From: Quality assurance and quality control in mammography: a review of available guidance worldwide
Dosimetry | Dose | ||||||
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Protocol ID | Technical (with test objects/phantom) | Clinical (with patient data) | Test equipment (dosimeters) | Quantities and units | AGD estimation | Conversion factors | Reference dose per projection |
Nordic | Standard breast model 45 mm PMMA equivalent to average breast (50 % adipose + 50 % glandular) | NA | IC | ESAK (mGy) and AGD or MGD (mGy) | AGD = ESD × conversion factors | Rosenstein (1985) | ≤0.8 mGy without grid |
≤2 with grid (OD = 1) | |||||||
EP | Standard breast model 45 ± 5 mm PMMA | 10 patients with a compressed breast thickness between 40 to 60 mm for dose measurements on patients with TLD | TLD or other dosimeter with a dynamic range 0.5–100 mGy | ESD (mGy), ESAK (mGy) and AGD or MGD (mGy | AGD = ESAK × gPB | Dance (1990) | 2.3 mGy for a standard phantom |
ACR | (1) Blocks of PMMA (20, 40, 60 and 80 mm) | NA | IC | Entrance Exposure estimated from technical factors recorded and tube output (mR/mAs) and MGD (mGy) | estimated for various thickness | Dance (1990); Wu (1991) and Sobol (1997) | ≤3 mGy (42 mm compressed breast thickness) |
(2) Standard breast Model 40-mm PMMA equivalent to 42 mm 50/50 mixture | |||||||
IPEM | (1) Blocks of PMMA (20-80 mm) | AGD for a series of breast examinations on each mammography system periodically. Data collection: breast thickness; kVp; mAs. Accuracy: ±2 mm | IC and electrometer | ESAK(K), AGD or MGD (mGy) | D = Kgcs | Dance (2000) for two age ranges 40–49 and 50-64 | 2 mGy (40 mm compressed breast thickness) |
(2) Standard breast model 45-mm PMMA, equivalent breast thickness 55 mm with 30 % glandularity | |||||||
EC | (1) Blocks of PMMA (20-80 mm) | AGD for a series of breast examinations on each mammography system. Data collection: breast thickness; kVp; mAs. Accuracy: ±2 mm | – | ESAK(K); AGD or MGD (mGy) | D = Kgcs | Dance (2000) for two age ranges 40–49 and 50-64 | 2.5 mGy for 45 mm |
(2) Standard breast model 45-mm PMMA, equivalent breast thickness 53 mm | |||||||
PQDCS | (1) Standard breast model 40-mm PMMA, equivalent to 42 mm 50/50 mixture | NA | IC and electrometer | Entrance Surface Dose (ESD) (mR); AGD or MGD (mrad/R) | AGD = ESD × conversion factors | Stanton (1984); Wu (1991, 1994) | ≤3 mGy for breast thickness of 42 mm |
IAEA-D | 45-mm thick PMMA phantom equivalent to ‘standard’ breast of thickness 50 mm and glandularity 50 % | A range of 10–50 patients. Reference requires that the compressed breast is between 40 and 60 mm thick, with a mean value of 50 ± 5 mm | IC or semiconductor Dosimeter or TLD | Incident air kerma, (mGy); Entrance surface air kerma (mGy); AGD or MGD (mGy) | DG = CDG50,Ki,PMMA sKi (standard breast) | Dance (2000) | – |
DG = cDG50,Ki. cDg,DG50.sKi (patient studies) | |||||||
BC NBSP | Blocks of PMMA (20–70 mm) | Based on IPSM89 (2005) and the European Protocol in Dosimetry in Mammography (1996) | IPSM89 (2005) and the European Protocol in Dosimetry in Mammography (1996) | ESAK(K); AGD or MGD (mGy) | D = Kgcs | Dance (2000) for two age ranges 40–49 and 50–64 | 2.5 mGy for 45 mm |
NQMCBSA | Standard phantom 42 mm 50 % adipose, 50 % glandular breast (i.e. ACR accreditation phantom) | – | – | – | – | – | ≤2.0 mGy for exposures made using typical clinical settings |
NHSBSP | (1) Blocks of PMMA (20–70 mm) | 50 patients recommended with a compressed breast thickness of 55 ± 5 mm; 10 patients should be included in the dose sample | – | ESAK(K); AGD or MGD (mGy) | D = Kgcs | Dance (2000) | 1 mGy for 20 mm PMMA; |
(2) Standard breast model 45-mm PMMA, equivalent breast thickness 53 mm | 2.5 mGy for 45 mm PMMA; | ||||||
6.5 mGy for 70 mm PMMA | |||||||
IAEA-SF | Standard breast model 45-mm PMMA, equivalent breast thickness 53 mm | NA | IC | ESAK(K); AGD or MGD (mGy) | D = Kgcs | Dance (2000) | Achievable: 2.0 mGy; |
Acceptable: 2.5 mGy | |||||||
IAEA-DM | Blocks of PMMA (20, 45, 70 mm) | NA | Calibrated detector at appropriated mammographic energies | Incident air kerma; AGD or MGD (mGy) | D = Kgcs | Dance (2000) | 1 mGy for 20 mm PMMA; 2.5 |
mGy for 45 mm PMMA; 6.5 | |||||||
mGy for 70 mm PMMA |