Browsing by Author "Dalah, Entesar Z"

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Establishing Diagnostic Reference Levels for Mammography Digital Breast Tomosynthesis, Contrast Enhance, Implants, Spot Compression, Magnification and Stereotactic Biopsy in Dubai Health Sector
(MDPI AG, 2025-03-07) Dalah, Entesar Z
The aim of this patient dose review is to establish a thorough diagnostic reference level (DRL) system. This entails calculating a DRL value for each possible image technique/view considered to perform a diagnostic mammogram in our practice. Diagnostic mammographies from a total of 1191 patients who underwent a diagnostic mammogram study in our designated diagnostic mammography center were collected and retrospectively analyzed. The DRL representing our health sector was set as the median of the mean glandular dose (MGD) for each possible image technique/view, including the 2D standard bilateral craniocaudal (LCC/RCC) and mediolateral oblique (LMLO/RMLO), the 2D bilateral spot compression CC and MLO (RSCC/LSCC and RSMLO/LSMLO), the 2D bilateral spot compression with magnification (RMSCC/LMSCC and RMSMLO/LMSMLO), the 3D AcademicEditor: ManuelCurado Received: 30January2025 Revised: 20February2025 Accepted: 4March2025 Published: 7 March2025 Citation: Dalah,E.Z.; Alkaabi, M.K.; Antony,N.A.;Al-Awadhi,H.M. Establishing Diagnostic Reference Levels for MammographyDigital Breast Tomosynthesis, Contrast Enhance, Implants, SpotCompression, MagnificationandStereotactic Biopsy in DubaiHealthSector. J. Imaging 2025, 11, 79. https://doi.org/10.3390/ jimaging11030079 Copyright: ©2025bytheauthors. Licensee MDPI,Basel,Switzerland. This article is an open access article distributed under the termsand conditions of the Creative Commons Attribution (CC BY)license (https://creativecommons.org/ licenses/by/4.0/). digital breast tomosynthesis CC and MLO (RCC/LCC and RMLO/LMLO), the 2D bilateral implant CC and MLO(RIMCC/LIMCCandRIMMLO/LIMMLO),the2Dbilateralcontrast enhanced CC and MLO(RCECC/LCECCandRCEMLO/LCEMLO)andthe2Dbilateral stereotactic biopsy guided CC (SBRCC/SBLCC). This patient dose review revealed that the highest MGD wasassociated with the 2D bilateral spot compression with magnification (MSCC/MSMLO)imageview. Forthecompressedbreastthickness (CBT) group 60–69 mm, the median and 75th percentile of the MGD values obtained were MSCC: 3.35 and 3.96, MSMLO:4.14 and 5.25 mGy respectively. Obvious MGD variations were witnessed across the different possible views even for the same CBT group. Our results are in line with the published DRLs when using same statistical quantity and CBT group.
Screening Mammography Diagnostic Reference Level System According to Compressed Breast Thickness: Dubai Health
(2024-08) Dalah, Entesar Z
Abstract Screening mammography is considered to be the most effective means for the early detection of breast cancer. However, epidemiological studies suggest that longitudinal exposure to screening mammography may raise breast cancer radiation-induced risk, which begs the need for optimization and internal auditing. The present work aims to establish a comprehensive well-structured Diagnostic Reference Level (DRL) system that can be confidently used to highlight healthcare centers in need of urgent action, as well as cases exceeding the dose notification level. Screening mammographies from a total of 2048 women who underwent screening mammography at seven different healthcare centers were collected and retrospectively analyzed. The typical DRL for each healthcare center was established and defined as per (A) bilateral image view (left craniocaudal (LCC), right craniocaudal (RCC), left mediolateral oblique (LMLO), and right mediolateral oblique (RMLO)) and (B) structured compressed breast thickness (CBT) criteria. Following this, the local DRL value was established per the bilateral image views for each CBT group. Screening mammography data from a total of 8877 images were used to build this comprehensive DRL system (LCC: 2163, RCC: 2206, LMLO: 2288, and RMLO: 2220). CBTs were classified into eight groups of <20 mm, 20-29 mm, 30-39 mm, 40-49 mm, 50-59 mm, 60-69 mm, 70-79 mm, 80-89 mm, and 90-110 mm. Using the Kruskal-Wallis test, significant dose differences were observed between all seven healthcare centers offering screening mammography. The local DRL values defined per bilateral image views for the CBT group 60-69 mm were (1.24 LCC, 1.23 RCC, 1.34 LMLO, and 1.32 RMLO) mGy. The local DRL defined per bilateral image view for a specific CBT highlighted at least one healthcare center in need of optimization. Such comprehensive DRL system is efficient, easy to use, and very clinically effective.
Typical and Local Diagnostic Reference Levels for Chest and Abdomen Radiography Examinations in Dubai Health Sector
(MDPI AG, 2025-01-13) Dalah, Entesar Z
Chest and abdomen radiographs are the most common radiograph examinations conducted in the Dubai Health sector, with both involving exposure to several radiosensitive organs. Diagnostic reference levels (DRLs) are accepted as an effective safety, optimization, and auditing tool in clinical practice. The present work aims to establish a comprehensive projection and weight-based structured DRL system that allows one to confidently highlight healthcare centers in need of urgent action. The data of a total of 5474 adult males and non-pregnant females who underwent chest and abdomen radiography examinations in five different healthcare centers were collected and retrospectively analyzed. The typical DRL (TDRL) for each healthcare center was established and defined per projection (chest: posterior anterior (PA), anterior–posterior (AP) and lateral (LAT); abdomen: erect and supine) for a weight band (60–80 kg) and for the whole data (no weight band). Local DRL (LDRL) values were established per project for the selected radiograph for the whole data (no weight band) and the 60–80 kg population. Chest radiography data from 1755 (60–80 kg) images were used to build this comprehensive DRL system (PA: 1471, AP: 252, and LAT: 32). Similarly, 611 (60–80 kg) abdomen radiographs were used to establish a DRL system (erect: 286 and supine: 325). The LDRL values defined per chest and abdomen projection for the weight band group (60–80 kg) were as follows: chest—0.51 PA, 2.46 AP, and 2.13 LAT dGy·cm2 ; abdomen—8.08 for erect and 5.95 for supine dGy·cm2 . The LDRL defined per abdomen projection for the 60–80 kg weight band highlighted at least one healthcare center in need of optimization. Such a system is efficient, easy to use, and very effective clinically.