Alrousan R, Alakhras M, Alzyoud K
Department of Applied Medical Sciences, Faculty of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, 21410, Jordan.
Department of Applied Medical Sciences, Faculty of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, 21410, Jordan.
Radiography (Lond). 2025 Aug 23;31(6):103131. doi: 10.1016/j.radi.2025.103131.
Diagnostic reference levels (DRLs) are one of the most important radiation protection methods in medical imaging to help optimize radiation exposure during imaging procedures. The study aimed to establish national DRL for digital mammography (DM) and digital breast tomosynthesis (DBT) in Jordan, considering variations in compressed breast thickness (CBT) and breast density.
The exposure parameters, average glandular dose (AGD), CBT, breast density, and viewing projection were extracted. The mean, median, 75th, and 95th percentiles were obtained for the AGD distribution of each projection for DM and DBT at three CBT ranges and two density categories. The difference in AGD between DM and DBT was determined.
The proposed national DRLs in Jordan for DM in CC view were 2.29, 1.78, and 2.40 mGy, while for MLO view were 1.17, 1.47, and 2.02 mGy at CBT ranges of 4-39, 40-59, 60-99 mm, respectively. For DBT in CC view, the DRLs were 2.17, 2.69, and 3.52 mGy, while in MLO view, the DRLs were 2.29, 2.67, and 3.49 mGy for the respective CBT ranges. The overall AGD of DBT was significantly higher compared to DM (P < 0.05). The AGD of high-density breasts was higher than low-density breasts for both DM and DBT (P < 0.001).
The proposed national DRLs in Jordan were higher than those reported in the literature, with AGD higher for DBT than that of DM.
Although the DRLs in Jordan remain below the International Atomic Energy Agency (IAEA) reported DRL, the fact that they exceed the previously established DRLs indicates a need for rigorous calibration and dose optimization methods to minimize unnecessary exposures, particularly in hospitals where the DRLs were near the DRLs set by the IAEA.
诊断参考水平（DRLs）是医学成像中最重要的辐射防护方法之一，有助于在成像过程中优化辐射暴露。本研究旨在考虑乳房压缩厚度（CBT）和乳房密度的变化，建立约旦数字乳腺摄影（DM）和数字乳腺断层合成（DBT）的国家诊断参考水平。
提取曝光参数、平均腺体剂量（AGD）、CBT、乳房密度和观察投影。获得了DM和DBT在三个CBT范围和两种密度类别下每个投影的AGD分布的均值、中位数、第75百分位数和第95百分位数。确定了DM和DBT之间AGD的差异。
约旦提出的DM在CC位的国家诊断参考水平在CBT范围为4 - 39、40 - 59、60 - 99 mm时分别为2.29、1.78和2.40 mGy，在MLO位分别为1.17、1.47和2.02 mGy。对于DBT在CC位，诊断参考水平分别为2.17、2.69和3.52 mGy，在MLO位，相应CBT范围的诊断参考水平分别为2.29、2.67和3.49 mGy。DBT的总体AGD显著高于DM（P < 0.05）。对于DM和DBT，高密度乳房的AGD均高于低密度乳房（P < 0.001）。
约旦提出的国家诊断参考水平高于文献报道的水平，DBT的AGD高于DM。
尽管约旦的诊断参考水平仍低于国际原子能机构（IAEA）报告的诊断参考水平，但它们超过了先前确定的诊断参考水平这一事实表明，需要严格的校准和剂量优化方法，以尽量减少不必要的暴露，特别是在诊断参考水平接近IAEA设定的诊断参考水平的医院。
