scholarly journals Evaluation of Radiation Doses and Estimation of the Risk of Radiation-Induced carcinogenesis in Women Undergoing Screening Mammography Examinations

2021 ◽  
Vol 14 (1) ◽  
pp. 249-255
Author(s):  
Zakaria Tahiri ◽  
Mounir Mkimel ◽  
Laila Jroundi ◽  
Fatima Zahra Laamrani
Keyword(s):  
Digital Mammography ◽  
Early Stage ◽  
Screening Mammography ◽  
International Standards ◽  
Microsoft Excel ◽  
Mean Glandular Dose ◽  
Radiation Induced ◽  
The Mean ◽  
Risk Of Cancer ◽  
Beir Vii

Digital Mammography is used as a screening tool to discover breast cancer at an early stage, the benefits and harms of this techniques is under scrutiny hence and Moroccan regulations governing radiation protection of patients have been strengthened, the need to investigate the dose received during screening mammography and the risk associated. This study is consisted of examining 126 mammography projections, for 63 women. All examinations were performed with a full digital mammography machine, technical and exposure parameters were recorded, statistical analysis was carried out using Microsoft Excel in order to calculate local DRLs and compare them with international standards. Cancer risk has been estimated using BEIR VII report methods. The mean glandular dose MGD was 1,09±0, 45 mGy and 1,26±0,74 mGy for craniocaudal (CC) and mediolateral oblique (MLO) respectively, DRLs were 1,34 for CC view and 1,36 for MLO view. Of the 100,000 women exposed, Lifetime Attributable Risk of cancer incidence has been found to be 0,76 for CC examination, 0.88 for MLO, and 1,64 for the full mammography protocol. Established local DRLs in this study are lower compared to that of United Kingdom and France and higher compared to that of Nigeria and Australia. A potential risk of radiation-induced carcinogenesis exists, and there is a need for optimization of screening mammography practices.

At Which Mean Glandular Dose Does the Benefit of Breast Cancer Deaths Averted Equal the Risk of Lives Lost to Screening From Radiation-induced Malignancy for Mammography With and Without Tomosynthesis?

2021 ◽  
Author(s):  
Matthew F Covington ◽  
Helen E Mrose ◽  
Matthew Brown
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Radiation Risk ◽  
Screening Mammography ◽  
Threshold Values ◽  
Mean Glandular Dose ◽  
Radiation Induced ◽  
Estimated Risk ◽  
Risk Ratios ◽  
Approximate Doubling

Abstract Objective To estimate benefit-to-radiation-risk mean glandular dose (MGD) equivalence values for screening mammography, defined as the yearly MGD (over a 10-year period) at which the estimated benefit of mammography in terms of deaths averted equals the estimated risk of lives lost to screening due to radiation exposure (a benefit-to-risk ratio of 1). Methods Benefit-to-risk ratios were calculated as the ratio of breast cancer deaths averted and lives lost to screening over 10-year intervals starting at age 40 for mammography and tomosynthesis using previously published methodology. The MGD values at which estimated benefit equals risk were tabulated. Results The MGD values at which benefit-to-risk equivalence points were met for digital screening mammography are 63 milligray (mGy) (ages 40–49), 88 mGy (ages 50–59), 176 mGy (ages 60–69), and 336 mGy (ages 70–79). The MGD values that met benefit-to-risk equivalence for screening tomosynthesis plus digital mammography or synthetic mammography are 80 mGy (ages 40–49), 111 mGy (ages 50–59), 224 mGy (ages 60–69), and 427 mGy (ages 70–79). Conclusion Cutoff MGD values at which the estimated benefit from screening equals the estimated risk are well above standard screening MGD exposures. Care is necessary to ensure that threshold values are not exceeded during a screening exam, particularly for women ages 40–49 years old when using digital mammography plus tomosynthesis (due to an approximate doubling of dose per exam that will more readily exceed cutoff MGD values) and when many additional views are obtained.

scholarly journals A comparison of selected dosimetric parameters of two Hodgkin Lymphoma radiotherapy techniques with reference to potential risk of radiation induced heart disease

2018 ◽  
Vol 24 (3) ◽  
pp. 121-126
Author(s):  
Elias Alibeyki ◽  
Saeid Karimkhani ◽  
Sepide Saadatmand ◽  
Parvaneh Shokrani
Keyword(s):  
Heart Disease ◽  
Hodgkin Lymphoma ◽  
Potential Risk ◽  
Dose Distribution ◽  
Early Stage ◽  
Organs At Risk ◽  
Young Patients ◽  
Mean Value ◽  
Radiation Induced ◽  
The Mean

