Marshall Wendy, Lillé Shelly
Radiol Technol. 2019 May;90(5):459-470.
To determine the feasibility of objectively critiquing mammography images and quantitatively assessing technologist performance, and to determine whether results can be compared to analyze performance.
The authors assessed mammography examinations performed by 3 experienced technologists using a quality improvement method to track factors that affect image quality. A total of 147 examinations were evaluated prior to the technologists receiving standardized positioning training, and an equal number of examinations were evaluated 2 months after the training. During the evaluations, data was collected that described the quality of the examinations and the technologists' behavior during the pre-exposure, acquisition, and postexposure process that affected image quality.
The authors selected 7 out of more than 140 prominent examples to demonstrate a methodology to evaluate image quality, to use the results to empower the technologist to improve their performance in areas that indicate positioning and compression weakness, and to track the technologist's improvement over time. Technologist 1 demonstrated the most dramatic improvement between the pre- and posteducational evaluations in the length of the pectoral muscle on the mediolateral oblique projection. Technologist 3 improved inclusion of the inframammary fold region by 18% between evaluations. Posteducational evaluations also demonstrated a decrease in the percent of examinations that passed posterior nipple line measurements. Compression force did not significantly change.
Identifying specific technologist actions that positively or negatively affect the quality of mammography examinations and then providing this information to the technologist with a suggested plan of corrective action can improve mammography service.
This clinical validation study for mammography quality improvement demonstrated that technologist performance affecting image quality can be measured when examination and threshold variables are controlled.
确定客观评判乳腺钼靶图像和定量评估技术人员操作表现的可行性，并确定结果是否可用于比较分析操作表现。
作者使用质量改进方法评估了3名经验丰富的技术人员进行的乳腺钼靶检查，以追踪影响图像质量的因素。在技术人员接受标准化定位培训之前，共评估了147次检查，培训2个月后评估了相同数量的检查。在评估过程中，收集了描述检查质量以及技术人员在曝光前、采集和曝光后过程中影响图像质量的行为的数据。
作者从140多个突出示例中挑选了7个，以展示一种评估图像质量的方法，利用结果促使技术人员在显示定位和压迫薄弱的方面改进其操作表现，并随时间追踪技术人员的改进情况。在内外侧斜位投照中，技术人员1在教育前后评估之间，胸肌长度方面表现出最显著的改进。在两次评估之间，技术人员3将乳房下皱襞区域的纳入情况提高了18%。教育后评估还显示，通过乳头后线测量的检查百分比有所下降。压迫力没有显著变化。
识别对乳腺钼靶检查质量有正面或负面影响的技术人员的具体操作，然后将此信息提供给技术人员并给出建议的纠正行动计划，可以改善乳腺钼靶服务。
这项乳腺钼靶质量改进的临床验证研究表明，当检查和阈值变量得到控制时，可以测量影响图像质量的技术人员操作表现。
