Reasons for failure of a mammography unit at clinical image review in the American College of Radiology Mammography Accreditation Program.
OBJECTIVE
To identify the most common deficiencies in the quality of mammograms submitted for clinical image evaluation (evaluation of image from actual patient referred for mammography).


METHODS
In 1997, the American College of Radiology Mammography Accreditation Program reviewed clinical images for 2,341 mammography units. For each mammography unit, the facility submitted bilateral mediolateral oblique and craniocaudal mammograms obtained in a woman with fatty breasts and a woman with dense breasts. Images were reviewed independently by two experienced radiologists. Reviewers listed the general categories and specific deficiencies that led to a decision to fail the unit that produced the clinical images.


RESULTS
Of the 2,341 mammography units, 1,034 (44%) failed the clinical image evaluation process. Of 6,128 categories cited by reviewers as deficient, 1,250 (20%) involved problems in positioning; 944 (15%), exposure; 887 (14%), compression; 806 (13%), sharpness; 785 (13%), contrast; 703 (11%), labeling; 465 (8%), artifacts; and 288 (5%), noise. A significantly higher proportion of failures was attributed to positioning deficiencies for fatty breasts than for dense breasts (P =.028). Higher proportions of failures in dense breasts were related to compression (P <.001) and exposure (P <.001) deficiencies.


CONCLUSIONS
Common problems in clinical image quality have been identified. This information should be useful for educators and facilities striving to improve the quality of mammography.
Bassett
L W
LW
Iris Cantor Center for Breast Imaging, University of California Los Angeles School of Medicine, USA.
Farria
D M
DM
Bansal
S
S
Farquhar
M A
MA
Wilcox
P A
PA
Feig
S A
SA
D000068:Accreditation / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008327:Mammography / Q000295:instrumentation / Q000592:standards* / Q000706:statistics & numerical data; D008485:Medical Audit / Q000379:methods*; D011872:Radiology Department, Hospital / Q000592:standards; D012189:Retrospective Studies; D012955:Societies, Medical; D014481:United States