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FIG. 16. An example of poor collimator adjustment. In this magnification view, the collimator has not been adjusted by the serviceorganization to allow the entire detector to be irradiated, leaving a marked white border on the bottom and right-hand margins of theimage. Apart from being disconcerting for the radiologist interpreting the study, this allows an unacceptable amount of breast tissue tobe missed, most seriously on the chest wall.36
6. OUTLINE OF QUALITY CONTROL TESTSQC tests are intended to verify the stability of the operation of the equipment or elements used to acquire themammogram. The tests have been classified into two types: essential and desirable, with respect to their importancein influencing image quality and dose. The performance of the first category of tests is considered indispensable;however, it is recommended that the tests in the second category also be carried out if adequate <strong>human</strong> resourcesand equipment can be made available.Essential refers to tests that:Test Priority— Must be done in a facility; or— The minimum frequency at which the tests must be performed.Desirable describes:— The test procedures that should be performed if feasible; or— The frequency at which the tests should be performed if feasible.Many of the tests need to be performed very frequently (weekly and daily). Therefore, it is recommended thatthese tests be performed by local personnel who are present daily in the facility (technical personnel, normallyradiographers). In the majority of cases, the lower frequency (and more specialized) tests have been assigned tomedical physicists. Tolerance values for the tests are indicated. These, too, are classified into two categories:acceptable and achievable. In some cases, only the acceptable level has been defined.Performance StandardsAcceptable indicates that performance must be within these tolerances;if it is not, the equipment should not be used.Achievable indicates the level of performance that should be attained under favourable circumstances;this is the level at which a facility should work if it is feasible.A facility should strive to ensure that equipment operates at the achievable level of performance, as this willproduce the highest image quality and the most appropriate dose performance. It is recognized, however, thatlimited resources, uncorrectable environmental factors and other factors may occasionally prevent the achievablelevels from being obtained. In no case should the facility continue to perform mammography if the equipment doesnot meet the acceptable standard of operation, because below this level the value of the procedure and/or its safetyis considered unacceptable. Each test in the QC programme has a specified tolerance level for achievable andacceptable results, as applicable. Should the results of a test fall outside the specified tolerance, the test shouldusually be repeated to confirm the result before action is taken.Suitable minimum specifications for test equipment are provided in Appendix II.Table 4 in Section 7 of this publication lists all the QC tests to be carried out by the radiographer; those QCtests to be carried out by the medical physicist are listed in Table 10 in Section 8 of this publication. In some cases,either person could perform a particular test, so the tests are listed in both tables. In such cases, a decision must bemade as to who will actually perform the test, and that person should consistently carry out the test thereafter.37
Page 1 and 2: X raysdel matrixCs scintillatorLine
Page 3 and 4: QUALITY ASSURANCE PROGRAMMEFOR DIGI
Page 5 and 6: IAEA HUMAN HEALTH SERIES No. 17QUAL
Page 7 and 8: FOREWORDThe application of radiatio
Page 14: An effective QA programme is necess
Page 17 and 18: The Integrating the Healthcare Ente
Page 21 and 22: technology. Systems containing othe
Page 23 and 24: X raysTop electrodea-Se layerCharge
Page 25 and 26: dose received by inhomogeneous real
Page 27 and 28: 2.3.8.1. Soft copy displayFlat pane
Page 29 and 30: 3. ELEMENTS OF HIGH QUALITY MAMMOGR
Page 31: — The ability to mask edges of ma
Page 34 and 35: Disposal orsaleNew facility(start h
Page 36 and 37: 4.2.3. Radiographer (mammography te
Page 38 and 39: 5.2.2. Electronic versus geometric
Page 40 and 41: To allow full utilization of the di
Page 42 and 43: 5.7. ARTEFACTSWhile the incidence o
Page 44 and 45: FIG. 10. Detector crystallization.
Page 46 and 47: FIG. 13. A more subtle example of a
Page 51 and 52: 7. RADIOGRAPHER’S QUALITY CONTROL
Page 53 and 54: 7.1. DAILY TESTS7.1.1. Monitor insp
Page 55 and 56: 7.1.3. Daily flat field phantom ima
Page 57 and 58: 7.1.4. Visual inspection for artefa
Page 59 and 60: 7.1.5. Laser printer sensitometry7.
