Slid e 1 Slid e 2 Introduction Digital Mammography QA ... · Digital Mammography QA: Comparing the Manufacturers Recommendations Eric A. Berns, Ph.D. ... – Modulation in Hi Res

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Digital Mammogra phyQA:

Comparing theManufacturer s

Recom mendations

Eric A. Berns, Ph.D.Eric A. Berns, Ph.D.

Northwestern University Medical SchoolNorthwestern University Medical SchoolLynn Sage Comprehensive Breast CenterLynn Sage Comprehensive Breast Center

Chicago, ILChicago, IL

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�� What is QC and why is it important?What is QC and why is it important?

�� Review & compare QC testsReview & compare QC tests

�� Key take home pointsKey take home points

IntroductionIntroduction

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�� MQSAMQSA

–– Mammography Quality Standards ActMammography Quality Standards Act

�� ACRACR

–– American College of RadiologyAmerican College of Radiology

IntroductionIntroductionSlide 4

ScreenScreen--FilmFilm

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FFDMFFDM

�� In FFDM, the manufacturer designs and mandates theirIn FFDM, the manufacturer designs and mandates theirown QC programown QC program

�� In FFDM, you must the manufacturersIn FFDM, you must the manufacturers’’ QC programQC program

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RWSRWS

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Quality Control: Why?Quality Control: Why?

�� Reduce exposure to patients and personnelReduce exposure to patients and personnel

�� Consistent image qualityConsistent image quality

�� Detect and correct for potential problems,Detect and correct for potential problems,

before they impact image qualitybefore they impact image quality

Slide 13

What is Quality Control?What is Quality Control?

�� Determination of what isDetermination of what is ““NormalNormal””

�� Detection of what isDetection of what is ““AbnormalAbnormal””

�� Understanding of how to return toUnderstanding of how to return to ““NormalNormal”” fromfrom ““AbnormalAbnormal””

�� In particular, in FFDM, how do you know what you areIn particular, in FFDM, how do you know what you are

seeing is what it is supposed to be?seeing is what it is supposed to be?

Slide 14

�� Golden Rules for Medical Physicist & Tech QCGolden Rules for Medical Physicist & Tech QC

–– Must use manufacturerMust use manufacturer’’s QC proceduress QC procedures

–– ManufacturersManufacturers’’ QC may refer to Monitor ManufacturersQC may refer to Monitor Manufacturers’’ QCQC

–– Multimodality Workstations have own separate QCMultimodality Workstations have own separate QC

–– Printers may have their own QCPrinters may have their own QC

Before You Begin QCBefore You Begin QC

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�� ACR AccreditationACR Accreditation -- www.acr.orgwww.acr.org–– Physics formsPhysics forms

•• http://acr.org/accreditation/mammography/mammo_qc_forms.aspxhttp://acr.org/accreditation/mammography/mammo_qc_forms.aspx

•• GEGE Senographe 2000D, DS, and EssentialSenographe 2000D, DS, and Essential

–– Fischer SenoscanFischer Senoscan–– Lorad SeleniaLorad Selenia–– Siemens NovationSiemens Novation–– Fuji FCRmFuji FCRm

•• NoteNote: if using unit for both screen: if using unit for both screen--film & CR, you must accredit forfilm & CR, you must accredit forbothboth

�� FDA AccreditationFDA Accreditation–– www.fda.gov/cdrh/mammography/www.fda.gov/cdrh/mammography/–– Other vendors when approvedOther vendors when approved

Before You BeginBefore You BeginSlide 16

Before You BeginBefore You Begin

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��Note:Note:

––For new unitFor new unit: Must use most current: Must use most current

versionversion

––For renewal unitFor renewal unit: Can use older: Can use older

version (version used when testedversion (version used when tested

previously)previously)

Slide 22

Vs.Vs.

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�� ScreenScreen--Film MammoFilm Mammo

–– Ensure locks, detents, angulation indicators, andEnsure locks, detents, angulation indicators, and

mechanical support devices operate properlymechanical support devices operate properly

�� FFDMFFDM

–– SameSame

Mammo Unit EvaluationMammo Unit EvaluationSlide 24


–– Assure XAssure X--ray field aligns with the light fieldray field aligns with the light field

–– Collimator allows full coverage of receptorCollimator allows full coverage of receptor

–– Chest wall edge of compression paddle aligns with chest wall ofChest wall edge of compression paddle aligns with chest wall of

receptorreceptor

�� FFDMFFDM

–– SameSame

–– Multiple targe/filters and/or multiple paddle positionsMultiple targe/filters and/or multiple paddle positions

–– Chest Wall Missed TissueChest Wall Missed Tissue

–– Compression Plate Overlap on the Chest Wall SideCompression Plate Overlap on the Chest Wall Side

CollimationCollimation

Slide 25

CollimationCollimation

Fuji FCRmFuji FCRm

GEGE2000D,2000D,

DS,DS,EssentialEssential

FischerFischerSenoscanSenoscan

LoradLoradSeleniaSelenia

SiemensSiemensNovationNovation

Same as ScreenSame as Screen--FilmFilm XX XX XX XX XX

Multiple target/filterMultiple target/filtercombocombo’’ss XX XX XX

Multiple paddleMultiple paddlepositionspositions XX XX XX

Chest Wall & MissedChest Wall & MissedTissueTissue XX XX

Compression PlateCompression PlateOverlap on ChestOverlap on ChestWallWall

XX

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�� Colli mat ionCollimat ion

–– Test for routinely usedTest for routinel y used

•• Collimator, bucky,Collima tor, bucky,

compr ession paddlecompre ssion paddle

combocombo ’’ss

•• target materialstarget materials

Fuji FCRmFuji FCRm

Slide 27

�� Collimatio nCollimatio n–– Mo/MoMo/Mo

–– Rh/RhRh/Rh

–– Diff erent paddle positi onsDifferent paddle positio ns

GEGESlide 28

�� Col limatio nColl imation

Fische r SenoscanFisch er Senoscan

Slide 29

�� Collim ationCollimation

Fischer Senosc anFischer Senosca nSlide 30

�� Col limatio n Assessme ntCol limation Asses sment

–– Use coin techniques asUse coin techniques as

described in ACR Manualdescribed in ACR Manual

–– 24 x 30 cm24 x 30 cm

–– 18 x 24 cm (left, center,18 x 24 cm (lef t, center,

rightright –– paddle shifts)paddle shifts)

