## 5 Conclusions  
This study revealed significant differences in radiation dose levels between hospitals and within the same hospital for the same type of examination. This is important when establishing recommendations for dose optimization. The results presented here provide the first dosimetric information related to AGD per CC and MLO projections in mammography and per woman in the country. The average breast thickness reported in this study can be used as the standard for Sudanese women. These results constitute important steps when protecting patients from radiation exposure and will help promote dose optimization in X-ray mammography nationally and beyond. This study provides important baseline data for dose optimization and setting national diagnostic reference levels. The present study reveals the need for projects that establish consistency in mammographic practice across all sites before any further dose audits.  
\begin{table}
\begin{tabular}{c c c c c c} \hline \multirow{2}{*}{**Data Origin**} & \multirow{2}{*}{**Sample**} & \multirow{2}{*}{**Mean CBT (mm)**} & \multicolumn{2}{c}{**AGD (mGy)**} & \multirow{2}{*}{**Ref.**} \\ \cline{3-3} \cline{5-6}  & & & **per View** & & **per Woman** \\ \hline \multirow{2}{*}{Spain} & \multirow{2}{*}{5034} & CC: 49.0 & Mean CC:1.8 & \multirow{2}{*}{Mean MLO:1.95} & \multirow{2}{*}{Mean 3.75} & [28] \\  & & MLO:54 & Mean MLO:1.95 & & & \\ \hline \multirow{2}{*}{Australia} & \multirow{2}{*}{42.0} & \multirow{2}{*}{Mean:1.6} & Mean: 4.6 & \multirow{2}{*}{[29]} \\  & & & & Mean CC:1.2 & \\  & & & Mean MLO:1.5 & & \\ \hline \multirow{2}{*}{Malta} & \multirow{2}{*}{759} & CC:53.8 & Mean CC:1.06 & \multirow{2}{*}{Mean 2.13} & \multirow{2}{*}{[31]} \\  & & MLO63.4 & Mean MLO:1.07 & & \\ \hline \multirow{2}{*}{Serbia} & \multirow{2}{*}{53} & CC:49.5 & Mean CC:2.8 & \multirow{2}{*}{Mean 7.1} & \multirow{2}{*}{[32]} \\  & & MLO:56 & Mean MLO:4.3 & & \\ \hline \multirow{2}{*}{Iran} & \multirow{2}{*}{298} & CC:49.7 & Mean CC:2.0 & \multirow{2}{*}{Mean 4.4} & \multirow{2}{*}{[33]} \\  & & MLO:58.5 & Mean MLO:2.4 & & \\ \hline \multirow{2}{*}{Ireland} & \multirow{2}{*}{2910} & CC:60.5 & Mean CC:1.27 & \multirow{2}{*}{Mean 2.61} & \multirow{2}{*}{[34]} \\  & & MLO:63 & Mean MLO:1.34 & & \\ \hline \multirow{2}{*}{Malaysia} & \multirow{2}{*}{300} & CC:37.51 & Median CC:1.44 & \multirow{2}{*}{mean: 3.37} & \multirow{2}{*}{[35]} \\  & & MLO:44.5 & Median MLO: 1.65 & & \\ \hline \multirow{2}{*}{Sudan} & \multirow{2}{*}{247} & CC:38 & Mean:CC = 1.36 & \multirow{2}{*}{Mean 5.10} & \multirow{2}{*}{This} \\  & & MLO:43 & MLO = 1.19 & & \\ \hline \end{tabular}
\end{table}
Table 4: Comparison of MGD values obtained in this study with the results presented in similar studies in the literature.  
**Author Contributions:** Conceptualization, I.I.S., N.A.A. and E.B.; methodology, S.M., A.M. and A.F.; validation, M.A.I. and N.H.; formal analysis, A.F. and M.K.M.A.; investigation, N.H., N.A.A. and E.B.; resources, S.M. and A.M.; data curation: S.M. and A.M.; writing--original draft preparation, M.A.I., M.K.M.A., A.F. and N.H.; writing--review and editing, I.I.S., E.B. and N.A.A.; visualization, N.H.; supervision, I.I.S. and N.A.A.; project administration, I.I.S.; funding acquisition, I.I.S. All authors have read and agreed to the published version of the manuscript.  
**Funding:** This work was supported and funded by the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University (IMSIU) (Grant number IMSIU-RG23001).  
**Institutional Review Board Statement:** Not applicable.  
**Informed Consent Statement:** Not applicable.  
**Data Availability Statement:** Data can be made available from the authors upon reasonable request.  
**Acknowledgments:** The authors would like to thank the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University for supporting this project.  
**Conflicts of Interest:** The authors declare no conflict of interest.