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— Mid-density (MD) — the step closest to but not below an optical density of 1.20 or the working opticaldensity;— Base + fog (B + F) — the lightest step.(3) Record and plot these four values (D max , DD, MD and (B + F)) on the laser printer sensitometry chart (Chart 4in Annex I).(4) Record completion of the sensitometry procedure on the daily and weekly checklist (Chart 1 in Annex I).7.1.5.4. Interpretation of results and conclusionsThe tolerances for film sensitometry are given in Table 5.TABLE 5. TOLERANCES FOR FILM SENSITOMETRYParameter Acceptable tolerance Achievable toleranceD maxa≥ROL – 0.15 or 3.50, whichever is less≥ROL – 0.10 or 3.50, whichever is lessDD ROL ± 0.15 ROL ± 0.10MD ROL ± 0.15 ROL ± 0.10B + F ≤ROL + 0.03 —aNote that there is no upper control limit.7.1.5.5. Recommendations and corrective actions(1) If D max falls below the acceptable limit of ROL – 0.15, or is less than 3.50, or if the DD or MD falls outsidethe acceptable limit of ROL ± 0.15, the source of the problem must be determined and corrected before digitalmammograms are printed. In addition, the data points outside tolerance should be circled and the cause of theproblem noted in the ‘Remarks’ section of the control chart. After correction, the new data point should beplotted on the same date.(2) If D max falls below its achievable ROL by more than 0.10, or if the DD or MD falls outside of the ROL ± 0.10achievable limit, but these parameters are still within the acceptable limits, the test should be repeatedimmediately. If the same result is obtained, it is acceptable to print films, but the printer or processor shouldbe monitored closely.(3) If the B + F exceeds the control limit of ROL + 0.03, the source of the problem must be determined andcorrected before digital mammograms are printed.On wet processors, the most likely sources of change are processing chemistry, replenishment andtemperature changes. For example, if few films have been printed for some time, the processing chemistry mayhave oxidized and may not have been properly replenished. On dry processors, a likely source of change is the drumtemperature. On both types of processor, a change in film emulsion batches could lead to a change in film opticaldensities. If this occurs, an internal recalibration of the printer should be carried out.48
7.1.6. Image plate erasure (CR systems only)7.1.6.1. ScopeCR plates may retain signals from previous exposures (lag). In addition, they are susceptible to artefactualsignals arising from both naturally occurring and <strong>human</strong>-made sources of ionizing radiation. Although the platereading system automatically erases plates after each readout, it is necessary to perform additional erasure of platesthat have been unused for some time. It is recommended that this erasure be repeated before clinical exposures onplates that have not been used for more than eight hours. Some manufacturers provide a mechanism to carry out amore intensive erasure, which should be performed periodically, typically weekly. In both cases, the manufacturer’sinstructions should be followed.— Objective: To ensure that all plates remain free of clinically significant artefactual signals arising fromnaturally occurring and <strong>human</strong>-made sources.— Minimum frequency: Daily for standard erasure procedure; weekly for intensive erasure, or as recommendedby manufacturer.7.1.6.2. Methodology(1) Perform a daily/weekly erasure of each plate, as recommended by the plate manufacturer.(2) Record on the daily and weekly checklist (Chart 1 in Annex I) that the task has been completed.7.1.6.3. Recommendations and corrective actionsIt should be recognized that CR plates have a finite lifetime during which they perform to the specified level.If erasure procedures fail to remove residual artefacts, the plates should be replaced.49
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X raysdel matrixCs scintillatorLine
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QUALITY ASSURANCE PROGRAMMEFOR DIGI
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IAEA HUMAN HEALTH SERIES No. 17QUAL
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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 48 and 49: FIG. 16. An example of poor collima
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: 7.1.5. Laser printer sensitometry7.
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
Page 101 and 102: (2) Stack the 20 and 25 mm PMMA sla
Page 103 and 104: TABLE 13. ACCEPTABLE AND ACHIEVABLE
Page 105 and 106: 8.5. DETECTOR PERFORMANCE8.5.1. Bas
Page 107 and 108: 8.5.2. Detector response and noise8
Page 109 and 110: 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
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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
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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
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GLOSSARYair kerma. The energy depos
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image quality. The overall merit of
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CONTRIBUTORS TO DRAFTING AND REVIEW
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