title: Latin American dose survey results in mammography studies under IAEA programme: radiological protection of patients in medical exposures (TSA3).
abstract: Latin American countries (Argentina, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Paraguay, Uruguay and Venezuela) working under the International Atomic Energy Agency (IAEA) Technical Cooperation Programme: TSA3 Radiological Protection of Patients in Medical Exposures have joined efforts in the optimisation of radiation protection in mammography practice. Through surveys of patient doses, the region has a unique database of diagnostic reference levels for analogue and digital equipment that will direct future optimisation activities towards the early detection of breast cancer among asymptomatic women. During RLA9/057 (2007-09) 24 institutions participated with analogue equipment in a dose survey. Regional training on methodology and measurement equipment was addressed in May 2007. The mean glandular dose (DG) was estimated using the incident kerma in air and relevant conversion coefficients for both projections craneo caudal and mediolateral oblique (CC and MLO). For Phase 2, RLA9/067 (2010-11), it was decided to include also digital systems in order to see their impact in future dose optimisation activities. Any new country that joined the project received training in the activities through IAEA expert missions. Twenty-nine new institutions participated (9 analogue and 20 digital equipment). A total of 2262 patient doses were collected during this study and from them D(G) (mGy) for both projections were estimated for each institution and country. Regional results (75 percentile in mGy) show for CC and MLO views, respectively: RLA9/057 (analogue) 2.63 and 3.17; RLA/067: 2.57 and 3.15 (analogue) and 2.69 and 2.90 (digital). Regarding only digital equipment for CC and MLO, respectively, computed radiography systems showed 2.59 and 2.78 and direct digital radiography (DDR) systems 2.78 and 3.04. Based on the IAEA Basic Safety Standard (BSS) reference dose (3 mGy), it can be observed that there is enough room to start optimisation processes in Latin America (LA); several countries or even particular institutions have values much higher than the 3 mGy. The main issues to address are lack of well-established quality assurance programmes for mammography, not enough medical physicists with training in mammography, an increase in patient doses with the introduction of digital equipment and to create awareness on radiation risk and optimisation strategies.
authors.affiliation: Centro de Investigación en Ciencias Atómicas, Nucleares y Moleculares, University of Costa Rica, San Pedro, San Jose, Costa Rica patricia.mora@ucr.ac.cr.
authors.forename: Patricia
authors.initials: P
authors.lastname: Mora
authors.affiliation: Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
authors.forename: Susana
authors.initials: S
authors.lastname: Blanco
authors.affiliation: Universidade Federal de Pernambuco, Recife, Brazil.
authors.forename: Helen
authors.initials: H
authors.lastname: Khoury
authors.affiliation: Faculty of Health and Odontology, Diego Portales University, Santiago, Chile and Radiological Sciences Center, Health Sciences Faculty, Tarapaca University, Arica, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Leyton
authors.affiliation: Centro de Protección e Higiene de las Radiaciones (CPHR), La Habana, Cuba.
authors.forename: Juan
authors.initials: J
authors.lastname: Cárdenas
authors.affiliation: Hospital Oncológico SOLCA Nucleo de Quito, Quito, Ecuador.
authors.forename: María Yolanda
authors.initials: MY
authors.lastname: Defaz
authors.affiliation: Unidad Reguladora de Radiaciones Ionizantes, Ministerio de Salud, El Salvador.
authors.forename: Fernando
authors.initials: F
authors.lastname: Garay
authors.affiliation: Dirección General de Energía (DGE), Ministerio de Energía y Minas, Cuidad de Guatemala, Guatemala.
authors.forename: Flaviano
authors.initials: F
authors.lastname: Telón
authors.affiliation: Instituto Nacional de Investigaciones Nucleares, Mexico DF, Mexico.
authors.forename: Juan Garcia
authors.initials: JG
authors.lastname: Aguilar
authors.affiliation: Laboratorio de Física de Radiaciones y Metrologia, Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua.
authors.forename: Norma
authors.initials: N
authors.lastname: Roas
authors.affiliation: Ministerio de Salud Pública y Bienestar Social, Asuncion, Paraguay.
authors.forename: Mirtha
authors.initials: M
authors.lastname: Gamarra
authors.affiliation: Centro de Investigaciones Nucleares, Asunción, Uruguay.
authors.forename: Daniel
authors.initials: D
authors.lastname: Blanco
authors.affiliation: Hospital Oncológico 'Dr. Luis Razetti', Caracas, Venezuela.
authors.forename: Ana Rosa
authors.initials: AR
authors.lastname: Quintero
authors.affiliation: Radiation Protection of Patient Unit, NSRW, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Nader
mesh_terms: D001943:Breast Neoplasms; D005260:Female; D006306:Health Surveys; D006801:Humans; D007390:International Agencies; D007843:Latin America; D008327:Mammography / Q000379:methods*; D009678:Nuclear Energy; D011829:Radiation Dosage; D011835:Radiation Protection / Q000592:standards*