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Digital mammography


Mammography, be it screen-film or digital mammography, is one of the most demanding examinations in medical imaging requiring fine detail, high contrast, low patient motion, low noise images, and appropriate viewing conditions.

First and foremost, mammography must be carried out using dedicated mammographic imaging equipment with low energy output (molybdenum x-ray tube anode, or a tungsten anode at low kilovoltage, e.g., 30 kVp) imaging capability. It is not appropriate to do mammographic examinations with other than a dedicated mammography system.

Important Principles

The reader should first review the materials in the previous section, 1.7 Screen-Film Mammography, as the basic principles for screen-film and digital mammography are similar.

There are several manuals available regarding mammographic imaging. These emphasize the importance and proper use of technology, but also stress the importance of correct patient positioning and breast compression. Although the medical physicists do not directly play a role in positioning and compression, they must understand the need and assure that the equipment is function appropriately.

Image quality is extremely important in digital mammography and it is essential to assure that the entire mammographic imaging system is functioning optimally. This includes the mammographic x-ray system, the digital image acquisition system, the mammography archival and communications system, the viewing area, and digital displays. There is a section in the ACR Mammography Quality Control Manual entitled “Important Points” which discusses many of these areas and, although written for screen-film mammography is also applicable to digital mammography.

Introduction to References

The essential references include information on both screen-film and digital mammography since much of the information regarding screen-film mammography is also applicable to digital mammography. The IAEA has published the document: Quality Assurance Programme for Digital Mammography.

  Click here for more details on the IAEA text, including supplementary  interactive material    

Also included are three essential references to the American College of Radiology Mammography Accreditation Program. The ACR Mammography Accreditation Program Quality Control Manual; the ACR Mammography Accreditation Requirements containing a concise list of the requirements for dedicated mammography equipment in the Equipment section and for quality control in the Quality Control Section; and The Practice Guidelines for Determinants of Image Quality in Digital Mammography providing specific guidance relative to digital mammography.

The NCRP report covers the history of mammography and patient dose and risk, and provides guidance for the overall mammography screening programme and quality control, for screen-film and digital systems.