Diagnostic reference levels for mammography now a step closer
Radiation dose benchmarks — or as they are known in health care, diagnostic reference levels (DRLs) — help hospitals and clinics reduce unnecessary radiation exposure for patients during medical imaging. Currently, Australia has official DRLs for coronary angiography, CT scans, nuclear medicine and PET scans, but none for mammography. Now, with the publication in an academic journal of the country’s first 3D mammography radiation dose benchmarks, Australia is a step closer to mammography DRLs.
2D mammography is the predominant method for breast cancer screening services, but this study involved a type of 3D mammography — called digital breast tomosynthesis (DBT). DBT offers better visualisation of breast tissue and is, therefore, the standard scan for people who are experiencing breast cancer symptoms or have a high risk of breast cancer.
The published set of benchmarks — by Michelle Kostidis, Peter Barnes, Julie Nguyen and Molly O’Donohue — were developed through analysis of 9000+ anonymised images. Through their analysis, the researchers found that variation in radiation dose was closely linked to how thick each patient’s breast was when compressed. Accordingly, the radiation dose benchmarks represent four different compressed breast thickness measurements, as is shown in the following table:
| Compressed breast thickness | Radiation dose |
|---|---|
| 13–49 mm | 1.5 mGy |
| 50–74 mm | 2.70 mGy |
| 75–99 mm | 3.90 mGy |
| 100–118 mm | 4.70 mGy |
“We know breast tissue is particularly radiosensitive. Tracking the radiation dose patients receive during DBT scans is really important for quality assurance and patient safety,” said Bianca Magill, a Board Director at the Australian Society of Medical Imaging and Radiation Therapy and mammographer who regularly performs DBT scans on patients. “This research represents the first step towards diagnostic reference levels. More studies contributing further data and analysis will lead to important standards in Australian mammography.”
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‘Local diagnostic reference levels in digital breast tomosynthesis’ has been published open access in Journal of Medical Radiation Sciences and you can read it at doi.org/10.1002/jmrs.892.
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