Evaluation of radiation dose, focal spot, and automatic exposure of newer film-screen mammography units.

Fifteen recently introduced mammographic units representing eight different models and manufacturers were evaluated to see whether the equipment performance equaled claims made by the manufacturers. Focal-spot size was measured by pinhole and slit methods. Eight automatic exposure control systems on five models were tested by measuring the optical density produced by imaging at 28 and 30 kVp, with and without a grid and with test objects of varying thicknesses of BR12 epoxy material. Comparable mean glandular dose for a 4-cm-thick BR12 test object was measured for 13 of the units under manual or automatic exposures. Nominal focal-spot size was larger than stated for six of the 15 large focal spots and for seven of the 12 microfocal spots. Comparable doses under automatic exposure control varied more than 100% between units from different manufacturers, while the doses of units from the same manufacturer varied less than 20%. Automatic exposure control systems were operational in eight of the 15 units, but four of these eight were found to be out of calibration. There are considerable performance variations that need to be evaluated before acceptance and use of new mammographic equipment.