MO‐D‐103‐01: Mammography QA
Authors: Jacobson D , Martin M 
Published: July 2013

2D Digital Mammography ‐ An Update on Vendor‐Recommended QC Tests

Quality Assurance (QA) and Quality Control (QC) are especially important in mammography, where achieving high image quality within reasonable dose limits is vitally important for a number of reasons including the following:

1. Early and accurate detection profoundly improves the prognosis for the patient with breast cancer

2. Population screening delivers radiation to a large number of asymptomatic women

3. Optimization of image quality and minimization of radiation dose is essential to accomplish the goals of mammography screening

The requirements for QC in mammography are also significant in that they are the first to be defined and regulated by a federal law, i.e. the Food and Drug Administration's Mammography Quality Standards Act (MQSA). Under current FDA MQSA regulations, manufacturers must define a QC program for each mammography imaging system offered, and this program must be followed in detail by both physicists testing the device and other clinical users performing routine QA functions on a daily basis.

In this lecture the QC testing programs currently specified by all digital mammography vendors will be summarized. Recent advances in the automation of QC measurements by manufacturers will be highlighted and potential future developments will be presented.

Learning Objectives:

1. Attendees will gain an understanding of the general requirements for mammography QC

2. Attendees will gain an understanding of the QC programs currently specified by mammography vendors

3. Attendees will become aware of potential future universal QC requirements in mammography

Stereotactic Breast Imaging System QC

The performance of the eleven specified physics tests on a Stereotactic Breast Biopsy (SBB) System required for accreditation by the American College of Radiology (ACR) will be covered in this presentation, for systems both with and without Automatic Exposure Control (AEC) devices, and for both prone biopsy tables and add‐on SBB units for digital FFDM units. Image Quality, expected values for Half‐Value‐Layer (HVL) measurements and typical patient doses for each matrix size available on SBB systems will be discussed. Clinical advantages/disadvantages of both types of systems will be covered relative to approach methods and areas available for sampling. The importance of testing the location of the biopsy needle or tissue sampling device for reproducibility and accuracy will be discussed relative to various phantoms that may be used to verify this location accuracy. Quality Control (QC) tests to be performed by the mammography technologist will be covered in addition to the required physics tests. Requirements for training and education of the staff (physician, physicist, and technologist) required to achieve ACR accreditation will be reviewed in light of the additional requirement for SBB units to be accredited for those breast imaging centers wishing to obtain the ACR designation of a Breast Imaging Center of Excellence.

Learning Objectives:

1. Attendees will be aware of the required physics tests to be performed annually and for acceptance of Stereotactic Breast Biopsy (SBB) System.

2. Attendees will be aware of the expected values of Half‐Value Layer and patient doses for SBB systems for common matrix sizes available on these units.

3. Attendees will be aware of the requirements for personnel performing SBB exams or physics evaluations in both Continuing Education and Continuing Experience for accreditation by the American College of Radiology.

4. Attendees will be aware of the required Quality Control Tests to be performed by both the technologist and physicist on SBB units.