[Film quality in film mammography. Article II: Signal/noise ratio of the recording system as a quantitative measure of quality. Final evaluation of recording systems (author's transl)].

During consideration of three film mammographic systems (see article I), the concept of signal/noise ratio is developed as a quantitative measure of film quality. The ability to recognise detail related to detail size, film blackening and exposure geometry was studied for various systems, and the quality profiles are discussed. There is a considerable difference in quality between industrial films without screens and film-screen combinations; however, exposure geometry during mammography has a considerable effect which tends to reduce the difference. Consequently, detail sizes of 200 mu to 1,000 mu (including the majority of mammographic micro-calcifications) are shown about equally well. Contrast for the lo-dose system (D = 1.1) is somewhat less than for adequately exposed industrial film (D = 2.0) or for Cronex 75 m with lo-dose screen (D = 1.5 to 2.0). The lo-dose system (D = 1.1) is 8.6 times more sensitive than Cronex 75 m (D = 2.0), and the system Cronex 75 m with lo-dose screens is 11.6 times more sensitive. Over-exposure with the lo-dose system, contrary to industrial film, rapidly leads to unsatisfactory results (loss of contrast and increased granularity for D greater than 1.5). On the other hand it is often not possible to obtain an adequate exposure (D = 2.0) when using industrial film. For these reasons it is often an advantage to examine large breasts (with considerable geometric unsharpness) and the dense breasts of young women with a film-screen combination (eg. lo-dose system) which requires approximately one eighth of the dose necessary for industrial film. For small or easily compressable breasts (little geometric unsharpness) best results are obtained, using an adequate exposure by employing industrial film; radiation dose it then acceptable. Detailed analysis of the systems has shown that the recording system unsharpness of film-screen combinations in mammography should be reduced.