Lorad SeleniaLorad Selenia

Slide 31

�� Chest Wall andChest Wall and

Missed TissueMissed Tissue

–– Place coin tangent toPlace coin tangent to

chest wall edge ofches t wall edge of

buckybucky

–– Measure coin andMeasure coin and

subtr act from fullsubtr act from full

diameterdiameter

–– Missed tissue must beMissed tissue must be

< 5 mm< 5 mm

Siemens Novation DRSiemens Novation DRSlide 32

�� Compression Plate OverlapCompression Plate Overlap

on Chest Wallon Chest Wall

–– Mount paddleMount paddle

–– Measure overlappin g dista nceMeasure overlappin g distanc e

–– Add the mi ssed tissu e valueAdd the mi ssed tissu e value

for totalfor tota l

–– Must be < 6.5 mmMust be < 6.5 mm

–– Must evalu ate forMust evalu ate for ALLALL

compre ssion paddlescompre ssion paddles

inc lud ing magincl uding mag

Siemen s Novation DRSiemens Novat ion DR

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–– LineLine--pair test toolpair test tool

•• Focal spotFocal spot

�� FFDMFFDM

–– LineLine--pair test toolpair test tool

•• Focal spotFocal spot

•• Detector & imaging chainDetector & imaging chain

Limiting Spatial ResolutionLimiting Spatial ResolutionSlide 34

Spatial Resolu tionSpatial Resolu tion

Fuji FCRmFuji FCRm

GEGE2000D,2000D,





Same as ScreenSame as Screen--FilmFilm(Focal Spot Eval)(Focal Spot Eval) XX

Measure using LPMeasure using LPphantom on top ofphantom on top ofacrylicacrylic

XX XX XX

MTFMTF XX XX

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�� System ResolutionSystem Resolution

–– Up to 10 lp/mm Test PatternUp to 10 lp/mm Test Pattern

–– 4 cm acrylic4 cm acrylic

–– Parallel & Perpendicular to tube with 3Parallel & Perpendicular to tube with 3--55

degree angledegree angle

�� The system limiting spatial resolution must be:The system limiting spatial resolution must be:

> 8 lp/mm> 8 lp/mm ++ 2 lp/mm (6 to 10 lp/mm)2 lp/mm (6 to 10 lp/mm)

Fuji FCRmFuji FCRmSlide 36

�� Evaluation of System ResolutionEvaluation of System Resolution–– 3.153.15--16.6 lp/mm Test Pattern16.6 lp/mm Test Pattern–– Modulation in Normal mode @ 7 lp/mm must beModulation in Normal mode @ 7 lp/mm must be >> 10%10%–– Modulation in Hi Res mode at 11.1 lp/mm must beModulation in Hi Res mode at 11.1 lp/mm must be >> 5%5%

Fischer SenoscanFischer Senoscan

Slide 37

�� Focal Spot EvaluationFocal Spot Evaluation

••Mo/MoMo/Mo

••Rh/RhRh/Rh

••Large & Small SpotsLarge & Small Spots

(1.5 mag)(1.5 mag)

GE 2000D, DS, & EssentialGE 2000D, DS, & EssentialSlide 38

�� MTF MeasurementMTF Measurement –– MonthlyMonthly –– Raw ImageRaw Image

MTF (% ) = (Std. Dev.)x 222/ (Mean Dark ROIMT F (%) = (Std. Dev.)x 222/ (Mean Dark ROI –– Mean Light ROI)Mean Light ROI)

MTF (%) @M TF (%) @ 22 lp/mm > 58% MTF (%) @lp/mm > 58% MTF (%) @ 44 lp/mm > 25%lp/mm > 25%

GE 2000DGE 2000D

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GE 2000DGE 2000D

�� 2000D Add endum: Sub2000D Adden dum: Sub --system MTFsystem MTF–– Optiona l replacem ent for MTF & Focal spotOption al replacement for MTF & Focal sp ot

–– No need for fil mNo need for fil m

•• Use speci fic bar pattern & 4.5 cm acrylic blo ckUse specific bar pattern & 4.5 cm acryl ic bloc k

•• Use ROI tool s to calculate subUse ROI tool s to calculate sub --system MTFsystem MTF

•• Repeat at 1.8 magRepeat at 1.8 mag

Slide 40

�� MTF and CNR MeasurementMTF and CNR Measurement -- WeeklyWeekly–– Test consistency of CNR and ensureTest consistency of CNR and ensure

contrast is adequatecontrast is adequate•• IQST Test toolIQST Test tool

�� Action Limit:Action Limit:–– MTF @ 2 lp/mm > 58%, MTF @ 4 lp/mm > 25%MTF @ 2 lp/mm > 58%, MTF @ 4 lp/mm > 25%

–– Change in CNR must not exceed 0.2Change in CNR must not exceed 0.2

GE DS & EssentialGE DS & Essential

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�� Evaluation of System ResolutionEvaluation of System Resolution–– 55--15 lp/mm Test Pattern15 lp/mm Test Pattern

�� The system limiting spatial resolution must be:The system limiting spatial resolution must be:> 7 lp/mm> 7 lp/mm

Lorad & SiemensLorad & SiemensSlide 42


–– Measure optical densitiesMeasure optical densities

•• Different thicknesses using clinical modesDifferent thicknesses using clinical modes

•• Different density settings (Different density settings (--2,2, --1, 0, +1, +2, etc.)1, 0, +1, +2, etc.)

�� FFDMFFDM

–– Measure resultant techniquesMeasure resultant techniques

–– Measure signal, exposure, & SNR valuesMeasure signal, exposure, & SNR values

AEC PerformanceAEC Performance

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AECAEC

Fuji FCRmFuji FCRm

GEGE2000D,2000D,





Same as ScreenSame as Screen--FilmFilm

Density ControlDensity ControlFunctionFunction XX XX XX

ACR ReproducibilityACR Reproducibility XX

Image Mode TrackingImage Mode Tracking XX XX XX XX

CNRCNR XX

SNRSNR XX XX XX

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�� Density Control FunctionDensity Control Function

–– 4 cm acrylic, ACR phantom technique4 cm acrylic, ACR phantom technique

–– Repeat atRepeat at --2,2, --1, 0, +1, +2 etc. density1, 0, +1, +2 etc. density

–– Record mAsRecord mAs

–– mAs change should be 5 to 15% per stepmAs change should be 5 to 15% per step

Fuji FCRmFuji FCRm

Slide 45

�� Reproducibility & Image Mode TrackingReproducibility & Image Mode Tracking–– 4 cm acrylic with clinical technique4 cm acrylic with clinical technique

–– Position ion chamber in beamPosition ion chamber in beam

–– Record mAs and XRecord mAs and X

–– Repeat 3 timesRepeat 3 times

–– Repeat in each mode (small, large, mag, no grid)Repeat in each mode (small, large, mag, no grid)

–– Action LimitsAction Limits::

•• Coefficient of variation for Exposure or mAs must not exceedCoefficient of variation for Exposure or mAs must not exceed

0.050.05

•• No significant difference in exposure between small and largeNo significant difference in exposure between small and large

bucky when using similar gridsbucky when using similar grids


�� CNR Per Object ThicknessCNR Per Object Thickness

–– CNR using clinical technique for 2 cmCNR using clinical technique for 2 cm

–– Repeat for 4 and 6 cmRepeat for 4 and 6 cm

–– Action LimitsAction Limits::

•• CNR of 2 cm relative to 4 cm must beCNR of 2 cm relative to 4 cm must be >> 100%100%

•• CNR of 6 cm relative to 4 cm must beCNR of 6 cm relative to 4 cm must be >> 75%75%

Fuji FCRmFuji FCRm

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�� AOP Mode and SNR CheckAOP Mode and SNR Check–– Variable thicknesses of acrylicVariable thicknesses of acrylic–– Std, AutoStd, Auto–– Evaluate :Evaluate:

•• Correct techni ques?Correct techni ques ?

