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7.4. QUARTERLY TESTS7.4.1. Printed image quality7.4.1.1. Scope— Objective: To ensure that the printed image quality is consistently high.— Frequency: Quarterly and when reduced printed image quality is suspected. This test applies only to sitesprinting hard copies.7.4.1.2. Instrumentation(1) Magnifying lens (4× to 5× magnification).(2) Ruler.(3) Modified TG18-QC patterns (Fig. 26). Use test patterns that are specific to the digital mammography units inthe facility.FIG. 26. Modified TG18-QC image with test objects indicated: A — 0–5% contrast square; B — 95–100% contrast square;C — horizontal and vertical line pairs; D — squares going from black to white; E — 5 cm lines.70
7.4.1.3. Methodology(1) Annotate the modified TG18-QC pattern image with rulers measuring the length of the horizontal and vertical5 cm rulers (arrow E, Fig. 26). This should only need to be done the first time the image is used, if theannotated image is ‘locked’ and not deleted from the workstations.(2) Print (from both the acquisition workstation and the radiologist review workstation(s)) the TG18-QC testpattern appropriate for each type of digital mammography unit used to generate images for interpretation.(3) Examine the resulting films carefully on the radiologist viewbox, using the magnifying glass.(4) Record the visibility of the different test objects on the printed image quality chart (Chart 12 in Annex I).(5) Measure the length of the 5 cm calibration lines in the horizontal and vertical directions.(6) Record the outcome of the test on the monthly, quarterly and semi-annual checklist (Chart 2 in Annex I).7.4.1.4. Interpretation of results and conclusions(1) The 0–5% contrast square and 95–100% contrast square should be distinguishable.(2) The finest horizontal and vertical line pairs should be visible in all four corners (Fig. 27).(3) The squares of different shades from black to white should be distinct.(4) Lines should appear straight and even, without apparent distortions.(5) There should be no distracting artefacts.(6) The 5 cm lines should be between 4.7 and 5.3 cm long on the printed image.7.4.1.5. Recommendations and corrective actionIf the printed film quality is unacceptable, the test should be repeated. If the results remain unacceptable, itmay be appropriate to contact the responsible medical physicist for further advice on implementing therecommendation listed below:If these results are not achieved, the printer should be serviced to correct the problem immediately, if there isno other means for primary interpretation.7.4.1.6. Time frame for corrective actionIf this test fails, do not print patient films until corrective action has been taken.FIG. 27. Detail of horizontal and vertical line pairs from TG18-QC test pattern.71
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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
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An effective QA programme is necess
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The Integrating the Healthcare Ente
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technology. Systems containing othe
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X raysTop electrodea-Se layerCharge
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dose received by inhomogeneous real
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2.3.8.1. Soft copy displayFlat pane
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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 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: 7.3.3.5. Recommendations and correc
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
Page 111 and 112: (13) Using the annotation tool on t
Page 113 and 114: Breast supportPMMA slabBreast suppo
Page 115 and 116: (10) Place the thinner test object
Page 117 and 118: 8.6. EVALUATION OF SYSTEM RESOLUTIO
Page 119 and 120: TABLE 17. ACCEPTABLE FREQUENCIES AT
Page 121 and 122: 8.7. X RAY EQUIPMENT CHARACTERISTIC
Page 123 and 124: 8.7.2. Incident air kerma at the en
Page 125 and 126: 8.8. DOSIMETRY8.8.1. Mean glandular
Page 127 and 128: TABLE 21. ACCEPTABLE AND ACHIEVABLE
Page 129 and 130: FIG. 34. Suggested layout for ruler
Page 131 and 132: 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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