Abstract Purpose: Hodgkin lymphoma (HL) is one of the most frequent malignancies among pediatric patients. One of the common causes of death in HL survivors after radiation therapy (RT), is radiation-induced heart disease (RIHD). The aim of this study was to compare several dosimetric parameters for two methods of early stage Hodgkin lymphoma radiotherapy with reference to potential risk of RIHD. Materials and Methods: Using a series of computed tomography slices of 40 young patients, treatment planning was done in two methods of HL RT, including involved field (IFRT) and involved site (ISRT) in doses of 20, 30, and 35 Gy. Contouring of clinical target volume as well as the organs at risk, including the heart, was performed by a radiation oncologist. The mean and maximum dose of heart (Dheart-mean and Dheart-max), the volume of heart receiving a dose more than 25 Gy (V25), and the standard deviation of dose as a dose homogeneity index in heart, were used to compare the RIHD risk. Results: The mean value for Dheart-mean in ISRT method in all doses was less compare to IFRT. Maximum reduction in mean value of Dheart-mean occurred at moving from 30 Gy IFRT to ISRT by 9.53 Gy (p < 0.001) and minimum was between 35 Gy IFRT and ISRT. The mean value for Dheart-max was fewer in IFRT rather than ISRT and the maximum difference was between 35 Gy IFRT and ISRT (1.35 Gy). The mean of V25 of heart was 26.66% and 23.74% in 35 Gy IFRT and ISRT, respectively, and dose distribution was more homogeneous in IFRT. Conclusions: If Dheart-max and V25 of heart or homogeneity of dose distribution in heart are considered as determining factors in RIHD, then IFRT can be considered optimum, especially in 35 Gy IFRT; while, assuming the Dheart-mean as the most important factor in RIHD, superiority of ISRT over IFRT is observed.

scholarly journals Late Radiation–Related Toxicities in Patients Treated for Early-Stage Cervical Carcinoma by Surgery and Adjuvant Radiotherapy: A Retrospective Imaging Study

2021 ◽  
Vol 27 ◽  
Author(s):  
Katarina Nadova ◽  
Miroslava Burghardtova ◽  
Klara Fejfarova ◽  
Klaudia Reginacova ◽  
Hana Malikova
Keyword(s):  
Cervical Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Inclusion Criteria ◽  
Imaging Results ◽  
The Mean ◽  
Risk Of Cancer ◽  
Tomography Scan

Surgical treatment is preferred therapy of early-stage cervical carcinoma. In the risk of cancer recurrence surgery is often followed by adjuvant radiotherapy. In our retrospective study we aimed at identifying late (≥6 months) and very late (≥5 years) radiation adverse effects on imaging scans as CT, PET/CT and MRI in patients who underwent successful treatment for cervical carcinoma by radical surgery combined with radiotherapy ± chemotherapy. We correlated imaging results with clinical manifestations. We selected young and middle-aged patients with long life expectancy, as late radiation-related toxicities may significantly affect their quality of life. Patients were selected from those who were primary diagnosed and treated between the years 1987–2011 and regularly visited our Oncology department in years 2011–2012. Following inclusion criteria were applied: age ≤55 years at diagnosis, clinical follow-up ≥5 years and at least one tomography scan ≥3 years after finished treatment. One hundred and three subjects were reviewed: 73 patients met all inclusion criteria, while 30 patients fulfilled the inclusion criteria except for available tomography scan ≥3 years after therapy. The mean imaging follow-up was 11.2 ± 7.6 years and the mean clinical follow-up was 15.0 ± 6.9 years. In 20 (27%) subjects 27 cases grade I radiation-related toxicities were found; 9 (33%) of those 27 cases were clinically silent. In 14 (19%) females only grade I toxicities were observed. Grade III-IV toxicities were found in 5 (6.8%) subjects. No grade V toxicities were observed. We concluded that severe late side effects caused by radiotherapy were exceedingly rare in females successfully treated for early-stage cervical carcinoma, only 1 bilateral osteonecrosis, 2 cases of ileus, and 2 potentially radiation-induced tumors were found. The majority of radiation-related comorbidities found on imaging scans were clinically silent.

