Optimizing Digital Mammographic Image Quality for Full-Field Digital Detectors: Artifacts Encountered during the QC Process.

Early detection of breast cancer through routine mammographic screening has been shown to reduce mortality from breast cancer by up to 30% in multiple studies. However, this reduction of mortality is possible only with careful attention to image quality by the medical physicist, radiologic technologist, and interpreting radiologist. The accepted quality control (QC) processes for analog mammography are well established. However, now that use of digital units is widespread in both the United States and internationally, information regarding the necessary steps and the inherent challenges that might be encountered at each step needs to be elucidated. In this review, the essential steps of the QC process for digital mammography are reviewed, with special attention to the possible problems that can occur during the QC process, many of which can lead to image artifacts. For each of the daily, weekly, monthly, and semiannual QC tests, we review the steps and expected performance and provide examples of some of the common artifacts that may be encountered. Understanding the components of the QC process and recognizing problems that may result in a suboptimal image is critical to ensure optimal image quality in an effort to maximize early detection of breast cancer.