Department of Science and Technologies of Radiation and Biosignals in Health, Lisbon School of Health Technology-ESTeSL, Lisbon, Portugal,
Insights Imaging. 2013 Oct;4(5):539-53. doi: 10.1007/s13244-013-0269-1. Epub 2013 Aug 4.
Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide.
Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment.
Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines.
The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources.
•An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.
回顾现有的乳腺摄影质量保证（QA）指南，并讨论其对协调全球实践的贡献。
在不同的来源上进行文献检索，以确定国际组织、医疗保健提供者、专业/科学协会在全球范围内提供的乳腺摄影 QA 指南文件。对确定的指南文件进行审查，并对选择的文件进行比较，比较类型包括临床/技术、技术和建议的 QA 方法，重点是剂量和图像质量（IQ）性能评估。
共审查了 14 份协议（针对传统和数字乳腺摄影）。所有协议都包括对与乳腺摄影设备相关的采集、处理和显示系统的测试建议。所有审查的指南都强调了剂量评估和自动曝光控制（AEC）系统测试的重要性。建议用于评估 IQ 的测试方法存在差异。建议的测试集中在低对比度检测、空间分辨率和噪声评估上。建议根据美国医学物理学家协会的指南对图像显示进行 QC。
现有的乳腺摄影 QA 指南源自关键文件（美国放射学院和欧盟指南），尽管细节和方法存在差异，但提出了类似的测试。报告 QA 数据的研究应详细说明实验技术，以允许进行稳健的数据比较。旨在实施乳腺摄影/QA 计划的国家可以根据可用技术和资源选择/优先考虑测试。
有效的 QA 计划应在临床环境中切实可行。
QA 应涵盖成像链的各个阶段：采集、处理和显示。
AEC 系统 QC 测试易于实施，并提供设备性能信息。
