Evaluation of scatter radiation dose to eye lens and thyroid gland from digital mammography

Main Article Content

Patamaporn Molee
Panatsada Awikunprasert
Naruporn Marukatat
Vithit Pungkun

Abstract

Background: Digital mammography is a well-established screening examination for breast cancer due to its high sensitivity and specificity. However, digital mammography uses X-ray which is an ionizing radiation that can cause injury to all types of cells. In the patient positioning for mammography, the radiosensitive organs such as eye lens and thyroid gland are close to the radiation beam. Therefore, it is necessary to measure the scattered radiation dose to monitor and control the exposure within the standard limit.


Objectives: To study the scatter radiation dose of eye lens and thyroid gland and absorbed doses of breasts in patients undergoing digital mammography at Vajira Hospital, Bangkok, Thailand.

Materials and methods: Optically Stimulated Luminescent (OSL) dosimeters were taped to the patient's skin over the right and left lateral canthal angles, right and left thyroid lobes of 60 women (age range, 40–70 years) to measure the scattered radiation dose at each location in two routine mammographic projections; the cranial–caudal and the mediolateral oblique projections. The accumulated OSL dosimeters from patients were analyzed on a dosimeter reader. Breast compression thickness, compression force, average entrance skin dose, and glandular dose displayed on the mammography unit were recorded for each projection.


Results: The average scatter radiation dose to the skin overlying the right and left lateral canthal angles were 0.082 and 0.076 mGy, the right and left thyroid lobes were 0.929 and 0.883 mGy respectively. We found that the average scatter radiation doses were not exceed the radiation protection standards. On average, patients receive a glandular dose (AGD) of about 2.64 mGy. AGD was not exceed the dose limit recommended by the ACR where AGD of an ACR accreditation phantom shall not exceed 3 mGy. The average absorbed dose of breasts in digital mammography at Vajira Hospital was within the standard level. Meanwhile, the mean entrance skin dose was 9.96 mGy closer to the limit set by the IAEA, which was specified not to exceed 10 mGy for breasts of thickness between 4 and 6 cm.


Conclusion: The scatter radiation dose and absorbed doses determined through our study were within the standard level. Maximum visibility, especially for the signs of pathology, was achieved by imaging protocols that optimize the procedure and balance the quality requirements with the radiation dose to the patient. Monitoring of radiation dose in mammography reduces the risk of ionizing radiation and promotes the quality of public health services.

Article Details

How to Cite
Molee, P., Awikunprasert, P. ., Marukatat, N., & Pungkun, V. (2021). Evaluation of scatter radiation dose to eye lens and thyroid gland from digital mammography. Journal of Associated Medical Sciences, 54(3), 66–72. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/248929
Section
Research Articles

References

Insamran W, Sangrajrang S. National Cancer Control Program of Thailand. Asian Pacific Journal of Cancer Prevention. 2020; 21(3): 577-82.

Aekplakorn W. Breast Cancer Screening. Journal of Health Science. 2016; 25(4): 2.

Coldman A, Phillips N, Wilson C, Decker K, Chiarelli AM, Brisson J, et al. Pan-Canadian Study of Mammography Screening and Mortality from Breast Cancer. JNCI: Journal of the National Cancer Institute. 2014; 106(11).

Andolina V, Lillé S. Mammographic Imaging: A Practical Guide: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2011.

Ciatto S, Houssami N, Bernardi D, Caumo F, Pellegrini M, Brunelli S, et al. Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. The Lancet Oncology. 2013; 14(7): 583-9.

Houssami N, Skaane P. Overview of the evidence on digital breast tomosynthesis in breast cancer detection. The Breast. 2013; 22(2): 101-8.

Carbonaro LA, Di Leo G, Clauser P, Trimboli RM, Verardi N, Fedeli MP, et al. Impact on the recall rate of digital breast tomosynthesis as an adjunct to digital mammography in the screening setting. A double reading experience and review of the literature. European Journal of Radiology. 2016; 85(4): 808-14.

Chetlen AL, Brown KL, King SH, Kasales CJ, Schetter SE, Mack JA, et al. Journal Club: Scatter Radiation Dose From Digital Screening Mammography Measured in a Representative Patient Population. American Journal of Roentgenology. 2016; 206(2): 359-64; quiz 65.

Lim CS, Lee SB, Jin GH. Performance of optically stimulated luminescence Al2O3 dosimeter for low doses of diagnostic energy X-rays. Applied Radiation and Isotopes. 2011; 69(10): 1486-9.

Okazaki T, Hayashi H, Takegami K, Okino H, Kimoto N, Maehata I, et al. Fundamental Study of nanoDot OSL Dosimeters for Entrance Skin Dose Measurement in Diagnostic X-ray Examinations. Journal of Radiation Protection and Research. 2016; 41(3): 229-36.

Siu AL. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine. 2016; 164(4): 279-96.

Awikunprasert P, Chandaeng T, Kuepitak K, Pungkun V, Kianprasit J. Radiation Dose and Dose Distribution from Fluoroscopy: Phantom Study. Srinagarind Medical Journal. 2019; 34(6): 565-73.

Kawaguchi A, Matsunaga Y, Suzuki S, Chida K. Energy dependence and angular dependence of an optically stimulated luminescence dosimeter in the mammography energy range. Journal of Applied Clinical Medical Physics. 2017; 18(2): 191-6.

Mettler FA. Medical effects and risks of exposure to ionising radiation. Journal of Radiological Protection. 2012; 32(1): N9-n13.

The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Annals of the ICRP. 2007; 37(2-4): 1-332.

Chusin T, Matsubara K, Takemura A, Okubo R, Ogawa Y. Assessment of scatter radiation dose and absorbed doses in eye lens and thyroid gland during digital breast tomosynthesis. Journal of Applied Clinical Medical Physics. 2019; 20(1): 340-7.

Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleiman NJ, Macvittie TJ, et al. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs--threshold doses for tissue reactions in a radiation protection context. Annals of the ICRP. 2012; 41(1-2): 1-322.

Yuan MK, Chang SC, Hsu LC, Pan PJ, Huang CC, Leu HB. Mammography and the risk of thyroid and hematological cancers: a nationwide population-based study.The Breast Journal. 2014; 20(5): 496-501.

Theerakul K, Krisanachinda A. Radiation dose from digital breast tomosynthesis system. Chulalongkorn Medical Journal. 2014; 58(3): 235-45.

RMK MA, England A, Tootell AK, Hogg P. Radiation dose from digital breast tomosynthesis screening - A comparison with full field digital mammography. J Med Imaging Radiat Sci. 2020; 51(4): 599-603.

Berns EA, Pfeiffer DE, Butler PF, Adent C, Baird R, Baker JA, et al. Digital Mammography Quality Control Manual. 2nd ed. Reston, Va: American College of Radiology; 2018.

Optimization of the Radiological Protection of Patients: Image Quality and Dose in Mammography (Coordinated Research in Europe). Vienna: International Atomic Energy Agency; 2005.