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Med. Pr. 2002;53(4)

Mammography in Łódź: doses received by patients and condition of diagnostic facilities

Mammografia w Łodzi - dawki dla pacjentek a stan aparatury diagnostycznej

Maria Anna Staniszewska, Sylwia Papierz

Abstract

Mammography is a radiodiagnostic technique that has been long recognized and highly praised, nevertheless it should be remembered that it is beneficial only if the X-ray picture quality ensures correct diagnosis and the dose received by patients is reasonably low.
The authors present the results of dose measurements in patients. The study covered 12 mammographs used in the Łódź radiological laboratories. Thermoluminescent dosimeters placed directly on the patientśs breast during the examination incranio-caudal projection were used for dose measurements. Although the measurements were taken only in patients with the compressed breast thickness close to 5 cm - a standard adopted for accreditation phantom - a sixfold difference between extreme dosevalues was observed (ranging from 4 to 24 mGy).
Nine mammographs were also tested for quality control according to the protocol consistent with the recommendations of the European Commission, and elaborated by the Department of Radiological Protection of the Nofer Institute of Occupational Medicine in Łódś. An improper functioning of the automatic exposure control, especially with respect to the selection of the amount of emitted radiation in relation to the thickness of the object examined, was found to be the most frequent defect (in 7 of the 9 mammographs). Regarding that so called automatic option of the apparatus is used in a large majority of examinations, this may denote poor picture quality or too high dose received by patients, and even wrong diagnosis.
In addition, the unsatisfactory quality of accredited phantom picture was found in three mammographs, which was equal to rather poor quality of clinical picture, and consequently a very limited legibility of anatomic details.
The results of the measurements show that a certain part of mammographic examinations is performed in a way far from being perfect. But an actual improvement of the present situation depends on ensuring permanent quality control and,even more important, on providing funds necessary to cover all costs involved in remedial interventions.

Key words

mammography, image-quality, doses, patients