iaea human health series publications - SEDIM

3. ELEMENTS OF HIGH QUALITY MAMMOGRAPHY3.1. PERSONNELThere are many elements that contribute to the mammography process. The experience of personnel directlyand indirectly involved in the process is crucial to the final outcome. In this respect it is essential that:— The mammography images are acquired by experienced radiographers trained specifically in mammography.— The images are interpreted by an appropriately trained and experienced radiologist.— A medical physicist is available as a consultant to the facility. This may be on a full time or part time basis,according to the QA and radiation protection needs of the facility. (See Section 4.2.4 and appendix I ofRef. [34] for the specific requirements that a medical physicist should meet.)— Well trained and experienced personnel service and maintain the mammography equipment.— There is training on the specific mammographic unit, usually provided by the manufacturer as part of thepurchase package.Access to staff with training in information technology is highly desirable [35].3.2. EQUIPMENT3.2.1. Digital mammography X ray unitThe digital mammography X ray unit must be specifically designed for mammography and include thefollowing key features:— An X ray tube with a nominal focal spot of 0.3 mm [36].— A magnification stand and a second, smaller focal spot of nominal size (≤0.15 mm), if magnificationmammography is performed (this capability should be present on systems that are used for diagnosticmammography and not exclusively for screening).— A beryllium exit window.— Appropriate X ray target material and beam filter(s) for the X ray target. (For examples of target–filtercombinations in use at the time of writing, see Table 3; the latest version of this table will be posted on theIAEA web site at: http://humanhealth.iaea.org.— A motorized compression device.— Readout of compression thickness and force.—AEC.— Scatter rejection capability.— A focus image distance greater than 60 cm.— A detector with dimensions large enough to image most compressed breasts without the need for multipleexposures. Typically, this may mean larger than 24 cm × 26 cm, although there may be geographic variationsin this requirement.— An acquisition workstation with a monitor of sufficient resolution (3 MP is recommended) to allow theradiographer to ensure the quality of the mammography images. This is particularly important when hardcopy images are used for clinical diagnoses.The room in which the digital mammography unit is sited should have stable temperature and humidity forsatisfactory operation. This will require appropriate air conditioning. More complete details on siting amammography unit are provided in Appendix I.17