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Sample records for mammography quality improvement

  1. Quality control of physician-performed mammography. Importance of original attempts to improve quality

    International Nuclear Information System (INIS)

    Nakayama, Takashi; Terada, Hiroshi; Kotsuma, Yoshikazu

    2006-01-01

    In order to perform effective breast cancer screening with mammography, family doctors should be encouraged to participate. At institutions without specific radiology technicians, physicians themselves are required to perform mammography and operate the equipment, otherwise it is difficult to consistently obtain good-quality mammograms. Our institutions have been given a grade ''A'' evaluation by the Central Committee for Quality Control of Mammographic Screening (CCQCMS), due largely to our own efforts and promotion. Here we report our experience in solving a number of problems that occurred during the establishment of our system. We used the SEPIO standard mammography apparatus with a MD-100/CM-H screen/filter system, and developed films using a TCX-202 automatic film processor. Problems due to asymmetry of the bilateral breasts and lack of retroglandular fat tissue space and inframammary folds seen on our initial mammograms were overcome by placing marks at the postion of the AEC sensor, and at both ends and the center of the film on a bucky table. We simplified the markers by removing several complicated ones. We tried to rectify areas of the image that were obscured due to the difference in size between the inside of the cassette and the screen. Physicians and a radiology technician attended a mammography study course once weekly, and attempted to improve the quality of mammograms and our reading ability by obtaining advice from members of the CCQCMS. Manufacturers responded with considerable delay to our attempt to overcome the troublesome appearance of numerous microcalfication-like artifact shadows caused by screens. In conclusion, in order to perform effective breast cancer screening with mammography, we must obtain mammograms of good quality, for which it is necessary to always try to seek new ways of improving. At the same time, manufacturers need to respond quickly to queries and problems related to quality control. (author)

  2. Quality assurance in mammography

    International Nuclear Information System (INIS)

    Fosmark, H.; Olerud, H.M.

    1992-01-01

    Guidelines in mammography are given, including competence of staff, performance of equipment and quality control procedures. The purpose of the guidelines is to ensure optimum diagnostic quality. 5 refs

  3. Image quality in mammography

    International Nuclear Information System (INIS)

    Haus, A.G.; Doi, K.; Metz, C.E.; Bernstein, J.

    1976-01-01

    In mammography, image quality is a function of the shape, size, and x-ray absorption properties of the anatomic part to be radiographed and of the lesion to be detected; it also depends on geometric unsharpness, and the resolution, characteristic curve and noise properties of the recording system. X-ray energy spectra, modulation transfer functions, Wiener spectra, characteristic and gradient curves, and radiographs of a breast phantom and of a resected breast specimen containing microcalcifications are used in a review of some current considerations of the factors, and the complex relationship among factors, that affect image quality in mammography. Image quality and patient radiation exposure in mammography are interrelated. An approach to the problem of evaluating the trade-off between diagnostic certainty and the cost or risk of performing a breast imaging procedure is discussed

  4. Control of quality in mammography

    International Nuclear Information System (INIS)

    2006-10-01

    The present protocol of quality control/quality assurance in mammography is the result of the work of two regional projects realised in Latin America within the frame of ARCAL with the support of the IAEA. The first is ARCAL LV (RLA/6/043) project on quality assurance/quality control in mammography studies which analysed the present situation of the mammography in the member countries of the project which include: Bolivia, Colombia, Costa Rica, Cuba, El Salvador, Guatemala, Nicaragua, Panama, Paraguay, Peru, Dominican Republic and Republic of Venezuela and the second is ARCAL XLIX (RLA/9/035) project, whose members were Brazil, Colombia, Cuba, Chile, Mexico, and Peru, worked the application of Basic Safety Standards for the protection against ionising radiation with the aim to improve radiation protection in X-ray diagnosis medical practices through the implementation of the Basic Safety Standards (BSS) related to x-ray diagnosis in selected hospitals located in each country involved in the project. The work of both projects had been consolidated and harmonized in the present publication

  5. Quality control of mammography departments in Slovakia

    International Nuclear Information System (INIS)

    Horvathova, M.; Nikodemova, D.

    2007-01-01

    Complete test of publication follows. Considering the fact that mammary gland is the most sensitive organ to ionizing radiation, the Commission of the Ministry of Health of SR for QA in radiology organized a pilot two-run country wide audit conducted in 42 mammography departments that have met the beforehand criteria. During the audit the methods for establishing the individual parameters in technical and clinical part of quality assurance in mammography were elaborated and implemented. Technical and clinical parameters of the imaging process that mostly affect the quality of diagnostic information were followed up. These parameters included: the object thickness compensation, optical density deviation, evaluation of the film quality by means of special phantom, etc. Important measurement of ESDs at participating departments enabled to compare the radiation load of mammography patients in Slovakia with reference values in European guidelines. The uniform standard method for QA at mammography departments was elaborated and published as the regulation of the Ministry of Health for performance of preventive mammography examinations in SR. The presented results show the improved quality of mammography examinations due to regular check-ups of technical and clinical parameters and fulfilment of the required values in all parameters. The audit results are the basis for continuous quality assessment of mammography departments as a main prerequisite for conducting preventive examinations and for health insurance purposes.