Effect of Compression Force and Target or Target/Filter Combination on Mean Glandular Dose for Japanese Women in Full-Field Digital Mammography System

2021 ◽  
Vol 11 (10) ◽  
pp. 2695-2700
Author(s):  
Mie Ishii ◽  
Mai Nakamura ◽  
Rie Ishii ◽  
Keiichi Shida ◽  
Toshikazu Hatada ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Japanese Women ◽  
Compression Pressure ◽  
Full Field ◽  
Breast Compression ◽  
Mean Glandular Dose ◽  
Full Field Digital Mammography ◽  
The Mean ◽  
The Difference ◽  
Breast Thickness

We constructed a mammography database of 807 Japanese women and 2,772 images obtained using five commercial full-field digital mammography (FFDM) devices at four different facilities. Five types of mammography devices fabricated by four manufacturers were used: one with a Mo target (AMULET F), one with Mo and Rh targets (Senographe DS), one with Mo and W targets (AMULET), and two with a W target (MAMMOMAT Fusion and Selenia Dimensions). The purpose of this study was to focus on the mean glandular dose (MGD) in the database and analyze the difference in the MGD of Japanese women radiographed by mammographic devices with different targets or target/filter combinations. Furthermore, we clarify the difference between the displayed and measured MGDs for the three types of mammography devices. The average compression pressure and compression breast thickness of the Japanese women in the mammography in this study were 90.9±21.7 N and 43.3±12.9 mm, respectively. The breast compression pressure slightly varied depending on the facility or FFDM device, while the compression breast thickness decreased with the increase in the compression pressure for all FFDM devices. Differences in breast compression thickness existed depending on the mammography devices. The MGDs of the two types of mammography devices using the W target were smallest (1.335±0.358, 1.218±0.464 mGy). The displayed and measured MGDs of the three types of FFDM devices had a good correlation. However, the difference between the displayed and measured MGDs of the two devices increased with the MGD.

The evolution of breast cancer screening in the Medicare population: Clinical and economic implications.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1595-1595
Author(s):  
Brigid K. Killelea ◽  
Jessica B. Long ◽  
Xiaomei Ma ◽  
Rong Wang ◽  
Anees B. Chagpar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Early Stage ◽  
Early Period ◽  
Stage At Diagnosis ◽  
Economic Implications ◽  
Medicare Program ◽  
Significant Difference ◽  
The Mean

1595 Background: Breast screening has evolved as newer approaches to mammography, ultrasound, and MRI have diffused into clinical practice. The use of these technologies and their impact on screening-related costs and outcomes remain undefined, particularly among older women. Methods: Using the Surveillance Epidemiology and End Results – Medicare linked database, we identified women aged 66 and older without a diagnosis of breast cancer. We constructed two cohorts (2001 vs. 2006) and followed each for two years. We assessed changes in imaging technology, screening-related costs (defined as costs for screening and subsequent imaging and testing, adjusted to 2009 USD), and stage at diagnosis between the two cohorts. Results: There were 136,845 women in the 2001-2002 (earlier) cohort and 137,733 in the 2006-2007 (later) cohort. The mean age was 76.9 and 77.2 respectively, (p<.001). The proportion of women receiving any screening mammogram was 42.5% in the earlier cohort and 43.4% in the later cohort, (p<.001). The use of digital mammography for screening increased from 2.2% to 15.0%, (p<.001). The use of any computer aided detection (CAD) increased from 3.2% to 29.3% (p<.001). MRI use increased from 0.03% to 0.2%, and ultrasound use from 4.0% to 4.5% (p <.001 for both). Average screening-related cost increased 31%, from $101 to $132 (p<.001). There was no significant difference in early stage at diagnosis over time (58.1% of women were in situ/stage I in early period vs. 57.2% in later period, p=.65). Conclusions: The use of digital mammography and CAD increased substantially between 2001 and 2007, contributing to a 31% increase in screening-related costs for women in the Medicare program. The increased cost of screening and downstream testing must be evaluated in context of an absence of benefit in terms of stage at diagnosis.

scholarly journals Relationship of the Mean Glandular Dose with Compressed Breast Thickness in Digital Mammography

2020 ◽  
Vol 10 (1) ◽  
pp. 11-15
Author(s):  
Samjhana Khadka ◽  
Anamika Jha ◽  
Ranjit Kumar Chaudhary ◽  
Shanta Lall Shrestha
Keyword(s):  
Pearson Correlation ◽  
Mean Value ◽  
Age Group ◽  
Dose Equivalent ◽  
Mean Glandular Dose ◽  
Radiation Induced Cancer ◽  
Radiation Induced ◽  
The Mean ◽  
Relationship Of ◽  
Breast Thickness

