International Research and Academic scholar society

IRASS Journal of Applied Medical and Pharmaceutical Sciences

Issue-10(October), Volume-3 2026

1. Diagnostic Reference Levels in Mammography: Dosimetric Principles, Rev...
323

TAYO NGUETSA Marcellin Girez*, YENE ZANG Bernard Severin, EMVOUTOU M. Jeanne Valerie
Department of Radiology and Medical Imaging, Green Hope University of Somalia, Centre Médical La Cathédrale, Cameroon., Institut de Recherche Médical et d’étude des Plantes Médicinales
1-9
https://doi.org/10.5281/zenodo.23094592

Breast cancer now tops incidence rankings in much of sub-Saharan Africa, yet most countries lack nationally endorsed diagnostic reference levels (DRLs) for mammography. This narrative review synthesizes the dosimetric foundations of mammography dose metrics, maps international DRL values published since 2018, and examines why Cameroon, despite a rising cancer burden and IAEA-supported regulatory reform, has not translated optimization principles into practice. Three questions guided the work: what quantities and conversion formalisms underpin mammography DRLs; how comparable are current international values given methodological heterogeneity; and what structural, technical, and human-resource barriers obstruct implementation in Cameroon, along with a phased roadmap that is feasible rather than aspirational. A systematic search of PubMed, Scopus, Web of Science, and grey literature from the IAEA, ICRP, and the Cameroonian Ministry of Public Health yielded 58 primary sources. The evidence shows wide variation in reported DRLs, driven by phantomversus patient-based protocols, thickness stratification choices, and the transition from 2D digital mammography to digital breast tomosynthesis, while Cameroon faces an almost complete absence of calibrated dosimetry equipment, clinically qualified medical physicists, and a national dose registry. A pragmatic six-phase pathway is proposed, beginning with an equipment census and phantom-based pilot at four to six centers, progressing through provisional local DRLs to regulatory adoption and regional harmonization via the AFRA network. The review concludes that sustainable DRL implementation in resource-limited settings demands phased investment in metrology infrastructure and workforce development before national values can be meaningfully set.

2. Image Quality Assessment in Chest Radiography According to European Gu...
1

TAYO NGUETSA Marcellin Girez*, YENE ZANG Bernard Severin, EMVOUTOU M. Jeanne Valerie, KITIO Dresnel Chiline, NGOKA T. Franck
Department of Radiology and Medical Imaging, Green Hope University of Somalia., Centre Médical La Cathédrale, Cameroon., Institut de Recherche Médical et d’étude des Plantes Médicinales, Faculty of Science, University of Ebolowa, Cameroon., Kesmonds International University
10-20
https://doi.org/10.5281/zenodo.23191354

Chest radiography remains the cornerstone of diagnostic imaging globally, functioning as a primary triage and diagnostic tool for a diverse array of cardiopulmonary pathologies, particularly tuberculosis and pneumonia. In resource-constrained environments like Cameroon, healthcare systems exhibit an extreme reliance on chest radiography; however, the structural frameworks necessary to optimize image quality and minimize patient radiation dose are frequently inadequate. This narrative review evaluates the clinical relevance and practical implementation of stringent European image quality guidelines specifically the EUR 16260 anatomical criteria and the European Union Directive 2013/59/Euratom within the Cameroonian context. The analysis synthesizes current methods of image quality assessment, encompassing visual grading analysis, reject and repeat audits, standardized exposure indices (IEC 62494-1), and the integration of artificial intelligence tools such as CAD4TB. Translating European standards to Cameroon encounters profound structural barriers, driven primarily by a critical shortage of radiological personnel, with a radiologist density of approximately two per million inhabitants compared to the European average of 127 per million. Additional friction points include the unmonitored transition from analogue to digital radiography, the inconsistent application of Diagnostic Reference Levels (DRLs), and the limited enforcement capacity of the National Radiation Protection Agency (ANRP). Despite these systemic hurdles, strategic opportunities exist to elevate diagnostic standards. Expanding teleradiology networks to support remote facilities, implementing low-cost quality assurance audits, and leveraging artificial intelligence for automated image assessment offer viable solutions to bridge the quality gap. The establishment of localized DRLs and the prioritized training of radiographers and medical physics experts stand as essential prerequisites for achieving sustainable diagnostic excellence and radiation safety in Cameroon. Establishing routine diagnostic reference levels for standard procedures is a universally recommended practice for adhering strictly to the ALARA principle.

3. MRI Safety in Resource-Limited Settings: Relevance and Implementation...
2

TAYO NGUETSA Marcellin Girez*, KITIO Dresnel Chiline, NGOKA T. Franck, MBALLA A. Jean Claude
Department of Radiology and Medical Imaging, Green Hope University of Somalia., Faculty of Science, University of Ebolowa, Cameroon
21-31
https://doi.org/10.5281/zenodo.23357986

Background: Magnetic resonance imaging (MRI) is a critical diagnostic modality, yet its availability in Sub-Saharan Africa remains disproportionately low. As countries like Cameroon gradually expand their diagnostic infrastructure often relying on refurbished equipment the implementation of stringent international MRI safety standards becomes increasingly complex. Objective: This narrative review evaluates the relevance of international MRI safety guidelines (e.g., ACR, IEC, ICNIRP) to the Cameroonian healthcare context, identifies specific implementation barriers, and proposes context-adapted strategies for resource-limited settings. Methods: Following the Scale for the Assessment of Narrative Review Articles (SANRA) criteria, a comprehensive literature search was conducted across PubMed/PMC, Scopus, and the grey literature of major regulatory bodies (WHO, ICNIRP, IEC, ACR) for publications predominantly between 2015 and 2025. The synthesis focused on safety standards, the health-system context in Cameroon, and the emergence of low-field MRI technologies. Findings: International standards are biophysically universally applicable but architecturally and economically misaligned with Cameroonian realities. Major implementation challenges include severe shortages of certified Medical Resonance Safety Officers (MRSOs) and medical physicists, inadequate facility space for strict four-zone layouts, reliance on refurbished scanners with outdated safety software, and unreliable power and helium supply chains. Local studies indicate significant gaps in general imaging referral guidelines among clinicians, translating to heightened risks in MRI environments. Conclusions: Direct transcription of high-income country MRI safety protocols to Cameroon is impractical. A staged, risk-based implementation strategy, integration of safety training into local medical physics curricula, and the adoption of ultra-low-field portable MRI systems offer viable pathways to improve diagnostic equity without compromising patient safety.





Submit Manuscript