Page 61 and 62: 7.1.6. Image plate erasure (CR syst
Page 63 and 64: FIG. 19. Modified TG18-QC pattern w
Page 65 and 66: FIG. 21. Radiologist workstation wi
Page 67 and 68: 7.2.1.6. Time frame for corrective
Page 69 and 70: 7.2.3. Weekly quality control test
Page 71 and 72: Note: It is not necessary to view t
Page 73 and 74: TABLE 7. TOLERANCES FOR IMAGING WEE
Page 75 and 76: 7.2.4.4. Interpretation of results
Page 77 and 78: 7.3.1.5. Recommendations and correc
Page 79 and 80: artefacts are typically best seen w
Page 81 and 82: 7.3.3.5. Recommendations and correc
Page 83 and 84: 7.4.1.3. Methodology(1) Annotate th
Page 85 and 86: RECORD OF DIGITAL MAMMOGRAPHY REPEA
Page 87 and 88: (3) Including examinations of at le
Page 89 and 90: 7.5. SEMI-ANNUAL TESTS7.5.1. Comput
Page 91 and 92: 8. MEDICAL PHYSICIST’S QUALITY CO
Page 93 and 94: 8.1. NOTE ON IMAGE NAMING CONVENTIO
Page 95 and 96: (16) On any randomly selected patie
Page 97 and 98: FIG. 30. Positioning of bathroom sc
Page 99 and 100:
(6) The target, filter, kV, grid, d
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(2) Stack the 20 and 25 mm PMMA sla
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TABLE 13. ACCEPTABLE AND ACHIEVABLE
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8.5. DETECTOR PERFORMANCE8.5.1. Bas
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8.5.2. Detector response and noise8
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the service engineer responsible fo
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(13) Using the annotation tool on t
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Breast supportPMMA slabBreast suppo
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(10) Place the thinner test object
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8.6. EVALUATION OF SYSTEM RESOLUTIO
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TABLE 17. ACCEPTABLE FREQUENCIES AT
Page 121 and 122:
8.7. X RAY EQUIPMENT CHARACTERISTIC
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8.7.2. Incident air kerma at the en
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8.8. DOSIMETRY8.8.1. Mean glandular
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TABLE 21. ACCEPTABLE AND ACHIEVABLE
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FIG. 34. Suggested layout for ruler
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8.10. IMAGE DISPLAY QUALITYThe accu
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FIG. 35. Modified TG18-QC test patt
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8.10.1.5. Interpretation of results
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8.10.2. Monitor luminance response
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TABLE 22. MONITOR PERFORMANCE TOLER
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FIG. 38. Measurement of illuminatio
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8.11. LASER PRINTER8.11.1. Laser pr
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8.11.1.5. Recommendations and corre
Page 147:
8.12.1.4. Interpretation of results
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iopsies are performed, a sink is of
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Appendix IISPECIFICATIONS OF TEST E
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TABLE 24. SPECIFICATIONS OF TEST EQ
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FIG. 40. Image acquired with a unif
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FIG. 43. The left hand image is par
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FIG. 45. A TG18-QC test pattern dis
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[29] ALSAGER, A., YOUNG, K.C., ODUK
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Annex IRADIOGRAPHER DATA COLLECTION
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Chart 2 — DIGITAL MAMMOGRAPHY (DM
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Chart 4 LASER PRINTER SENSITOMETRY
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Chart 6 — WEEKLY DISPLAY MONITOR
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Chart 7(b) WEEKLY QC TEST OBJECT:
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Chart 9 — SAFETY AND FUNCTION CHE
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Chart 11 — LASER PRINTER ARTEFACT
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Chart 13(a) — RECORD OF DIGITAL M
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Chart 14 — CR PLATE SENSITIVITY M
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Annex IIITHE MAMMOGRAPHY EXTRACTThe
Page 185 and 186:
GLOSSARYair kerma. The energy depos
Page 187 and 188:
image quality. The overall merit of
Page 189:
CONTRIBUTORS TO DRAFTING AND REVIEW
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