Evaluation of Image Quality and Mean Glandular Dose for Patients Undergoing Mammography X-Ray Examination at Tikur Anbessa Specialized Hospital, Ethiopia
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Date
2025-07-01
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Addis Ababa University
Abstract
Background: Breast cancer is the most commonly diagnosed cancer and the most common cause of cancer related death in women. Mammography is the imaging modality of choice for early breast cancer detection at curable stage. But acquiring good quality mammograms are challenging to obtain because of poor contrast between normal and pathologic breast tissues. Furthermore, inappropriate mammographic technique can lead to unnecessary high radiation dose to the breast tissue and poor image quality resulting in incorrect diagnoses and high number of unnecessary biopsies. The mammography unit at Addis Ababa University, Tikur Anbessa Specialized Hospital, may produce poor-quality mammography images with the highest breast doses. Hence, the objective of this study was to assess the image quality and breast doses in all mammography practices at Tikur Anbessa Specialized Hospital. Methods: The sample size was determined based on the International Commission for Radiation Protection (ICRP) recommendations for conducting such studies. According to the ICRP, patient dose surveys should include at least 50 patients. Technical parameters for each patient, such as peak kilovoltage, compressed breast thickness, and milliampere seconds for each patient was recorded by data collectors. Remaining data on phantom image quality was gathered using various exposure modes and tube potentials. Furthermore, a variety of criteria are used to assess the clinical image quality of each mammogram, including the ability to clearly see the nipple and pectoralis muscle among others. The collected and cleaned data were entered into SPSS (version 27) and analyzed. P-value < 0.05 was considered statistically significant. Results: The average calculated mean glandular dose for the craniocaudal (CC) view was 1.153 mGy ranging between 0.436-1.929 mGy. The average calculated mean glandular dose for the mediolateral oblique (MLO) view was 1.217 mGy ranging between 0.457- 2.210 mGy. The average clinical image quality for CC and MLO was 78 and 80 % respectively. The phantom image quality turned out to be 4 fibers,3 simulated specks of calcifications, and 3 masses. Conclusion: The study concluded that the mammography unit at Tikur Anbesssa Specialized Hospital has kept the radiation exposure below the level recommended by the American College of Radiology (<3mGy) while achieving good image quality. Additionally, it validated the close comparison between computed mean glandular dose (MGD) and machine recorded MGD, indicating that machine recorded MGD can be used to follow radiation exposure, saving time and resources.
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Mammography, Compressed breast thickness, Mean glandular dose, peak kilovoltage, miliampereseconds Craniocaudal, Mediolateral oblique.