Quality assurance of full field digital mammography

Developments in digital mammography equipment have been very fast: the first digital mammography system was introduced in 1999, and new systems using different physical principles have since emerged and major improvements in equipment have occurred.

These improvements have solved some important quality issues that were present in some early digital mammography systems. However, image quality problems still occur relatively frequent and technical quality control is important to recognize and quantify them. Both the acceptance/6-monthly quality control tests and (at least) weekly quality control as recommended in the European Guidelines are therefore essential for high-quality mammography.

In the Dutch screening programme, technical quality control is performed against the Dutch Guidelines, which are very similar to the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis. However, some additional tests are performed: a more extensive noise evaluation and a more precise image quality evaluation. These might be included in an update of the European Guidelines.

In this presentation, some major failures, which have occurred recently, will be shown: significant additional noise (electronic and structural noise), disturbing artefacts, insufficient image quality, major ghosting, and so on.

Recently the European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services (Euref) started a new project to update the European Guidelines, and is performing type testing in which it is determined whether a system is able to pass the Guidelines. When buying new mammography equipment, this type testing (by Euref) might be taken into account.