2011 Joint AAPM/COMP Meeting
Dr. Rasika Rajapakshe, PhD, British Columbia Cancer Agency, Kelowna, BC, V1Y 5L3, Canada
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Lack of national and international standards for quality control for digital mammography
dictates that users have to follow manufacturer's recommendations. This leads to
significant additional work for facilities with digital mammography systems from
multiple vendors. Therefore, a comprehensive and unified quality control test for medical
physicists and mammography technologists was developed for the Screening
Mammography Program of British Columbia (SMPBC), in collaboration with Ontario
Breast Screening Program with the intent of using them as a national standard in Canada.
The quality control tests developed for the ACRIN DMIST study were used as the
starting point for the new tests; however, due to the recent implementation of AEC
algorithms by some manufacturers, it has become difficult to use the uniform phantom
suggested by DMIST work. To address this, a simple 19 cm diameter semicircle uniform
phantom was designed. Furthermore, it was found that the technologist weekly image
quality test should be performed on "FOR PRESENTATION" images so that changes in
image processing algorithms (similar to changes in film processing conditions) can be
identified. IHE Mammography Integration Profile compliance was also included as part
of the Medical Physicists tests.
The new unified quality control procedures have been adopted as the standard in the
province of BC for more than two years. This unified approach has made it possible to
streamline and manage the quality control of screening mammography facilities within
the province. The technologist weekly image quality test done with "FOR
PRESENTATION" images instead of "FOR PROCESSING" images (as suggested by
ACRIN DMIST study findings) have uncovered changes in image processing algorithms
that were implemented by manufacturers without the knowledge of the users. The new
semicircle uniform phantom is found to be suitable for testing the AEC performance of
every digital mammography unit used in the province of BC.
Due to the success in the use of the new unified QC tests in the province of BC, we are in
the process of promoting this as a national standard for digital mammography quality
control in Canada.
This presentation will provide an overview of the development and implementation of
these vendor neutral unified quality control procedures and its advantages.
1. Understand the type of testing required for Digital mammography systems.
2. Understand the advantages of a unified QA procedure.
3. Understand some of the technical and logistical issues involved in implementing
vendor neutral QA procedures.
4. Understand the importance of using IHE Mammography Integration Profile as
part of the Medical Physicist testing.