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A survey on performance status of mammography machines: image quality and dosimetry studies using a standard mammography imaging phantom.

It is essential to perform quality control (QC) tests on mammography equipment in order to produce an appropriate image quality at a lower radiation dose to patients. Imaging and dosimetric measurements on 15 mammography machines located at the busiest radiology centres of Mumbai, India were carried out using a standard CIRS breast imaging phantom in order to see the level of image quality and breast doses. The QC tests include evaluations of image quality and the mean glandular doses (MGD), which is derived from the breast entrance exposure, half-value layer (HVL), compressed breast thickness (CBT) and breast tissue compositions. At the majority of the centres, film-processing and darkroom conditions were not found to be maintained, which is required to meet the technical development specifications for the mammography film in use as recommended by the American College of Radiology (ACR). In most of the surveyed centres, the viewbox luminance and room illuminance conditions were not found to be in line with the mammography requirements recommended by the ACR. The measured HVL values of the machines were in the range of 0.27-0.39 mm aluminium (Al) with a mean value of 0.33±0.04 mm Al at 28 kV(p) following the recommendation provided by ACR. The measured MGDs were in the range of 0.14-3.80 mGy with a mean value of 1.34 mGy. The measured MGDs vary between centre to centre by a factor of 27.14. Referring to patient doses and image quality, it was observed that only one mammography centre has exceeded the recommended MGD, i.e. 3.0 mGy per view with the value of 3.80 mGy and at eight mammography centres the measured central background density (CBD) values for mammography phantom image are found to be less than the recommended CBD limit value of 1.2-2.0 optical density.