N. A. Alomairy et al.: Radioprotection 2026, 61( 2), 132 – 139 137
MGD values and quartile distribution suggests that the majority of patients received doses within a narrow range, indicating consistency in the quality of mammography performed. Compared to studies in other countries, this study’ s CBT values were relatively lower. The Saudi CBT values( 39.7 mm for CC and 52.7 mm for MLO) were on the lower end of the range compared to Iran, Sudan, and Uganda( Abdallah et al., 2021, Odongo et al., 2024; Riabi et al., 2010). This may be related to regional differences in body composition, breast density, or population demographics. For example, elevated CBT values for Sudan( Abdallah et al., 2021) and Iran( Riabi et al., 2010) can be explained by either local somatotypes, lifestyle factors, or the different age structures of the samples. Furthermore, the variations in the number of subjects and geographical range could also affect the values reported.
The decreasing MGD values reflect the proper utilization of optimized imaging protocols and modern technology in Saudi Arabia in accordance with the ALARA principle that aims to minimize radiation exposure while maintaining image quality. Our findings suggest that Saudi mammographic screening programs are already in compliance with some global standards for radiation protection and dose optimization. These findings will guide future studies and improve clinical practices in mammography for better patient outcomes in the field of breast cancer screening.
5 Limitations and future works
Further optimization of mammography techniques for the purpose of lowering the doses of radiation while still being of diagnostic quality is required. The population sample size could also be expanded in future studies to include various kinds of breast density, age, and risk categories. One limitation of this study is the absence of breast density data, which was not available in the PACS and therefore not included in the analysis. Future investigations should incorporate breast density assessment to better understand its influence on MGD. Additionally, there could be the long-term follow-up of patients exposed to cumulative doses in repeated mammography examinations regarding efficacy and safety. Future studies should also investigate the impact of different target / filter combinations and AEC modes on MGD. These technical settings can significantly influence dose optimization and image quality. Future studies will endeavor to combine diagnostic performance and image quality grading( e. g., the European Quality Criteria or the reduction of contrast-detail phantoms) with dose evaluation. Finally, comparing it with other imaging methodologies � such as contrast enhancement in mammography or MRI related to dose consideration, diagnostic performance, and patient safety may prove beneficial. These alternatives offer the possibility of lower radiation exposure and the potential for improved awareness of sensitivity for dense breasts.
6 Conclusion
This study emphasizes the importance of balancing image quality and patient safety by assessing MGD and ESD in routine mammography examinations. From this data, it has been observed that the MGD values in this study are far below the average international benchmarks, reflecting good dose management and thus confirming the sample location’ s conformity to the diagnostic reference levels. The discrepancies in dose between CC and MLO projections are largely because of differences in breast thickness and the presence of the pectoralis muscle in MLO images. This indicates the importance of regular quality control and precise dosimetric assessment to minimize radiation risks while maintaining diagnostic accuracy. This paper illustrates that, even using worldwide standards and optimization of exposure settings, there is a great potential for reducing patient radiation exposure.
Funding
The author gratefully acknowledges the funding of the Deanship of Graduate Studies and Scientific Research, Jazan University, Saudi Arabia, through Project Number: GSSRD-24.
Conflicts of interest
The author declares no conflicts of interest in relation to this article.
Data availability statement
The datasets used and / or analysed during the current study available from the corresponding author on reasonable request.
Author contribution statement
NA was responsible for the study’ s conception, design, and implementation, as well as manuscript preparation, revision, findings interpretation, final approval, and overall project management. RA, SH, SA, WA, and AS played a crucial role in data collection, and analysis. All authors reviewed, contributed to, and approved the final manuscript.
Ethics approval
All ethical considerations were adhered to, including obtaining approval from the Local Committee for Research Ethics at Jazan University( Reference number: REC-46 / 06 / 1244).
Informed consent
Because of the retrospective nature of the data collection, the individual patient consent requirement was waived for this study.
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