•• Adequate SNR?Adequate SNR?

2.5 cm2.5 cmAcrylicAcrylic

4.0 cm4.0 cmAcryli cAcryli c

6.0 cm Acryl ic6.0 cm Acrylic

AcrylicThickness

Target-Filter

SelectedkVp

SelectedmAs

2.5cm Mo-Mo 27 kVp 20-60

4.0cm Mo-Rh 28 kVp 35-90

6.0cm Rh-Rh 32 kVp 35-90

EachEach ““ rawraw ”” image must have a measured SNR ofimage must have a measured SNR ofat least 50at least 50

GE 2000DGE 2000DSlide 48

GE DS & Essentia lGE DS & Essent ial

�� DS specific QC testsDS specific QC tests–– AOP Mode and SNR CheckAOP Mode and SNR Check

•• Use builtUse built --in softw are for image acquis itionin softw are for image acqu is ition

•• AOP: STD/AutoAOP: STD/Auto

Acrylic ThicknessAcrylic Thickness(mm)(mm)

Exposure ParametersExposure ParametersFor AOP STD mode olyFor AOP STD mode oly

Track/FilterTrack/Filter mAsmAs kVkV

2525 Mo/MoMo/Mo 2020--6060 2626

5050 Rh/RhRh/Rh 4040--9090 2929

6060 Rh/RhRh/Rh 4545--9595 3131

SNR must be > 50SNR must be > 50

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�� Automatic Exposure ControlAutomatic Exposure Control

–– AUTOAUTO--FILTERFILTER –– 2, 4, 6, 8 cm2, 4, 6, 8 cm

–– 4 cm (4 cm (--5 thru +5)5 thru +5)

–– Use ROI to measure mean pixel valueUse ROI to measure mean pixel value

inside virtual AEC detectorinside virtual AEC detector

�� Performance CriteriaPerformance Criteria

–– Pixel value should not vary by morePixel value should not vary by more

than 10% of meanthan 10% of mean

–– Exposure compensation steps shallExposure compensation steps shall

meet requirements in pixel value tablemeet requirements in pixel value table

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�� AEC Image Stability and Reproducibility and SNRAEC Image Stability and Reproducibility and SNR

–– ACR PhantomACR Phantom

–– Mo/Mo, 28 kV,Mo/Mo, 28 kV, ““HH””, sensor 1, sensor 1

–– Record mAs, SNR, Mean, Entrance Exposure (5 times)Record mAs, SNR, Mean, Entrance Exposure (5 times)

�� Action Limits:Action Limits:

–– Coef. of Var for mAS and X < 5%Coef. of Var for mAS and X < 5%

–– SNR and Mean shall not vary bySNR and Mean shall not vary by ++ 15% of Mean15% of Mean

Siemen s NovationSiemens Novat ion

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�� AEC Thicknes s TrackingAEC Thickne ss Tracking

–– 2, 4, and 6 cm2, 4, and 6 cm

–– ““ HH”” modemode

–– Max deviati on = (Max di fferenc e / mean value ) * 100Max dev iati on = (Max differenc e / mean value ) * 100



–– Measure if ODMeasure if OD’’s are consistents are consistent

–– Check for artifactsCheck for artifacts

�� FFDMFFDM

–– FlatFlat--field uniformityfield uniformity

–– Detector calibrationDetector calibration

–– Pixel correction testPixel correction test

–– CR Reader Scanner PerformanceCR Reader Scanner Performance

Uniformity of Screen Speed &Uniformity of Screen Speed &Detector PerformanceDetector Performance

Slide 53

Detect or Performanc eDetect or Performanc eFuji FCRmFuji FCRm

GEGE2000D,2000D,





Same as ScreenSame as Screen--FilmFilm(Screen Uniformity)(Screen Uniformity)

FlatFlat--Field UniformityField Uniformity XX XX

Detector CalibrationDetector Calibration XX XX XX

CR Reader ScannerCR Reader ScannerPerformancePerformance XX

Dynamic RangeDynamic Range XX

Primary ErasurePrimary Erasure XX

InterInter--PlatePlateConsistencyConsistency XX

Geometric DistortionGeometric Distortion XX

Pixel CorrectionPixel Correction XX

GhostingGhosting XX XX

Slide 54

�� Dynamic RangeDynamic Range

–– To confirm the dynamic range of reader and plateTo confirm the dynamic range of reader and plate

–– Use 2 & 4 cm acrylicUse 2 & 4 cm acrylic

–– Technique for 6 cmTechnique for 6 cm

–– View image to determine if 3 regions are visibleView image to determine if 3 regions are visible

and discernableand discernable

Fuji FCRmFuji FCRm

Slide 55

�� CR Reader Scanner PerformanceCR Reader Scanner Performance

–– Establish that IP reader & optics do not exhibit scan orEstablish that IP reader & optics do not exhibit scan or

print jitterprint jitter

–– NonNon--grid exposuregrid exposure

–– Position rulers inPosition rulers in ““TT”” formationformation

–– Expose & processExpose & process

–– Action Limit:Action Limit: Image must have smooth borders freeImage must have smooth borders free

from jagged edges or defectsfrom jagged edges or defects


�� Primary Erasure (Additive & Multiplicative)Primary Erasure (Additive & Multiplicative)–– To assess the erasure performance of reader andTo assess the erasure performance of reader and

platesplates

–– Additive:Additive: Shoot phantom, process, wait 1 minute,Shoot phantom, process, wait 1 minute,

reprocess, change S value to 10X original,reprocess, change S value to 10X original,

inspect for visibility of phantom imageinspect for visibility of phantom image

–– Multiplicative:Multiplicative: Shoot & process phantom, shoot 4Shoot & process phantom, shoot 4

cm acrylic on same cassette, process and inspectcm acrylic on same cassette, process and inspect

for visibility of phantom imagefor visibility of phantom image

Fuji FCRmFuji FCRm

Slide 57

�� InterInter--Plate ConsistencyPlate Consistency

–– To confirm xTo confirm x--ray absorption & SNR consistencyray absorption & SNR consistency

