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SErIES IAEA HumAn HEAltH SErIES IAEA Hum

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FORM FOR A MAMMOGRAPHY QA PROGRAMME<br />

Form MAM — Items to be reviewed by auditor Adequacy Comments<br />

I. General<br />

General condition of equipment and room<br />

Availability of an operator’s manual<br />

Training of personnel to use equipment<br />

Imaging protocols and involvement of medical<br />

physicist in development of protocols<br />

Acceptance testing policies, procedures and/or<br />

manual<br />

Quality assurance policies, procedures and/or<br />

manual<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

II. Quality Assurance (Acceptance Tests, Frequencies, Responsible Persons,<br />

Performance Criteria and Corrective Actions Taken)<br />

Evaluation of facility assembly<br />

<br />

Y NI N NA<br />

Beam limitation assessment<br />

X ray/light field alignment<br />

X ray/film alignment<br />

Evaluation of focal spot performance/high contrast<br />

resolution<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

Performance of automatic exposure control (AEC) system<br />

Operation backup timer<br />

Resultant film density<br />

<br />

Y NI N NA<br />

<br />

Y NI N NA<br />

155

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