Portuguese Study Of Mean Glandular Dose In Mammography And Comparison With European References

To characterise the mean glandular dose (MGD) in a sample of healthcare providers for digital mammography in Portugal. To compare the achieved values with European references. The MGD was measured on a poly-methyl-methacrylate phantom (45 mm) for each system using dosimeters. In addition, MGD was estimated using exposure settings collected from mammography exams in clinical context. Data were collected from 25 computed-radiography systems (CR) and 13 integrated digital (DR). For both measurements (phantom and clinical exposures), the average MGD for CR was higher compared to the DR. For CR the mean MGD was 1.85 mGy (CC projection) and 2.10 mGy (MLO projection). For DR systems the corresponding values were 1.54 mGy (CC) and 1.68 mGy (MLO). The average MGD obtained using both methods and for both technologies is within the acceptable reference range proposed by European guidelines (<2.5 mGy). Dose Reference Levels implementation should be the next step to optimise mammography practice in Portugal

Overview of the radiographers’ practice in 65 healthcare centers using digital mammography systems in Portugal

Purpose: To assess current practices in digital mammography (DM) in Portuguese healthcare providers using digital systems. To investigate compliance with European standards regarding mean glandular dose and quality control practice and to identify optimisation needs. Methods: Two questionnaires, targeted at breast radiographers and chief radiographers, were designed and applied in 65 imaging departments offering DM. Questions fielded were focused on the staff profile and technical/ clinical practice. Results: Prior to starting their activity in DM, 70% (82 out of 118) of the respondents received training in DM. The practice in 29 out of 59 providers was established by the manufacturers’ recommendations for image acquisition. Variations were observed between radiographers who belong to the same provider namely the selection of exposure parameters such as the target-filter combination and automatic mode. The use of the manual exposure mode was reported for imaging breast implants (44%) and surgical specimens (22%). The main causes of repeat examinations were skin folding (21%) and absence of pectoral muscle (PM) (20%). Conclusions: The study revealed opportunities to optimise radiographers’ practice in DM regarding the selection of exposure parameters. A robust and consistent training programme in DM and established local protocols can help to reduce the variations observed and improve clinical practice