–– Expose plates using clinical technique with 4cmExpose plates using clinical technique with 4cm

acrylicacrylic

–– Record mAS (must be withinRecord mAS (must be within ++10%)10%)

–– Calculate SNR (must be withinCalculate SNR (must be within ++15%)15%)


�� FlatFlat--field uniformityfield uniformity

–– Test to ensure detector performance acceptableTest to ensure detector performance acceptable

•• Measures detector uniformity (signal & noise)Measures detector uniformity (signal & noise)

•• Measures bad pixelsMeasures bad pixels

–– System automatically calculates pass/failSystem automatically calculates pass/fail

QAPQAP

GE 2000D, DS, & EssentialGE 2000D, DS, & Essential

Slide 59

�� Flat Field and Detector CalibrationFlat Field and Detector Calibration–– Run daily calibration using software Use 4 cmRun daily calibration using software Use 4 cm

acrylicacrylic

–– Exposure resulting in 1000 ADUExposure resulting in 1000 ADU’’ss

–– No Artifacts at WWNo Artifacts at WW >> 800800

–– Compute deviation between corner and centerCompute deviation between corner and center

meansmeans

–– Must be withinMust be within ++ 20% of center ROI20% of center ROI

FischerFischerSlide 60

��Geometric Dis tort ionGeometric Distortion

––Use a 40 mesh Cu screenUse a 40 mesh Cu screen

––Acq uire image at lowAcquire image at low

techniquetechnique

––Visually inspect forVisually inspect for

dis torti ons or blurringdist ortions or blurring


Slide 61

�� Detector CalibrationDetector Calibration –– Every two weeksEvery two weeks

–– 4 cm acrylic block4 cm acrylic block –– no paddleno paddle

–– Built in Calibration softwareBuilt in Calibration software

–– Follow onFollow on--screen instructionsscreen instructions

•• Review image for artifactsReview image for artifacts

•• Repeat until you have 8 imagesRepeat until you have 8 images

•• End calibrationEnd calibration

•• Calibration is performed automaticallyCalibration is performed automatically

Lorad SeleniaLorad SeleniaSlide 62

�� Detector GhostingDetector Ghosting

–– Assure ghosting does not interfere withAssure ghosting does not interfere with

image qualityimage quality

–– 4 cm acrylic covering half of detector4 cm acrylic covering half of detector

–– Set AEC clinicallySet AEC clinically

–– Make exposureMake exposure

–– 4 cm acrylic covering entire detector4 cm acrylic covering entire detector

–– Place 0.1 mm AL on topPlace 0.1 mm AL on top

–– Make 2Make 2ndnd exposure (AEC) as soon asexposure (AEC) as soon as

possible (~ 1 minute after first)possible (~ 1 minute after first)

�� Calculate Ghost Image FactorCalculate Ghost Image Factor ==

(Mean(MeanR3R3 –– MeanMeanR2R2 / Mean/ MeanR1R1 –– MeanMeanR2R2))

–– Must be withinMust be within ++ 0.30.3


Slide 63

�� Detector UniformityDetector Uniformity

–– Make exposure: 28 kV, 50 mAS,Make exposure: 28 kV, 50 mAS,

Mo/MoMo/Mo

–– Select ROI 128 x 128 pixelsSelect ROI 128 x 128 pixels

–– Record measurem ents in cornersRecor d measur ements in corners

and centerand center

–– Pixel value insi de each of 5 ROIPixel value insi de each of 5 ROI’’ss

shall not diff er by more than 10%shall not diff er by more than 10%

of meanof mean


�� Detector Calibration TestDetector Calibration Test

–– Objective: to determine if systemObjective: to determine if system

was correctly gain calibratedwas correctly gain calibrated

–– Must be done weeklyMust be done weekly

(technologist)(technologist)

–– Follow onFollow on--screen instructionsscreen instructions

–– Acquire 8 imagesAcquire 8 images

–– Images should be free of artifactsImages should be free of artifacts

Siemens NovationSiemens Novation

Slide 65

�� Ghost Image Evaluatio nGhost Image Evaluation

–– Setup with 2mm steel barSetup with 2mm steel bar

–– Exp 1Exp 1: Mo/Mo, 23 kV, 2 mAs: Mo/Mo, 23 kV, 2 mAs –– recor d meanrecord mean

–– Exp 2Exp 2: Mo/Mo, 28 kV, 200 mAs: Mo/Mo, 28 kV, 200 mAs -- remove steelremove stee l

–– Wait 180 seconds, place 4 cm Acrylic on topWait 180 seconds, place 4 cm Acrylic on top

–– Exp 3Exp 3: Mo/Mo, 28 kV, 14 mAs: Mo/Mo, 28 kV, 14 mAs

–– Calculate % Ghost ing = (PV1Calculate % Ghost ing = (PV1 –– PV2) / PV1PV2) / PV1

+PV2+PV2

�� Action Limi tAction Limi t : % Gho sti ng < 3%: % Ghosti ng < 3%


�� Pixel Correction TestPixel Correction Test

–– Cali bration mod eCalibra ti on mode

–– Create new pixel mapCreate new pixel map

–– Follow onFollow on --scre en instru ction sscreen instru ction s

–– Acquir e imageAcq uire image

–– Evaluat e image is free fromEvalua te imag e is free from

coll imato r or debris artif actscol lima tor or debris artifa cts

–– System compiles new pixe lSystem compiles new pixe l

mapmap

–– System di splay resultsSystem displ ay results –– mus tmust

meet requirementsmeet requirements


Slide 67


–– Evaluate cassettesEvaluate cassettes

�� FFDMFFDM

–– Evaluate detectorEvaluate detector

–– CR: Imaging PlatesCR: Imaging Plates

ArtifactsArtifactsSlide 68

Artifact sArtifac ts

Fuji FCRmFuji FCRm

GEGE2000D,2000D,






Expose Using AcrylicExpose Using Acrylic XX XX XX XX XX

Slide 69


Artifact evaluati onArtifa ct evaluation

Mo/MoMo/Mo Mo/RhMo/Rh Rh/RhRh/Rh

ArtifactsArtifacts

Slide 71

ArtifactsArtifacts

Slide 72

ArtifactsArtifacts

Slide 73

Possible cause:Possible cause:

condensation oncondensation on

detectordetector

ArtifactsArtifacts

Slide 74

Possible CausePossible Cause::

Detector dropout orDetector dropout or

mismis--registrationregistration

ArtifactsArtifacts

Slide 75

Processing Steps for Digital ImagesProcessing Steps for Digital Images

RawRaw ProcessedProcessedImageImageDetectionDetection

ImageImageCorrectionCorrection

ImageImageProcessingProcessing

ImageImageDisplayDisplay

CalibrationCalibrationFileFile



–– ACR Phantom ScoresACR Phantom Scores

–– Optical Density & ContrastOptical Density & Contrast

�� FFDMFFDM

–– ACR Phantom ScoresACR Phantom Scores

•• Pass/fail requirements differ by vendorPass/fail requirements differ by vendor

