# Assessment of a Patient Dose Monitoring System for Average
## 3 Results  
The mean AGD values and corresponding standard deviations (SDs) extracted from DoseWatch and calculated using the [PERSON] and [PERSON] methods are presented in Table 2.  
Table 3 displays the percentage of mammograms with AGD values below the acceptable and achievable dose levels established by the guidelines [17, 18, 19]. Figure 2 presents a comparison of the displayed and calculated AGD values with the acceptable and achievable dose levels for all images taken on the two mammographic units. The two patient subgroups, whose images were used for glandularity estimation with LIBRA software, were randomly selected from the main groups, ensuring they met the age range, HVL, and CBT criteria established by Dance. The patient subgroups consisted of 119 patients for Dimensions 1 and 124 patients for Dimensions 2. Figure 3 presents an \begin{table}
\begin{tabular}{l c c c c c c} \hline  & \multicolumn{2}{c}{**All Patients**} & \multicolumn{2}{c}{**243 Patients**} & \multicolumn{2}{c}{**Tabulated Values**} \\  & **Dim1** & **Dim2** & **Dim1** & **Dim2** & **Dance [2,3]** & **Boone [20]** \\ \hline Age & 30–90 & 21–93 & 40–64 & 40–64 & 40–64 & - \\ \hline kVp & 25–37 & 25–39 & 25–32 & 25–32 & – & 23–35 \\ \hline Exposure (mAs) & 29.2–353.9 & 21.5–447.7 & 35.0–198.5 & 46.7–219.5 & – & – \\ \hline HVL (mm) & 0.474–0.670 & 0.479–0.663 & 0.474–0.596 & 0.479–0.596 & 0.30–0.60 & 0.333–0.683 \\ \hline CBT (mm) & 14–108 & 10–139 & 22–74 & 20–79 & 20–110 & 20–90 \\ \hline Images with & & & & & & \\ CBT \textless{} 20 mm & 114 & 99 & - & - & - & - \\ and CBT \textgreater{} 90 mm & & & & & & \\ \hline Total images & 20,181 & 21,514 & 519 & 532 & - & - \\ \hline \end{tabular}
\end{table} 
Table 1: Ranges of DoseWatch patient age, kVp, exposure, HVL, and CBT for all images included in the study and for the two subgroups of patients, divided by mammographic unit. The number of images with CBT less than 20 mm and greater than 90 mm and the total number of images are also reported. For comparison, the values tabulated according to the models of Dance and Boone, used in the AGD calculation, are shown. \begin{table}
\begin{tabular}{c c c c} \hline  & \multicolumn{2}{c}{**Mean AGD, SD (mGy)**} \\ \cline{2-4}
**Unit** & **DoseWatch** & **Dance** & **Boone** \\ \hline Dim1 & 1.27, 0.45 & 1.21, 0.43 & 1.12, 0.45 \\ \hline Dim2 & 1.25, 0.41 & 1.19, 0.39 & 1.10, 0.41 \\ \hline \end{tabular}
\end{table} 
Table 2: Mean AGD of all the images acquired with Dim1 and Dim2 units and corresponding standard deviations (SDs) for displayed values (DoseWatch) and for Dance and Boone methods. \begin{table}
\begin{tabular}{c c c c c} \hline  & \multicolumn{2}{c}{**Mean AGD**} & \multicolumn{2}{c}{**\% of AGD \(\leq\) Acceptable**} & \multicolumn{2}{c}{**\% of AGD \(\leq\) Achievable**} \\  & \multicolumn{2}{c}{**(mGy)**} & \multicolumn{2}{c}{**Level**} & \multicolumn{2}{c}{**Level**} \\ \cline{2-5}
**Unit** & **Displayed** & **Calculated** & **Displayed** & **Calculated** & **Displayed** & **Calculated** \\  & **Values** & **Values** & **Values** & **Values** & **Values** \\ \hline Dim1 & 1.27 & 1.21 & 97.98\% & 98.52\% & 82.30\% & 85.61\% \\ \hline Dim2 & 1.25 & 1.19 & 98.56\% & 99.37\% & 82.40\% & 88.02\% \\ \hline \end{tabular}
\end{table} 
Table 3: Dose comparison of displayed and calculated AGD values with acceptable and achievable levels according to guidelines. Calculated values refer to [PERSON]’s method. example of how the LIBRA segmentation algorithm worked on a mammogram from one of the patients considered. For each image of the patients in the two selected subgroups, glandularity was calculated using LIBRA. The AGD evaluation was then performed using the [PERSON] and Boone methods, with the glandularity estimate obtained from LIBRA and that provided by the polynomial fit based on the data in [PERSON]'s Table 5 (reference [2]). The third-degree polynomial regression (3) for the g factor utilized HVL and thickness values from [PERSON]'s Table 2 (reference [2]).