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Mean glandular dose

From Wikipedia, the free encyclopedia

In mammography, mean glandular dose (MGD) is a quantity used to describe the absorbed dose of radiation to the breast. It is based on a measurement of air kerma and conversion factors. MGD can be calculated from measurements made with poly(methyl methacrylate) (PMMA) blocks. It is often used to compare typical doses to patients between different centres or internationally, and is the preferred measure of the potential risk from mammography.[1][2][3]

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Transcription

One of the most common reasons that I see people in my consulting room is because they're worried about swollen gland, and usually they're talking about swollen glands in their necks. I suspect the reason so many people worry about swollen glands is that they know that they can be a symptom of cancer. Well here's the good news: they almost always mean something much less scary. So let's think a little bit about what they are so we can understand why you get them, and what you need to look out for basically your glands, or "lymph glands" or "lymph nodes" are kind of like stations on a complicated railway network and the railway lines are your lymph channels. Now those lymph channels are filled with a fluid called lymph, and they carry the white blood cells which help your body to fight off infection around your body if you get an infection in one part or if your body spots an "invader" it activates your body's immune system, your defense mechanisms, and they send white cells rushing to the spot. They'll congregate at that Station, that lymph node, and that's why glands swell. If your slim you may be able to feel normal size glands actually they're about the size of a pea or a bit smaller and some of them are just underneath the skin whereas others are buried deep inside the inside of your tummy and inside your chest but those ones that you can feel, are mostly in the armpits in the groin and round the head and neck now, you have title tracks of lymph glands which go behind there and a little group in front of your ears you have more underneath the chin and yet more just above your collar bone here. We also have a chain which goes round the back of your scalp, right at the bottom there. so there are lots and lots of glands, and actually if you feel one, it may not be enlarged at all however by far the most common reason for lymph glands to get swollen is infection, and that does cause enlargement. Kids who have a lot of tonsillitis or sore throats, their glands will be going up and down like that all the time. If you have an infection it'll often make your glance well very quickly because your body is rushing very quickly to the spot those glands will not only be large, but then also be tender now which glands will be swollen will depend on where the infection is so for instance your whole leg cranes to the limp glands in your groin, so an infection in your toe could cause swollen glands in your groin. Very much less likely, breast cancer, or an infection in your breast, drains to the lymph glands in your armpit so it could cause inflammation if those ones there. Obviously, sore throats could also cause swollen glands inside your neck, but so too can say an infection on the skin of your scalp. Cancer much less commonly causes inflammation. Some infections like glandular fever can make all your glands swell, some cancers, such as cancer of the lymph system itself can make all your glands swell but those swollen glands tend in cancer to be much more slow growing, and they don't end to be tender at least at first. So how do you know if you do need to worry? Well certainly if you've got an infection and you've got swollen glands you can pretty much always be sure that that's why you've got the infection. Have a look on Patient.co.UK if you've got a sore throat to find out whether you've got tonsillitis for instance which often causes swollen glands and whether or not you need antibiotics for that. if you've got a source of infection and the lymph gland settle within a couple of weeks of the infection settling, you don't need to worry, but if you don't have an obvious cause of infection if the lymph glands swell and don't settle within a couple of weeks and if you have other symptoms like being generally unwell losing weight, night sweats, or fevers, do see a GP

Calculation

MGD can be calculated from a measured incident air kerma at the top of the breast, , as follows:[4]

converts from incident air kerma to MGD, with a glandularity of 50%, based on breast thickness and HVL. corrects for glandularity other than 50%, depending on the breast thickness and HVL, with two versions for ages 50–64 and 40–49. corrects for the x-ray spectra in use with a table of target/filter combinations.[4][5]

Applications

MGD is typically used to define limits on mammography exposures by national and international organisations such as the European Union and International Atomic Energy Agency, at <2.5 milligray (mGy) per exposure to a standard breast (4.5 cm PMMA).[6]

In routine quality assurance testing of mammographic equipment, MGD measurements for a range of effective breast thicknesses with PMMA, and from real patient exposures, is widely recommended.[2]

References

  1. ^ Yaffe, Marlin J.; Barnes, Gary T.; Conway, Burton J.; Haus, Arthur G.; Karellas, Andrew; Kimme-Smith, Carolyn; Paul Lin, Pei-Jan; Mawdsley, Gordon; Rauch, Phillip; Rothenberg, Lawrence N. (1990). Equipment requirements and quality control for mammography. New York, NY: American Association of Physics in Medicine. ISBN 978-0-883188-07-1.
  2. ^ a b Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos (4 August 2013). "Quality assurance and quality control in mammography: a review of available guidance worldwide". Insights into Imaging. 4 (5): 539–553. doi:10.1007/s13244-013-0269-1. PMC 3781250. PMID 23912879.
  3. ^ "Quality assurance guidelines for mammography including radiographic quality control". Public Health England. 2006.
  4. ^ a b IAEA (2011). Quality assurance programme for digital mammography. Vienna: International Atomic Energy Agency. ISBN 978-92-0-111410-5.
  5. ^ Dance, D R; Skinner, C L; Young, K C; Beckett, J R; Kotre, C J (1 November 2000). "Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol". Physics in Medicine and Biology. 45 (11): 3225–3240. Bibcode:2000PMB....45.3225D. doi:10.1088/0031-9155/45/11/308. PMID 11098900.
  6. ^ Health & Consumer Protection, Directorate-General (2006). Perry, N (ed.). European guidelines for quality assurance in breast cancer screening and diagnosis (4th ed.). Luxembourg: Office for Official Publ. of the Europ. Communities. p. 203. ISBN 978-92-79-01258-7.
This page was last edited on 6 May 2023, at 08:15
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