Mammography Screening Centre, Local Health Authority, Modena, Italy.
Mammography Screening Centre, St. Anna University Hospital, Ferrara, Italy.
J Med Radiat Sci. 2021 Sep;68(3):253-259. doi: 10.1002/jmrs.487. Epub 2021 Jun 3.
Mammography is one of the most technically demanding radiographic processes, and mammography quality assurance initiatives are priorities in the implementation of public health screening services. In the optimisation of image quality (IQ), radiographers play a major role. Between 1998 and 2009, the steering committee for mammography of a large population-based screening service in northern Italy undertook several audit checks of the imaging facilities. In 2009, the target age range of the screening service was extended. The mammogram volume was projected to increase steeply but with no substantial increase in the radiographer workforce.
In view of the potential impact on mammographic IQ, the passive audit approach was abandoned in favour of an active radiographer-oriented IQ review programme. Its technical basis consists of regularly repeated rounds of review of random samples of digital mammograms performed by each first-level radiographer and by more experienced local reference radiographers, with IQ classification, followed by a training effort and a monitoring work.
The mammogram volume grew from 140,822 in 2008 to 319,394 in 2014 (+127%) and then stabilised. In 2012, the proportion of mammograms with a poor IQ rose from 0.6% to 19.3%, paralleled by a substantial decrease of mammograms interpreted to have a moderate and perfect IQ. Conversely, a generalised improvement occurred in both rounds of 2016 and in the first round of 2018.
In the new challenging scenario, the programme proved to be effective. A successful IQ review initiative is one that encourages radiographers to participate with a positive and confident attitude.
乳腺 X 线摄影是最具技术挑战性的放射成像过程之一，乳腺 X 线摄影质量保证计划是实施公共卫生筛查服务的优先事项。在图像质量（IQ）优化方面，放射技师起着重要作用。在意大利北部一个大型基于人群的筛查服务的乳腺 X 线摄影指导委员会于 1998 年至 2009 年期间，对成像设备进行了几次审核检查。2009 年，筛查服务的目标年龄范围扩大。预计乳腺 X 线摄影数量会急剧增加，但放射技师的劳动力不会有实质性增加。
鉴于对乳腺 X 线摄影 IQ 的潜在影响，主动以放射技师为导向的 IQ 审查计划取代了被动审核方法。其技术基础包括由每位初级放射技师和经验丰富的本地参考放射技师定期重复审查随机数字乳腺 X 线摄影样本，对 IQ 进行分类，然后进行培训和监测工作。
乳腺 X 线摄影数量从 2008 年的 140822 例增加到 2014 年的 319394 例（增长 127%），然后稳定下来。2012 年，低 IQ 乳腺 X 线摄影的比例从 0.6%上升到 19.3%，同时中、高 IQ 乳腺 X 线摄影的数量显著下降。相反，2016 年两轮和 2018 年第一轮都普遍有所改善。
在新的挑战性环境下，该计划被证明是有效的。成功的 IQ 审查计划可以鼓励放射技师以积极和自信的态度参与。
