusko, Kovacevic Milojko
Radiation and Environmental Protection Department, Vinca Institute of Nuclear Sciences, 12-14 M. P. Alasa Str., Vinca, PO Box 522, 11001 Belgrade, Serbia.
Radiat Prot Dosimetry. 2010 Jun;140(1):75-80. doi: 10.1093/rpd/ncq040. Epub 2010 Feb 16.
The primary objective of this study is to investigate the actual mammography dose levels in Serbia and establish a baseline dose database for the future screening programme. The mean glandular dose (MGD) was assessed for standard size breast substituted by 45 mm polymethyl methacrylate (PMMA) phantom and imaged under typical clinical conditions at 30 screen-film mammography facilities. Average MGD was (1.9 +/- 1.0) mGy, with a range of 0.12-5.2 mGy. These results were used for the calculation of the initial diagnostic reference levels in mammography in Serbia, which was set to 2.1 mGy for a standard breast. At some facilities, high doses were observed and the assessed MGD was supplemented by a patient dose survey. MGD was measured for 53 women having a diagnostic mammography in cranio-caudal (CC) and mediolateral oblique (MLO) projections at the largest mammography facilities in Serbia. The parameters recorded were: age, compressed breast thickness, tube potential (in kV), tube loading (in mAs) and the MLO projection angle. The average MGD per image was 2.8 mGy for the CC projection and 4.3 mGy for the MLO projection. Dose to breast was compared with dose for PMMA phantoms of various sizes, assessed at the same facilities. The results have indicated that phantom dose values can assist in setting optimisation activities in mammography. Both phantom and patient dose values indicated unnecessary high doses in facilities with an extremely high mammography workload. For these facilities, urgent dose-reduction measures and follow-up actions were recommended.
本研究的主要目的是调查塞尔维亚的实际乳腺钼靶剂量水平，并为未来的筛查计划建立一个基线剂量数据库。使用45毫米聚甲基丙烯酸甲酯（PMMA）体模替代标准尺寸乳房，在30家屏-片乳腺钼靶检查设施的典型临床条件下进行成像，评估平均腺体剂量（MGD）。平均MGD为（1.9±1.0）mGy，范围为0.12 - 5.2 mGy。这些结果用于计算塞尔维亚乳腺钼靶检查的初始诊断参考水平，标准乳房的该水平设定为2.1 mGy。在一些设施中观察到高剂量情况，并通过患者剂量调查对评估的MGD进行补充。在塞尔维亚最大的乳腺钼靶检查设施中，对53名进行乳腺诊断性钼靶检查的女性在头尾位（CC）和内外斜位（MLO）投照下测量MGD。记录的参数有：年龄、乳房压缩厚度、管电压（千伏）、管负荷（毫安秒）和MLO投照角度。CC投照每张图像的平均MGD为2.8 mGy，MLO投照为4.3 mGy。将乳房剂量与在相同设施评估的各种尺寸PMMA体模的剂量进行比较。结果表明，体模剂量值有助于在乳腺钼靶检查中开展优化活动。体模和患者剂量值均表明，在乳腺钼靶检查工作量极大的设施中存在不必要的高剂量。对于这些设施，建议采取紧急剂量降低措施和后续行动。