–– SignalSignal--toto--Noise Ratio (SNR)Noise Ratio (SNR)

–– ContrastContrast--toto--Noise Ratio (CNR)Noise Ratio (CNR)

Image QualityImage Quality

Slide 77


Fuji FCRmFuji FCRm

GEGE2000D,2000D,






Manual TechniquesManual Techniques XX XX

Clinical TechniqueClinical Technique XX XX PartialPartial

CNRCNR XX XX XX XX XX

Slide 78

ACR Phantom ImagingACR Phantom Imaging

GE & Fischer &GE & Fischer &FujiFuji

Lorad &Lorad &SiemensSiemens

FibersFibers 44 55

SpecksSpecks 33 44

MassesMasses 33 44


Slide 79

�� ACR Phantom ImagingACR Phantom Imaging

–– Manual technique (Mo/Mo, 26Manual technique (Mo/Mo, 26

kVp , 125 mAS)kVp, 125 mAS)

–– Score theScore the process edproc essed imageimage

–– Acquisition workstationAcquisition work stati on

–– Each monitor of the RWSEach monitor of the RWS

–– Laser imagerLaser imager

GE 2000DGE 2000DSlide 80

�� ContrastContrast--toto--Noise Test (CNR)Noise Test (CNR)

–– To examine consistency of CNRTo examine consistency of CNR

ratio measured over timeratio measured over time

–– Use theUse the rawraw imageimage

–– ++ 20% of baseline20% of baseline

Backg roun d ROIBackg roun d ROI Mass ROIMass ROI

CNR = (MeanCNR = (Meanbackgroundbackground -- MeanMeanmassmass)/SD)/SDbackgroundbackground

GE 2000DGE 2000D

Slide 81

GE DSGE DS

�� DS specific QC testsDS specific QC tests

–– Phantom Image Qualit yPhantom Image Qualit y

•• Manual technique: Rh/Rh, 29 kVp, 56 mAsManual technique: Rh/Rh, 29 kVp, 56 mAs

–– MTF and CNR Measurem entMTF and CNR Measuremen t

•• Use IQST test toolUse IQST test tool

•• Use builtUse built --in softw are for image acquis iti onin softw are for imag e acq uisition

•• Manual technique: Rh/Rh 30 kVp, 56 mAsManual technique: Rh/Rh 30 kVp, 56 mAs

•• Result s are automatically displayed (pass/fa il)Results are automatically displayed (pass/fail )

•• Same acti on limits as 2000DSame acti on limits as 2000D

Slide 82

�� Phantom Image Acquisit ion Test and Image QualityPhantom Image Acq uisit ion Test and Image Quality–– Select Techni ques to give 1000 ADUSelect Techni ques to give 1000 ADU

–– Compare backgroun d mean, StdDev, and ADU levelCompar e backgroun d mean, StdDev, and ADU level

differe nce to baselin e value sdi fference to baselin e value s

–– Score : 4 fi bers, 3 speck grou ps, and 3 massesScore : 4 fi bers, 3 speck grou ps, and 3 masses


Slide 83

�� Phantom Image QualityPhantom Image Quali ty–– Select clinical exposure mode (i.e. AUTOSelect clinical expo sure mode (i.e. AUTO--FILTER)FILTER)

–– Prin t filmPrint film

–– Measure backgroun d OD and dens ity differ enceMeasure backgro und OD and density differ ence ––

Plot on tech work sheetsPlo t on tech worksh eets

•• Background must beBackground mus t be >> 1.20 OD1.20 OD ++ 0.200.20

•• DD must beDD mus t be >> 0.400.40 ++ 0.050.05

–– Score on each Sof t Copy WorkstationScore on each Soft Copy Workst ation

•• 5 fibers5 fibers

•• 4 spec k gr oups4 speck groups

•• 4 masses4 masses

Lorad SeleniaLorad SeleniaSlide 84

�� Phantom Image Qualit yPhantom Image Qualit y

–– Position phantom 1 cmPositio n phantom 1 cm

over chest wal l edgeover chest wall edge

–– Select: 28 kV, AECSelect: 28 kV, AEC--Auto,Auto,

Mo/MoMo/Mo

–– Score on RWS or FilmScore on RWS or Film

–– FiberFiber >> 55

–– SpecksSpecks >> 44

–– MassesMasses >> 44


Slide 85

�� SNR and CNR MeasurementsSNR and CNR Measurements

–– SNRSNR at leastat least >> 4040

–– CNRCNR should stay withinshould stay within ±±15% of baseline15% of baseline

•• Obtained during acceptance testingObtained during acceptance testing

Lorad & SiemensLorad & SiemensSlide 86

�� ContrastContrast--toto--Noise Test (CNR)Noise Test (CNR)

–– To examine consistency of CNR ratio measured over timeTo examine consistency of CNR ratio measured over time

–– Use 4 cm acrylic & 0.2 mm AlUse 4 cm acrylic & 0.2 mm Al

–– Manual technique (Mo/Mo, 26 kVp, 125 mAs)Manual technique (Mo/Mo, 26 kVp, 125 mAs)

–– Calculate CNR using softwareCalculate CNR using software

–– ++ 20% of baseline20% of baseline

Fuji FCRmFuji FCRm

Slide 87


–– Assure that actual kVp isAssure that actual kVp is

•• Accurate (Accurate (++ 5% of indicated)5% of indicated)

•• Reproducible (Coeff. Var.Reproducible (Coeff. Var. << 2%)2%)

�� FFDMFFDM

–– SameSame

kVpkVpSlide 88


–– Assure HVL is adequate to minimize patientAssure HVL is adequate to minimize patient

dosedose

–– HVL shall meet FDAHVL shall meet FDA’’s Performance Standardss Performance Standards

�� FFDMFFDM

–– SameSame

HVLHVL

Note the lead sheetNote the lead sheet

Slide 89


–– Dose for single CC view of ACR phantom shallDose for single CC view of ACR phantom shall

not exceed 3.0 mGy per exposurenot exceed 3.0 mGy per exposure

�� FFDMFFDM

–– SameSame

DoseDoseSlide 90


–– System shall be capable of producing aSystem shall be capable of producing a

minimum output of 7.0 mGy/sec @ 28 kVpminimum output of 7.0 mGy/sec @ 28 kVp

Mo/Mo over 3.0 second periodMo/Mo over 3.0 second period

�� FFDMFFDM

–– SameSame

–– S value confirmationS value confirmation

–– Exposure LinearityExposure Linearity

Radiation OutputRadiation Output

Slide 91

Radiati on OutputRadiat ion Output

Fuji FCRmFuji FCRm

GEGE2000D,2000D,





Same as ScreenSame as Screen--FilmFilm XX XX XX XX

S Value ConfirmationS Value Confirmation XX

Exposure LinearityExposure Linearity XX

Slide 92

�� S Value Confirma tio nS Value Confirmati on

–– Make exposure at 25 kV Mo/Mo to give XMake exposure at 25 kV Mo/Mo to give X

>> 20 mR20 mR

–– Exposure cassette at th is techn iqueExposure cassette at this techn ique

(wait 10 min. & pro cess)(wait 10 min. & process)

