Mammography Quality Assurance: Technical and Clinical Report

This report examines the critical role of quality assurance (QA) in mammography, emphasizing the importance of systematic approaches to improve performance in breast cancer screening. It details the implementation of QA programs, which provide a framework for enhancing performance and identifying deviations from optimal practices. The report discusses the technical and clinical aspects of mammography QA, including image acquisition, processing, and display, as well as breast dose assessment and image quality criteria. It highlights the multidisciplinary team approach involving radiologists, medical physicists, and radiographers, and references national and international guidelines. Furthermore, the report considers the impact of digital mammography on QA programs and explores testing stages, including x-ray production, image receptor testing, and artifact analysis. The conclusion stresses the importance of collaboration and teamwork to promote the success of QA programs and improve patient outcomes.

Running head: QUALITY ASSURANCE IN MAMMOGRAPHY 1
Quality Assurance in Mammography
Name of student
Institutional affiliation

QUALITY ASSURANCE IN MAMMOGRAPHY 2
In achieving the goals of mammography, quality control standards should be adopted
during the technical, training and clinical trial of the breast cancer. However, the range of
activities included in the process should have a wide implication on the mammography imaging
process. In such a consideration, a systematic approach to assessing improved performance is
realized through the implementation of the quality assurance (QA) program. Besides, the QA
programs provide a framework for increased performance by enhancing the feedback mechanism
to allow for the identification of deviations from the optimal performance of the mammographic
equipment, training requirements, and suboptimal clinical practice (LI et al., 2001). Furthermore,
for an effective QA program, the clinical settings should be enacted to improve the practice. As
well, adequate test equipment should be instituted to arrive at a standard method of obtaining the
desired outcomes along with the quality of the subjective metrics. Such a consideration should
ensure that the costs incurred are small to make the process affordable. Nevertheless, equipment
testing should address critical imaging stages and be implemented in a multidisciplinary team
approach that includes, the radiologists, medical physicist, radiographer. In other words, the
national and international guidelines on the quality of mammography are based on the technical
aspects as well as clinical aspects such as epidemiology, pathology, surgery, and interventions
(Klabunde et al., 2001). Such a scenario has been enhanced through the development of digital
mammography to increase the efficiency of the QA programs while encouraging the new tests
and procedures in QC.
Similarly, based on QA and QC measures in mammography, three main stages of testing
have been adopted for breast dose assessment, that is, image acquisition, processing, and display.
In testing image acquisition, the x-ray production system is recommended for the alignment of x-
ray fields, the accuracy of output resource, and the automatic exposure control versus thickness

QUALITY ASSURANCE IN MAMMOGRAPHY 3
of the breast in addition to the arrangement of the compression plate. Furthermore, the mean
glandular dose is essential in mammography for assessing the risk of radiation in the developing
breast cancer (Marshall, 2011). However, different protocols are used in measuring the required
mean glandular dose. Besides, the image receptor testing in digital mammography includes the
response function of the mammography system, image noise, uniformity of the signals, and
image artifacts. More so, in assessing the quality of the acquired image, technical and clinical
image quality criteria are employed using phantoms and test objects (Tsai et al., 2010).
Meanwhile, the analysis of artifacts focuses on the chemical processing and screen-film detector
degradation, which helps in the investigation of image acquisition problems in the CR systems.
Consequently, the QA testing of the mammographic systems and breast dosage
assessment depends on the image detection and acquisition system used in the procedures since
they have direct implications for the outcomes. The methods involved in assessing breast dose
vary due to the recommended breast phantoms and test objects. However, the use of a standard
methodology for dose assessment allows for the comparison of different techniques of
mammography and investigation of the technical setting of the breast dose. Therefore,
mammography is set to be beneficial if the QC tests can be acquired from the clinical and
technical aspects, which calls for collaboration and teamwork in the promotion of success of QA
programs.

QUALITY ASSURANCE IN MAMMOGRAPHY 4
References
Klabunde C, Bouchard F, Taplin S, Scharpantgen A, Ballard-Barbash R. Quality assurance for
screening mammography: an international comparison. J Epidemiol Community Health.
2001;55(3):204–212. doi: 10.1136/jech.55.3.204
Li Y, Poulos A, Mclean D, Rickard M. A review of methods of clinical image quality evaluation
in mammography.Eur J Radiol. 2010;74:122–131. doi: 10.1016/j.ejrad.2009.04.069.
Marshall NW, Mackenzie AHI.Quality control measurements for digital x-ray detectors.Phys
Med Biol. 2011;56:979–999. doi: 10.1088/0031-9155/56/4/007
Tsai HY, Chong NS, Ho YJ, Tyan YS.Evaluation of depth dose and glandular dose for digital
mammography.Radiat Meas. 2010;45(3–6):726–728. doi: 10.1016/j.radmeas.2010.02.005