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Access type: UnknownAuthor: search.filters.author.Arifi, Mirjeta Mediji

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    Diagnostic reference levels (DRLs) in digital mammography in the European context – a systematic review
    (Walter de Gruyter GmbH, 2025-08-28)
    Arifi, Mirjeta Mediji
    ;
    Ristova, Mimoza M.
    This systematic review examines the establishment of Diagnostic Reference Levels (DRLs) in digital mammography across 18 European countries, based on studies from 2005-2025. A total of 353 articles were identified through the comprehensive search of academic networks: Google Scholar, PubMed, Research Gate, Academia. Only 18 peer-reviewed studies met inclusion criteria – reporting Mean Glandular Dose (MGD)-based DRLs from Finland to Malta. Eight studies used patient data, four used phantom measurements, and six used both. To overcome the challenging comparison of the variety of reported parameters, we undertook some data harmonisation procedures, focusing on a common Compressed Breast Thickness (CBT) range of 50-59 mm. The DRLs varied notably by country, with 75th percentile MGDs ranging from 1.1 to 2.6 mGy and 95th percentile from 1.6 to 2.9 mGy, averaging to 1.44 mGy, which is lower than the achievable European level (2 mGy). The harmonisation approach enabled the derivation of a comparable dataset of average MGDs, facilitating cross-country comparisons and insights into radiation dose optimisation in digital mammography across Europe.
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    Breast Glandularity Distribution and Refining the Mean Glandular Dose Estimates in Digital Mammography
    (Ovid Technologies (Wolters Kluwer Health), 2025-10)
    Arifi, Mirjeta Mediji
    ;
    Background: In mammography, radiation dose is typically expressed as the mean glandular dose (MGD), which represents the dose delivered to the glandular tissue of the breast. Materials and Methods: This study compares MGD estimates obtained using three different methodologies: (I) MGD-Dance-Laboratory for Individualized Breast Radiodensity Assessment (LIBRA) – Calculated manually for each patient using Dance’s formula, incorporating mammographic breast density values derived from the LIBRA application, thereby replacing Dance’s standard glandularity assumption with image-specific values; (II) MGD-Dance – Calculated using Dance’s formula with the conventional assumption of 50% glandularity; (III) MGD-Displayed – Extracted directly from the Digital Imaging and Communication in Medicine header of each mammogram. Results: A total of 688 anonymized mammograms from 172 women undergoing routine screening were analyzed, with complete technical and patient-related data. The mean MGD values obtained by the three methods were: MGD-Dance-LIBRA: 2.97 mGy; MGD-Dance: 2.78 mGy; and MGD-Displayed: 2.81 mGy. The average glandularity across the dataset was estimated at 14%. A strong correlation was observed between MGD-Dance and MGD-Dance-LIBRA values (R² =0.9865). The refined dose estimation using image-specific glandularity from LIBRA consistently produced slightly higher values compared to the standard Dance method, highlighting the impact of the commonly assumed 50% glandularity, which overestimates the true average density. Conclusions: Incorporating individualized breast density estimates from the LIBRA application into Dance’s formula provides a more refined and accurate method for calculating MGD in digital mammography.