–– Record S valueRecord S value

–– CalculateCalculate ““ Corrected S valueCorrecte d S value ””

–– Action LimitAction Limit : Corrected S value sh ould: Corrected S value sh ould

not exceed the rang e of 120not exceed the range of 120 ++ 20% (96 <20% (96 <

S < 144)S < 144)

Fuji FCRmFuji FCRm

Slide 93

�� Exposure Lineari ty and Reprod uci bilityExposure Linearit y and Reprod ucib ility

–– Procedure:Procedure:

•• Measure exposure at specified techn iquesMeasur e exposur e at specified techniques

•• Calculate:Calculat e:

�� OutputOutput = Average exposure reading/mA= Averag e exposure reading/mA

�� Lin earit yLin earity = (A= (A--B)/(A+B) < 0.08B)/(A+B) < 0.08

�� Reprodu cibi li tyReproducibility = StdDev/Av g < 0.035 for each= StdDev/Av g < 0.035 for each

techniqu etechni que

Fischer Senosc anFischer Senosca nSlide 94


–– Luminance (Luminance (>> 3000 cd/m3000 cd/m22))

–– Room illuminance (Room illuminance (<< 50 lux)50 lux)

–– Viewbox cleaningViewbox cleaning

�� FFDMFFDM

–– SameSame

Viewing & Viewing ConditionsViewing & Viewing Conditions

Slide 95


–– Assess siteAssess site’’s QC programs QC program

–– Check that QC tests are properly performedCheck that QC tests are properly performed

–– Independent checks of tech QC testsIndependent checks of tech QC tests

�� FFDMFFDM

–– SameSame

Assessing Tech QCAssessing Tech QCSlide 96


–– Measure optical densitiesMeasure optical densities

•• Density difference, midDensity difference, mid--density, base+fogdensity, base+fog

•• Measures consistencyMeasures consistency

�� FFDMFFDM

–– ManufacturersManufacturers’’ recommendationsrecommendations

–– Some refer to printer manufacturersSome refer to printer manufacturers’’ recommendationsrecommendations

–– Typically identical to ACR SFM ManualTypically identical to ACR SFM Manual

Film ProcessingFilm Processing

Slide 97

Film Proces sor QCFilm Processor QC

Fuji FCRmFuji FCRm

GEGE2000D,2000D,





Follow PrinterFollow PrinterManufacturers QCManufacturers QC XX XX XX

If Not, Use TheirsIf Not, Use Theirs XX XX XX

Follow FFDMsFollow FFDMs’’ QCQC XX XX

Slide 98

�� Base + FogBase + Fog


Wet Processing Laser Printer

Northwes tern Memorial Hospital - Proce ssor ID: 2 - MAR 2006Base + Fog

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

1-M

ar-0

6

2-M

ar-06

3-M

ar-06

6-Mar-0

6

7-Mar-0

6

8-Mar-0

6

9-Mar-0

6

10-M

ar-0

6

13-Mar

-06

14-Mar

-06

serv ic

e3/

14

15-Mar-0

6

16-Mar-0

6

17-M

ar-06

20-M

ar-06

21-M

ar-0

6

22-Mar

-06

23-Mar

-06

24-Mar

-06

27-Mar-0

6

28-Mar-0

6

29-M

ar-06

30-M

ar-06

31-M

ar-06

Date

Base + Fog Action Limi t = 0.22

Base + Fog Daily Value

Base + Fog - Operating Level = 0.19

Northw estern Memoria l Hospit al - Process or ID: Kod ak 8900 - Oct2006 Base + Fog

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

October 2, 2

006

October

3,200

6

Octobe

r 4,20

06

October 5, 2

006

October

6, 200

6

October

9,20

06

Octo

ber10

, 200

6

Oct

ober 11,200

6

Octo

ber12

, 2006

Octo

ber 13

, 200

6

Oct

ober 16,200

6

Oct

ober17

, 2006

Octo

ber 18

, 200

6

Oct

ober 19,20

06

Octo

ber20

, 2006

Octo

ber 23, 200

6

Oct

ober 24,20

06

Octo

ber25

, 2006

Octo

ber 26, 200

6

Oct

ober 27,20

06

Octo

ber30

, 2006

Date

Base + Fog Act ion Limit = 0.23

Base + Fog Daily Value

Base + Fog - Operating Level = 0.2

Slide 99

�� MidMid--DensityDensity


Nor thwestern Memorial Hosp ital - Proces sor ID: 2 - MAR 2006Mid-Densi ty

1.30

1.40

1.50

1.60

1.70

1.80

1.90

2.00

2.10

2.20

2.30

1-Mar-0

6

2-M

ar-0

6

3-M

ar-06

6-Mar-0

6

7-M

ar-0

6

8-Mar-0

6

9-M

ar-0

6

10-Mar-0

6

13-M

ar-0

6

14-Mar-0

6

serv

i ce3/1

4

15-M

ar-0

6

16-M

ar-06

17-M

ar-0

6

20-Mar-0

6

21-M

ar-0

6

22-Mar-0

6

23-M

ar-06

24-M

ar-0

6

27-M

ar-06

28-M

ar-0

6

29-Mar-0

6

30-M

ar-06

31-M

ar-0

6

Date

Mid-Den sity Upper Control Li mit = 2.06

Mid-Den sity Daily Valu e

Mid-Den sity Daily Valu e Operating Level = 1.91

Mid-Den sity Lower Con trol Li mit = 1.76

MD Step=12

Northwes tern Memorial Hospital - Process or ID: Kodak 8900 - Oct 2006Mid-Density

