J Radiol Prot. 2025 Nov 25. doi: 10.1088/1361-6498/ae23d9. Online ahead of print.
ABSTRACT
Breast tissue is highly sensitive to ionizing radiation, making dose management in mammography crucial to reducing the risk of radiation-induced cancer and hereditary effects. Dose optimisation, guided by the ALARA principle, aims to minimise exposure while maintaining diagnostic quality. This study focuses on establishing National Diagnostic Reference Levels (NDRLs) for digital mammography in Nepal to support dose optimisation efforts. A retrospective analysis was conducted using data from 786 patients across six hospitals equipped with digital mammography systems. Both symptomatic and screening mammograms in cranial-caudal (CC) and mediolateral oblique (MLO) views were included for both breasts. Mean glandular dose (MGD) and entrance skin dose (ESD) were extracted from DICOM headers. For each mammogram view, data from a minimum of 50 patients were analysed. Technical parameters such as tube voltage (kVp), tube current (mAs), compression force (CF), and compressed breast thickness (CBT) were also documented. The established NDRLs for digital mammography are 1.03 mGy (RCC), 1.02 mGy (LCC), 1.18 mGy (RMLO), and 1.15 mGy (LMLO). The mean CBT and CF are 56±13 mm and 122±29 N, respectively. The overall NDRLs for CC and MLO views are 1.03 mGy and 1.17 mGy. Comparisons with other countries highlight the potential for further dose optimization to maintain diagnostically adequate images at lower exposure levels. Implementing such strategies can reduce patient radiation dose in digital mammography without compromising diagnostic performance.
PMID:41289610 | DOI:10.1088/1361-6498/ae23d9
