Xu Hui, Yue Baorong, Cheng Jinsheng, Deng Jun, Su Yinping, Zhao Qiaoqiao, Xue Ke, Feng Zechen, Niu Yantao, Sun Quanfu
Key Laboratory of Radiological Protection and Nuclear Emergency Chinese Center for Disease Control and Prevention, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China.
Beijing Center for Diseases Prevention and Control, Beijing, China.
Health Phys. 2024 Nov 1;127(5):600-606. doi: 10.1097/HP.0000000000001853. Epub 2024 Jul 24.
The primary purpose of this study was to report the mean glandular doses and to determine the national diagnostic reference levels for digital mammography based on data between 2016 and 2018 in China. The data from 19,076 mammograms (4,769 examinations) by random sampling from 118 digital mammography systems were compiled. Exposure factors included age, compressed breast thickness, kVp, mAs, target/filter combination, entrance surface air kerma, and mean glandular doses, which were retrospectively surveyed and recorded from the monitor. The national diagnostic reference levels (75th percentiles) in mean glandular dose were calculated across median value obtained for all included data and stratified to specific compressed breast thickness ranges. The patients' ages ranged from 22 to 88 y, with a median age of 45. The applied voltage and output medians were 28 kVp and 75.1 mAs for all exposure, respectively. The median CBTs were 45 mm and 48 mm for craniocaudal views and mediolateral oblique views, and the corresponding median mean glandular doses were 1.32 mGy and 1.40 mGy, respectively. The national diagnostic reference level at compressed breast thickness of 40-50 mm was 1.67 mGy for CC views and 1.71 mGy for MLO views. The median mean glandular doses varied significantly and increased with compressed breast thickness, demonstrating the necessity of establishing DRL according to breast thickness and optimizing the clinic's digital mammography practice in China.
本研究的主要目的是报告平均腺体剂量，并根据2016年至2018年中国的数据确定数字化乳腺摄影的国家诊断参考水平。从118台数字化乳腺摄影系统中随机抽取19076例乳房X线照片（4769次检查）的数据进行汇总。暴露因素包括年龄、乳房压缩厚度、管电压、管电流时间积、靶/滤过组合、体表空气比释动能和平均腺体剂量，这些数据通过回顾性调查从监测器中记录下来。根据所有纳入数据的中位数计算平均腺体剂量的国家诊断参考水平（第75百分位数），并按特定的乳房压缩厚度范围分层。患者年龄在22岁至88岁之间，中位年龄为45岁。所有曝光的管电压和输出量中位数分别为28 kVp和75.1 mAs。头尾位视图和内外侧斜位视图的乳房压缩厚度中位数分别为45 mm和48 mm，相应的平均腺体剂量中位数分别为1.32 mGy和1.40 mGy。乳房压缩厚度为40 - 50 mm时，头尾位视图的国家诊断参考水平为1.67 mGy，内外侧斜位视图为1.71 mGy。平均腺体剂量中位数变化显著，并随乳房压缩厚度增加，这表明在中国有必要根据乳房厚度建立诊断参考水平并优化临床数字化乳腺摄影实践。