0.70

0.80

0.90

1.00

1.10

1.20

1.30

1.40

1.50

1.60

1.70

Oct

ober 2, 200

6

Oct

ober 3, 200

6

Oct

ober4,

2006

Oct

ober5,

2006

Oct

ober6,

2006

Oct

ober9,

2006

October 10,

2006

October 11,

2006

October 12,

2006

October 13,

2006

October 16,

2006

October 17,

2006

October 18,

2006

October 19,

2006

October 20,

2006

October

23,20

06

October

24,20

06

October

25,20

06

October

26,20

06

October

27, 2

006

October

30, 2

006

Date

Mid-Density Upper Control Li mit = 1.48

Mid-Density Daily Value

Mid-Density Daily Value Operating Lev el = 1.33

Mid-Density Lower Cont rol Limit = 1.18


Slide 100

�� Density DifferenceDensity Difference


Northw ester n Memorial Hospital - Processor ID: 2 - MAR 2006Density Diff erence

1.50

1.60

1.70

1.80

1.90

2.00

2.10

2.20

2.30

2.40

2.50

2.60

1-Mar

-06

2-Mar-0

6

3-Mar

-06

6-Mar-0

6

7-Mar

-06

8-Mar-0

6

9-Mar-0

6

10-Mar-0

6

13-M

ar-06

14-Mar-0

6

service 3/1

4

15-Mar

-06

16-Mar-0

6

17-Mar

-06

20-Mar-0

6

21-Mar

-06

22-Mar-0

6

23-Mar

-06

24-Mar-0

6

27-M

ar-06

28-Mar-0

6

29-M

ar-06

30-Mar-0

6

31-M

ar-06

Date

Densit y Difference Upper Control Limit = 2.25

Densit y Difference Daily Value

Densit y Difference Daily Value Operating Level = 2.1

Densit y Difference Low er Control Limit = 1.95

HD Step=13 LD Step=10

Northwestern Memori al Hospital - Processor ID: Kodak 8900 - Oct 2006Density Dif ference

1.00

1.10

1.20

1.30

1.40

1.50

1.60

1.70

1.80

1.90

2.00

October

2, 2006

October

3, 2006

October 4, 20

06

October 5, 20

06

October 6,

2006

October 9,

2006

October 10, 2

006

October 11, 2

006

October 12, 20

06

October 13

, 2006

October 16,

2006

October

17,200

6

October 18, 2

006

October 19, 2

006

October 20, 20

06

October 23

, 2006

October 24,

2006

October

25,200

6

October

26,2006

October 27, 2

006

October 30, 20

06

Date

Density Difference Upper Control Li mit = 1.77

Density Difference Daily Value

Density Difference Daily Value Operat ing Level = 1.62

Density Difference Lower Contr ol Limit = 1.47


Slide 101

�� DDmaxmax


North western Memori al Hosp ital - Proc essor ID: Kodak 8900 - Oct2006 Dmax

2.60

2.70

2.80

2.90

3.00

3.10

3.20

3.30

3.40

3.50

3.60

3.70

3.80

3.90

4.00

October 2, 2006

October 3, 2006

October 4, 2006

October 5, 2006

October 6, 2006

October 9, 2006

Oc tober 10, 2006

October 11, 2006

Oc tober 12, 2006

October 13, 2006

October 16, 2006

October 17, 2006

October 18, 2006

October 19, 2006

Oc tober 20, 2006

October 23, 2006

October 24, 2006

October 25, 2006

October 26, 2006

October 27, 2006

October 30, 2006

October 31, 2006

Date

Dmax Daily Value

Dmax - Operating Level = 3.44

Dmax Act ion Limit = 3.19

Laser Printer

Slide 102

�� Laser Printer QCLaser Printer QC -- DailyDaily

•• SMPTE pattern fromSMPTE pattern fromAWSAWS

•• Measure ODMeasure OD

•• 10%, 40% and 90%10%, 40% and 90%

•• Plot midPlot mid--densitydensity(40%), density(40%), densitydifference (40diff erence(40--10%),10%),lower density (90%)lower density (90%)

•• ++ 15 from baseline15 from baseline

40%40%

10%10% 90%90%

LoradLorad

Slide 103

RWS QCRWS QC

Fuji FCRmFuji FCRm

GEGE2000D,2000D,





Follow monitorFollow monitormanufacturers QCmanufacturers QC XX XX XX

If Not, Use FFDMIf Not, Use FFDM’’ss XX XX XX

Use FFDMUse FFDMmanufacturersmanufacturers’’s QCs QC XX XX

Slide 104

Multim odality WorkstationsMultim odality Worksta tions�� FDA Approved Multimodality WorkstationsFDA Approved Multimodality Workstations

–– AGFA IMPAX MA3000AGFA IMPAX MA3000

–– Sectra IDS5/mxSectra IDS5/mx

–– Kodak DirectView PACS System 5Kodak DirectView PACS System 5

–– McKessonMcKesson’’s PACS Mammo Stations PACS Mammo Station

–– iCad Second Look 500MiCad Second Look 500M

–– Cedera ICedera I--ReadMammoReadMammo

–– Fuji SynapseFuji Synapse

–– GE Seno Advantage & CentricityGE Seno Advantage & Centricity

–– Fischer Senoview Plus (Cedera)Fischer Senoview Plus (Cedera)

–– Hologic SecureView DXHologic SecureView DX

–– Siemens MammoReportPlusSiemens MammoReportPlus

Slide 105

�� AGFA IMPAX MA3000AGFA IMPAX MA3000–– Clean monitor surfaceClean monitor surface–– Measure display white & blackMeasure display whi te & black–– Measure quality levelMeasure quality level–– Measure uniform ityMeasure uniform ity–– Calibrate displaysCalibrate displays–– View SMPTE patt ernView SMPTE pattern–– Viewing condition sViewing condition s

�� GE Seno Adva ntageGE Seno Ad vantage–– Viewing cond itions chec k and settingViewing cond itions chec k and settin g–– Monitor calib rati onMonitor calib ration–– Image quali tyImage quali ty –– SMPTE patt ernSMPTE pattern–– Analys is of screen uniformityAnalys is of screen uniformity

�� Siemens MammoReport PlusSiemens Mammo Report Plus–– Geometri c disto rtionGeometric disto rtion–– Reflec tionReflection–– Lumin ance ResponseLumin ance Response–– Lumin ance UniformityLumin ance Uniformi ty–– ResolutionResolution–– NoiseNoise–– Overall EvaluationOverall Evaluation

Slide 106

�� BarcoBarco–– II--Guard CheckGuard Check–– Quality LevelQuality Level–– Display WhiteDisplay White–– Calibration Settings CheckCalibration Settings Check

�� EizoEizo–– Pattern CheckPattern Check–– Luminance CheckLuminance Check–– Grays cale CheckGraysc ale Check–– Uniformi ty CheckUniformity Check

�� PlanarPlanar–– Monitor CleaningMonitor Cleaning–– Viewing Conditi ons CheckViewing Condi tions Check–– Monitor Calibration CheckMonitor Calibration Check–– Image Qual ityImage Quality –– SMPTESMPTE–– Visual Inspection for DisplayVisual Inspe ction for Display

DefectsDefec ts

Slide 107

�� Keep a good file system for naming & numbering theKeep a good file system for naming & numbering the

different QC testsdifferent QC tests

�� Archive all digital QC images on a CDArchive all digital QC images on a CD

�� Keep QC test tools in a safe placeKeep QC test tools in a safe place

�� Perform flatPerform flat--field imaging before phantom imaging testsfield imaging before phantom imaging tests

�� Perform testing in the morningPerform testing in the morning

�� Have a system for monitoring theHave a system for monitoring the ““Auto Print/Auto PushAuto Print/Auto Push””

functionsfunctions

SuggestionsSuggestionsSlide 108

�� Repeat testRepeat test

–– Clean plexiglass & move slightlyClean plexiglass & move slightly

�� Questions to ask yourself:Questions to ask yourself:

–– Are you using the correct image? Raw vs. Processed?Are you using the correct image? Raw vs. Processed?

