engleski

Survey of mammography practice in Croatia: equipment performance, image quality and dose

A national audit of mammography equipment performance, image quality and dose in Croatia has been conducted. Film processing parameters, optical density (OD), average glandular dose (AGD) to the standard breast, viewing conditions and image quality using TOR(MAM) test object were examined. Average film gradient ranged from 2.6 to 3.7, with a mean of 3.1. Tube voltage used for imaging of the standard 45 mm polymethylmethacrylate (PMMA) phantom ranged from 24 kV to 34 kV, and OD ranged from 0.75 to 1.94 with a mean of 1.26. AGD to the standard breast ranged from 0.4 mGy to 2.3 mGy with a mean of 1.1 mGy. Besides in clinical conditions, we imaged the standard phantom in the referent conditions with 28 kV and OD as close as possible to the 1.5. Then AGD ranged from 0.5 mGy to 2.6 mGy with a mean of 1.3 mGy. Image viewing conditions were generally unsatisfying with ambient light up to 500 lx and the most of the viewing boxes with luminance between 1000 cd/m2 and 2000 cd/m2. TOR(MAM) scoring of images taken in clinical and referent conditions was done by local radiologists in local image viewing conditions and by the referent radiologist in good image viewing conditions. Importance of OD and image viewing conditions for diagnostic information were analyzed. The survey showed that the main problem in Croatia is the lack of written quality assurance/quality control (QA/QC) procedures. Consequently, equipment performance, image quality and dose are unstable and activities to improve image quality or to reduce the dose are not evidence-based. This survey also had an educational purpose, introducing in Croatia the QC based on European Commission guidelines.

mammohraphy ; quality ; dose

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