1 MAMMOGRAPHY QAMAMMOGRAPHY QA

Quality Assurance, Quality Quality Assurance, Quality ControlControl

& Equipment& Equipment

Bushong Bushong Ch. 19 & 20Ch. 19 & 20

Rev. Spring 2009/2010

PURPOSE OF QCPURPOSE OF QCASSURES OPTIMUM PATIENT CAREASSURES OPTIMUM PATIENT CARE

by avoiding unnecessary repeat by avoiding unnecessary repeat exposures due to artifacts, exposures due to artifacts, processing problems and processing problems and

equipment failureequipment failure

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MQSA National Statistics

Total annual mammography procedures reported, as of March 1, 20101

38,057,377

  Percent of inspections with no violation 80.2%

Certification statistics, as of March 1, 2010   12,623

Certified facilities with FFDM2 units / Accredited FFDM units

5,402 / 7,963

 

•FEDERAL LEGISLATION•OCT. 1, 1994•EQUIPMENT DESIGN & OPERATION STANDARDS (DEDICATED UNITS)•INTENSIVE QUALITY CONTROL PROGRAM

WHAT DOES MQSA REPRESENT? __________________

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Quality controlQuality control is an equipment and processing is an equipment and processing evaluation program in diagnostic imaging evaluation program in diagnostic imaging centers.centers.

QC involves testingQC involves testing, record keeping and , record keeping and evaluation of imaging equipment and processingevaluation of imaging equipment and processing

QC Team includesQC Team includes Radiographer/Mammographer, Physicists and Radiographer/Mammographer, Physicists and RadiologistRadiologist

QA involves peopleQA involves people – scheduling, reports, waiting – scheduling, reports, waiting time and follow up examstime and follow up exams

““double reads” double reads”

MAMMO & Quality MAMMO & Quality ControlControl

See Bushong – CH. ____ PG ____

44 Elements of QC Elements of QC pg 333pg 333

TASKSTASKS Darkroom CleanDarkroom Clean Processor QC – Processor QC –

sensitometry/densitometrsensitometry/densitometry and DEVELOPER tempy and DEVELOPER temp

Screen CleaningScreen Cleaning VISUAL CHECKVISUAL CHECK Phantom ImagesPhantom Images Repeat Analysis Repeat Analysis (should (should

be less than 2% repeat rate - be less than 2% repeat rate - diagnostic rad = 5%)diagnostic rad = 5%)

FREQUENCYFREQUENCY DailyDaily

WeeklyWeekly

Monthly/Monthly/QuarterlyQuarterly

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MAMMO QCMAMMO QCSEMIANNUALLYSEMIANNUALLY DARKROOM FOGDARKROOM FOG SCREEN/FILM SCREEN/FILM

CONTACTCONTACT COMPRESSIONCOMPRESSION

NOT MORE THAN NOT MORE THAN 40 PSI40 PSI

(25 PSI(25 PSI

is average)is average)

MONTHLY Checks

66 QUALITY CONTROL QUALITY CONTROL

TOOLSTOOLS PHANTOMPHANTOM DIGITAL DIGITAL

THERMOMETERTHERMOMETER SCREEN CLEANERSCREEN CLEANER LINT FREE CLOTHSLINT FREE CLOTHS FIXER RETENTION FIXER RETENTION

TESTING KITTESTING KIT CHARTSCHARTS

77 Hypo RetentionHypo Retention

Checks for what?Checks for what?

Fixer left on film Fixer left on film – “Archival Properties”– “Archival Properties”

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WIRE MESH WIRE MESH

Checks for what

How long should you wait after loading a cassette to use it?

15 min & placed in an upright position

99 Types of Types of

Safelights?Safelights?

Wratten 6bWratten 6b GBXGBX Check for leaks/cracks?Check for leaks/cracks?

How often?

Bulb Wattage?

1010 For those still using film…For those still using film…

clean crossovers dailyclean crossovers daily

Use “dedicated” Use “dedicated” processor for only processor for only

mammomammo

1111

These specks were produced by flakes trapped between the film and the screen –

Not calcifications in the breast

DAILY QUALITY CONTROL

DARKROOM CLEANLINESS

WIPE COUNTERSDUST VENTS & LIGHTS

PROCESSORQUALITY CONTROL

Sensitometer stripDensitometer step

PHANTOM IMAGEAssures quality control of Radiographic Image

&graph results

VISUAL VISUAL

CHECKLISTCHECKLIST

MONTHLYMONTHLY

FIXER FIXER RETENTION RETENTION

MONTHLYMONTHLY

REPEATREPEAT

ANALYSISANALYSIS

DARKROOMDARKROOM

FOGFOG

SEMI-SEMI-ANNUALANNUAL

FILM/SCREENFILM/SCREEN

CONTACTCONTACT

SEMI-ANNUALSEMI-ANNUAL

COMPRESSIOCOMPRESSIONN

(25 PSI)(25 PSI)

SEMI-ANNUALSEMI-ANNUAL

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PHANTOM IMAGESPHANTOM IMAGES WEEKLY - to assure WEEKLY - to assure

film density, contrast, film density, contrast, uniformity and image uniformity and image quality are optimum – quality are optimum – Using the SAME Using the SAME cassette and technical cassette and technical factors each timefactors each time

4/5 masses 4/5 masses 3/4specks 3/4specks 4/6 fibers4/6 fibers should be seenshould be seen (see pg 500 review book)(see pg 500 review book)

1313 REPEAT ANALYSISREPEAT ANALYSIS

Mammography should be less than Mammography should be less than 22%%

Number of repeated filmNumber of repeated film Repeat Rate = --------------------------- X 100Repeat Rate = --------------------------- X 100 Total # of filmsTotal # of films

Diagnostic Radiology = less than 5%Diagnostic Radiology = less than 5% Students = less than 10 %Students = less than 10 %

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