Dalah Entesar Z, Alkaabi Maryam K, Al-Awadhi Hashim M, Antony Nisha A
HQ Diagnostic Imaging Department, Dubai Health, Dubai 2727, United Arab Emirates.
College of Medicine, Mohammed Bin Rashid University, Dubai Health, Dubai 2727, United Arab Emirates.
J Imaging. 2024 Aug 5;10(8):188. doi: 10.3390/jimaging10080188.
Screening mammography is considered to be the most effective means for the early detection of breast cancer. However, epidemiological studies suggest that longitudinal exposure to screening mammography may raise breast cancer radiation-induced risk, which begs the need for optimization and internal auditing. The present work aims to establish a comprehensive well-structured Diagnostic Reference Level (DRL) system that can be confidently used to highlight healthcare centers in need of urgent action, as well as cases exceeding the dose notification level. Screening mammographies from a total of 2048 women who underwent screening mammography at seven different healthcare centers were collected and retrospectively analyzed. The typical DRL for each healthcare center was established and defined as per (A) bilateral image view (left craniocaudal (LCC), right craniocaudal (RCC), left mediolateral oblique (LMLO), and right mediolateral oblique (RMLO)) and (B) structured compressed breast thickness (CBT) criteria. Following this, the local DRL value was established per the bilateral image views for each CBT group. Screening mammography data from a total of 8877 images were used to build this comprehensive DRL system (LCC: 2163, RCC: 2206, LMLO: 2288, and RMLO: 2220). CBTs were classified into eight groups of <20 mm, 20-29 mm, 30-39 mm, 40-49 mm, 50-59 mm, 60-69 mm, 70-79 mm, 80-89 mm, and 90-110 mm. Using the Kruskal-Wallis test, significant dose differences were observed between all seven healthcare centers offering screening mammography. The local DRL values defined per bilateral image views for the CBT group 60-69 mm were (1.24 LCC, 1.23 RCC, 1.34 LMLO, and 1.32 RMLO) mGy. The local DRL defined per bilateral image view for a specific CBT highlighted at least one healthcare center in need of optimization. Such comprehensive DRL system is efficient, easy to use, and very clinically effective.
乳腺筛查钼靶被认为是早期发现乳腺癌最有效的手段。然而，流行病学研究表明，长期接受乳腺筛查钼靶检查可能会增加乳腺癌的辐射诱发风险，这就需要进行优化和内部审核。目前的工作旨在建立一个全面且结构良好的诊断参考水平（DRL）系统，该系统可用于可靠地找出需要紧急采取行动的医疗中心，以及超过剂量通知水平的病例。收集并回顾性分析了在七个不同医疗中心接受乳腺筛查钼靶检查的2048名女性的筛查钼靶图像。根据（A）双侧图像视图（左侧头尾位（LCC）、右侧头尾位（RCC）、左侧内外斜位（LMLO）和右侧内外斜位（RMLO））和（B）结构化压缩乳腺厚度（CBT）标准，为每个医疗中心确定并定义了典型的DRL。在此之后，根据每个CBT组的双侧图像视图确定了局部DRL值。总共8877幅图像的乳腺筛查钼靶数据用于构建这个全面的DRL系统（LCC：2163幅、RCC：2206幅、LMLO：2288幅和RMLO：2220幅）。CBT被分为八组，分别为<20毫米、20 - 29毫米、30 - 39毫米、40 - 49毫米、50 - 59毫米、60 - 69毫米、70 - 79毫米、80 - 89毫米和90 - 110毫米。使用Kruskal - Wallis检验，在提供乳腺筛查钼靶检查的所有七个医疗中心之间观察到了显著的剂量差异。CBT组60 - 69毫米的双侧图像视图定义的局部DRL值为（1.24 LCC、1.23 RCC、1.34 LMLO和1.32 RMLO）毫戈瑞。为特定CBT的双侧图像视图定义的局部DRL突出显示了至少一个需要优化的医疗中心。这样的全面DRL系统高效、易于使用且临床效果显著。
