Average Glandular Dose (AGD) and Radiation Dose Optimization in Screen-Film and Digital X-ray Mammography

We determined the average glandular dose (AGD) from the craniocaudally (CC) and mediolateral oblique (MLO) views of 496 breasts (247 women) at eight clinics in Sudan. The incident air kerma from the X-ray tube output values and the typical patient-specific breast exposure factors were measured. The AGD values were inferred from the measured incident air kerma and breast-specific dose-conversion coefficients. The AGD per CC and MLO projection and per woman ranged from 0.56 to 2.89 mGy (average: 1.36), 0.48 to 2.08 mGy (average: 1.19), and 2.08 to 9.94 mGy (average: 5.10). The proposed national diagnostic reference levels (mGy) for digital mammography are 1.8 and 1.6 mGy for CC and MLO projection, respectively. Establishing the proposed diagnostic reference levels is an essential step in ensuring patient protection from radiation and will help promote dose optimization for X-ray mammography at the national level and beyond. These results provide important baseline data that can be used to formulate national diagnostic reference levels.