–– Are the ROIAre the ROI’’s in the correct location?s in the correct location?

�� ReRe--boot systemboot system

�� Call serviceCall service

–– ReRe--calibration solves most image quality problemscalibration solves most image quality problems

Troubleshooting QCTroubleshooting QC

Slide 109

�� Obtain proper handsObtain proper hands--on trainingon training

�� Must perform manufacturer specific QC testsMust perform manufacturer specific QC tests

�� ArtifactsArtifacts –– most problems can be seen heremost problems can be seen here

�� ReRe--booting and/or rebooting and/or re--calibrating fixes mostcalibrating fixes most

problemsproblems

�� Laser PrinterLaser Printer

–– DDmaxmax at least 3.5 ODat least 3.5 OD

–– MidMid--density about 1.5 ODdensity about 1.5 OD

Key Take Home PointsKey Take Home PointsSlide 110

�� Review workstation monitorsReview workstation monitors –– look at the clinicallook at the clinical

images!images!

–– Do they match?Do they match?

–– Appropriate dark and light levelsAppropriate dark and light levels

�� Be aware of separate QC for review workstationsBe aware of separate QC for review workstations

�� Know, and be involved with, your site QC programKnow, and be involved with, your site QC program

Key Take Home PointsKey Take Home Points

Slide 111

Thank YouThank You

Slide 112

SAM Questio nsSAM Quest ions

Digital Mammography QualityDigital Mammography Quality

Assurance: Comparing theAssurance: Comparing the

Manufacturers RecommendationsManufacturers Recommendations

Slide 113

In digital mammography , whoIn digital mammography, whomandate s the pass/fail criteria for sitemandates the pass/fail crit eria for sit eQC?QC?

18%

0%

62%

16%

4% 1.1. The American College of RadiologyThe American College of Radiology2.2. The FDAThe FDA3.3. The FFDM unit manufacturerThe FFDM unit manufacturer4.4. NEMANEMA5.5. MQSAMQSA

Slide 114

Answe r: 3Answer: 3 -- The FFDM uni tThe FFDM unitmanufacturermanufa cturer

ReferencesReferences

�� MQSA Regulations 900.12(e)(6)MQSA Regulations 900.12(e)(6)�� http://www.fda.gov/CDRH/MAMMOGRAhttp://www.fda.gov/CDRH/MAMMOGRA

PHY/frmamcom2.html#s90012PHY/frmamcom2.html#s90012

Slide 115

Answe r 3: The FFDM unitAnswer 3: The FFDM unitmanufacturermanufact urer

ExplanationExplanation

““the quality assurance program shall bethe quality assurance program shall besubstantially the same as the qualitysubstantially the same as the qualityassurance program recommended by theassurance program recommended by theimage receptor manufacturer, except thatimage receptor manufacturer, except thatthe minimum allowable dose for screenthe minimum allowable dose for screen--film systems in this sectionfilm systems in this section””

Slide 116

How do you accred it a Fuji CRHow do you accredit a Fuji CRMammograp hy system which usesMammography system whic h usesboth CR and screenboth CR and scree n--film on the samefil m on the samexx--ray system?ray system ?

0%

4%

92%

4% 1.1. As 1 mammography unit?As 1 mammography unit?2.2. As 2 mammography units?As 2 mammography units?3.3. You cannot use CR and film on theYou cannot use CR and film on the

same unit.same unit.4.4. CR is exempt from accreditationCR is exempt from accreditation

Slide 117

Answe r: 2Answer: 2 –– As 2 mammographyAs 2 mam mograph yunitsunits


�� http://www.acr.org/accreditation/mammography/http://www.acr.org/accreditation/mammography/mammo_faq/mammo_faq_mamac.aspx#8.0.1mammo_faq/mammo_faq_mamac.aspx#8.0.1

Slide 118

Answer: 2Answer: 2 -- As 2 mamm ograph yAs 2 mammographyunitsuni ts


As of November 15, 2006 facilities usingAs of November 15, 2006 facilities usingboth screenboth screen--film and CR on the samefilm and CR on the samemammography units must accredit thesemammography units must accredit these2 systems as 2 separate units.2 systems as 2 separate units.

Slide 119

What are the min imum passin g ACRWhat are the mini mum passi ng ACRphantom score s for the Lorad Selenia forphantom scores for the Lorad Selenia forweekly QC?weekly QC?

4%

0%

80%

11%

4% 1.1. 5 Fibers, 4 Speck Groups, 3 Masses5 Fibers, 4 Speck Groups, 3 Masses2.2. 4 Fibers, 3 Speck Groups, 3 Masses4 Fibers, 3 Speck Groups, 3 Masses3.3. 5 Fibers, 4 Speck Groups, 4 Masses5 Fibers, 4 Speck Groups, 4 Masses4.4. 4 Fibers, 4 Speck Groups, 3 Masses4 Fibers, 4 Speck Groups, 3 Masses5.5. 4 Fibers, 4 Speck Groups, 4 Masses4 Fibers, 4 Speck Groups, 4 Masses

Slide 120

Answer 3Answe r 3:: 5 Fibers, 4 Speck Grou ps, 45 Fibers , 4 Speck Groups, 4MassesMasses


�� Hologic. Lorad Selenia Quality ControlHologic. Lorad Selenia Quality ControlManual MANManual MAN--00093, Revision 003,00093, Revision 003,Bedford (MA): Hologic, 2005Bedford (MA): Hologic, 2005

Slide 121

Answer 3Ans wer 3:: 5 Fibers, 4 Speck Grou ps, 45 Fibers, 4 Speck Group s, 4MassesMasses


The Lorad Selenia QC manual states that the ACRThe Lorad Selenia QC manual states that the ACRPhantom minimum passing scores are asPhantom minimum passing scores are asfollows:follows:

�� 5 Fibers5 Fibers�� 4 Speck Groups4 Speck Groups�� 4 Masses4 Masses

Documents

Slid e 1 Slid e 2 Introduction Digital Mammography QA ... · Digital Mammography QA: Comparing the Manufacturers Recommendations Eric A. Berns, Ph.D. ... – Modulation in Hi Res