Introduction: Mammography is one of the most commonly performed radiological investigations for evaluation of breast cancer. As it involves ionizing radiation, there remains a risk of radiation induced cancer. In this study, we evaluated compressed breast thickness (CBT) and mean glandular dose (MGD) during routine mammography. Methods: This prospective study was performed in the Department of Radiology and Imaging of TUTH. Data of 500 consecutive patients who underwent mammography over a period of 4 months (June 2018 to September 2018) was collected. The age, CBT and MGD were recorded. Pearson correlation and paired-t tests were performed. Results: Most of the patients belonged to 41-50 years age group. MGD was significantly higher in patients with increased CBT. The CBT and MGD was higher in MLO view compared to CC views. The mean value of total MGD for four views was 5.1±1.4 mGy. There was significant positive correlation (r= 0.517) between CBT and MGD with increase in MGD with increase in CBT. Conclusions: The MGD and dose equivalent in our routine mammography is within the recommended limits. MGD increases with increasing CBT and vice-versa. Hence, decreasing the thickness of compressed breast, can decrease the amount of radiation absorbed by the glandular tissue of the breast.  

scholarly journals Comparison of Mean Glandular Dose between Full-Field Digital Mammography and Digital Breast Tomosynthesis

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1758
Author(s):  
Kar Choon Teoh ◽  
Hanani Abdul Manan ◽  
Norhashimah Mohd Norsuddin ◽  
Iqbal Hussain Rizuana
Keyword(s):  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Mean Glandular Dose ◽  
Full Field Digital Mammography ◽  
Dose Monitoring ◽  
Significant Difference ◽  
Radiation Induced ◽  
Breast Thickness

Early detection of breast cancer is diagnosed using mammography, the gold standard in breast screening. However, its increased use also provokes radiation-induced breast malignancy. Thus, monitoring and regulating the mean glandular dose (MGD) is essential. The purpose of this study was to determine MGD for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the radiology department of a single centre. We also analysed the exposure factors as a function of breast thickness. A total of 436 patients underwent both FFDM and DBT. MGD was auto calculated by the mammographic machine for each projection. Patients’ data included compressed breast thickness (CBT), peak kilovoltage (kVp), milliampere-seconds (mAs) and MGD (mGy). Result analysis showed that there is a significant difference in MGD between the two systems, namely FFDM and DBT. However, the MGD values in our centre were comparable to other centres, as well as the European guideline (<2.5 mGy) for a standard breast. Although DBT improves the clinical outcome and quality of diagnosis, the risk of radiation-induced carcinogenesis should not be neglected. Regular quality control testing on mammography equipment must be performed for dose monitoring in women following a screening mammography in the future.

scholarly journals Determine Cumulative Radiation Dose and Lifetime Cancer Risk in Marfan Syndrome Patients Who Underwent Computed Tomography Angiography of the Aorta in Northeast Thailand: A 5-Year Retrospective Cohort Study

Tomography ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. 120-130
Author(s):  
Narumol Chaosuwannakit ◽  
Phatraporn Aupongkaroon ◽  
Pattarapong Makarawate
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Cancer Risk ◽  
Lifetime Risk ◽  
Surveillance Imaging ◽  
Radiation Induced Cancer ◽  
Cumulative Radiation Dose ◽  
Radiation Induced ◽  
The Mean ◽  
Risk Of Cancer

Objective: To evaluate computed tomography angiography (CTA) data focusing on radiation dose parameters in Thais with Marfan syndrome (MFS) and estimate the distribution of cumulative radiation exposure from CTA surveillance and the risk of cancers. Methods: Between 1st January 2015 and 31st December 2020, we retrospectively evaluated the cumulative CTA radiation doses of MFS patients who underwent CTA at Khon Kaen University Hospital, a leading teaching hospital and advanced tertiary care institution in northeastern Thailand. We utilized the Radiation Risk Assessment Tool (RadRAT) established at the National Cancer Institute in Bethesda, Maryland, to evaluate the risk of cancer-related CTA radiation. Results: The study recruited 29 adult MFS patients who had CTA of the aorta during a 5-year study period with 89 CTA studies. The mean cumulative CTDI vol is 21.5 ± 14.68 mGy, mean cumulative DLP is 682.2 ± 466.7 mGy.cm, the mean baseline future risk for all cancer is 26,134 ± 7601 per 100,000, and the excess lifetime risk for all cancer is 2080.3 ± 1330 per 100,000. The excess lifetime risk of radiation-induced cancer associated with the CTA surveillance study is significantly lower than the risk of aortic dissection or rupture and lower than the baseline future cancer risk. Conclusions: We attempted to quantify the radiation-induced cancer risk from CTA surveillance imaging performed for MFS patients in this study, with all patients receiving a low-risk cumulative radiation dose (less than 1 Gy) and all patients having a low excessive lifetime risk of cancer as a result of CTA. The risk–benefit decision must be made at the point of care, and it entails balancing the benefits of surveillance imaging in anticipating rupture and providing practical, safe treatment, therefore avoiding morbidity and mortality.

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