Mohd Norsuddin Norhashimah, Segar Sharveeni, Ravintaran Rathieswari, Mohd Zain Norhayati, Abdul Karim Muhammad Khalis
Center for Diagnostic, Therapeutic and Investigative Studies (CODTIS), Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Medical Imaging Department, School of Health Sciences, KPJ Healthcare University College, Lot PT 17010, Persiaran Seriemas, Kota Seriemas, Nilai 71800, Malaysia.
Healthcare (Basel). 2022 Sep 30;10(10):1917. doi: 10.3390/healthcare10101917.
A set of national diagnostic reference levels (DRLs) was established in Malaysia for a range of breast thicknesses in 2013, but no updates for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT). Due to the increasing number of DBTs used and concern over radiation exposure, this study aimed to explore and establish local diagnostic reference levels for FFDM and DBT in Malaysia health facilities at different compressed breast thickness (CBT) ranges. The CBT, kilovoltage peak (kVp), Entrance surface dose (ESD), and average glandular dose (AGD) were retrospectively extracted from the mammography Digital Imaging and Communications in Medicine (DICOM) header. The 75th and 95th percentile values were obtained for the AGD distribution of each mammography projection for three sets of CBT range. The difference in AGD values between FFDM and DBT at three CBT ranges was determined. The DRLs for FFDM were 1.13 mGy, 1.52 mGy, and 2.87 mGy, while DBT were 1.18 mGy, 1.88 mGy, and 2.78 mGy at CBT ranges of 20−39 mm, 40−59 mm, and 60−99 mm, respectively. The AGD of DBT was significantly higher than FFDM for both mammographic views (p < 0.005). All three CBT groups showed a significant difference in AGD values for FFDM and DBT (p < 0.005). The local DRLs from this study were lower than the national DRLs, with the AGD of FFDM significantly lower than DBT.
2013年，马来西亚针对一系列乳房厚度制定了一套国家诊断参考水平（DRLs），但针对全场数字化乳腺摄影（FFDM）和数字乳腺断层合成（DBT）未进行更新。由于DBT的使用数量不断增加以及对辐射暴露的担忧，本研究旨在探索并确定马来西亚医疗机构中不同压缩乳房厚度（CBT）范围内FFDM和DBT的本地诊断参考水平。从乳腺摄影数字成像和通信医学（DICOM）头文件中回顾性提取CBT、峰值千伏（kVp）、体表入射剂量（ESD）和平均腺体剂量（AGD）。针对三组CBT范围，获取每个乳腺摄影投影AGD分布的第75百分位数和第95百分位数。确定了三个CBT范围内FFDM和DBT之间AGD值的差异。在CBT范围为20 - 39毫米、40 - 59毫米和60 - 99毫米时，FFDM的DRLs分别为1.13毫戈瑞、1.52毫戈瑞和2.87毫戈瑞，而DBT的DRLs分别为1.18毫戈瑞、1.88毫戈瑞和2.78毫戈瑞。对于两种乳腺摄影视图，DBT的AGD均显著高于FFDM（p < 0.005）。所有三个CBT组在FFDM和DBT的AGD值上均存在显著差异（p < 0.005）。本研究中的本地DRLs低于国家DRLs，FFDM的AGD显著低于DBT。