  6. Mammography quality assurance in Morocco

    International Nuclear Information System (INIS)

    Zaoui, F.; Talsmat, K.; Lalaoui, K.

    2001-01-01

    The 'Centre National de l'Energie, des Sciences et des Techniques Nucleaires' (CNESTEN) realised, from February 1999 to March 2000, a quality control of 41 mammography facilities in Morocco. The protocol and standards adopted for achieving the control of elements constituting the mammography chain are those elaborated by GIM and Qualix association. Statistics and conformities results are presented. The program was performed in order to demonstrate to the practitioners in mammography field, the utility and necessity to have a national quality assurance policy. The main objective of CNESTEN is to be accredited by the Moroccan government as a reference laboratory in quality control and dose evaluation in medical imaging and radiotherapy. To achieve this goal the CNESTEN has set up Medical Physic Unit well trained and equipped with the necessary instruments. (author)

  7. Quality assurance programme at Slovak mammography departments

    International Nuclear Information System (INIS)

    Horvathova, M.; Nikodemova, D.

    2004-01-01

    A co-ordinated research program (CRP) for optimisation of image quality in mammography in some Eastern European countries has been initiated by IAEA between 1999 and 2001 and the Slovak Republic took part in this program. The aim of this program was to implement the European QA/QC protocol in a sample of mammography departments and to achieve improvement of the image quality and patient dose reduction. On the national level 28 mammography units were chosen in accordance with equipment performance for quality control programme at this departments, for the first part of the mammography audit in the years 2002-2004. Realisation of CRP project contains: 1) Collection and evaluation of clinical images in agreement with EC criteria; 2) Evaluation of the image quality using mammography test phantom; 3) Measurements of the ESD at patients using TLD; 4) Intercomparison of TLD system calibration with IAEA laboratory; 5) Film reject analysis; 6) Implementation of QC program to the mammography units. The measurements of ESD on patients were performed with TLD (LiF 700 Harshaw). In the 6 month period were collected the results of measurements of: 1) object thickness compensation (measured weekly); 2) long time reproducibility (measured daily); 3) phantom image quality on the standard RMI 156 phantom (measured weekly); 4) ESD on phantom with TLD (once during the audit). Automatic Exposure Control compensation for the object thickness variation was measured by exposing different PMMA plates of thickness ranging from 20 to 60 mm, using the clinical settings. The long term reproducibility has been assessed from the measurements of the optical density and mAs product resulted from the exposure on the PMMA plates. In order to estimate the quality of the images the RMI 156 mammography accreditation phantom was chosen. The accreditation phantom contains test objects which simulate small structures seen in the breast (microcalcifications, fibrils, and tumor like masses). Results of

  8. Thermoluminescence dosimetry in quality imaging in CR mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Franco E, J.G. [UAM-Xochimilco, 04960 Mexico D.F. (Mexico); Azorin N, J. [UAM-Iztapalapa, 09340 Mexico D.F. (Mexico); Diaz G, J.A.I. [CICATA, Unidad Legaria, Av. Legaria 694, 11599 mexico D.F. (Mexico); Arreola, M. [Department of Radiology, Shands Hospital at UF, PO Box 100374, Gainesville, FL 32610-0374 (United States)

    2006-07-01

    The aim of this work is to estimate the average glandular dose with Thermoluminescence Dosimetry (TLD) and comparison with quality imaging in CR mammography. For measuring dose, FDA and ACR use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, Full Field Digital Mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one CR mammography system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium fluoro halide. We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated x-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose that overcomes 3.0 mGy and it doesn't improve the image quality and dose to the breast will be excessive. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement. (Author)

  9. Thermoluminescence dosimetry in quality imaging in CR mammography systems

    International Nuclear Information System (INIS)

    Gaona, E.; Franco E, J.G.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2006-01-01

    The aim of this work is to estimate the average glandular dose with Thermoluminescence Dosimetry (TLD) and comparison with quality imaging in CR mammography. For measuring dose, FDA and ACR use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, Full Field Digital Mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one CR mammography system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium fluoro halide. We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated x-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose that overcomes 3.0 mGy and it doesn't improve the image quality and dose to the breast will be excessive. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement. (Author)

  10. Improvements in mammography

    International Nuclear Information System (INIS)

    Redington, R.W.; Henkes, J.L.

    1976-01-01

    Equipment for positioning and supporting patients during tomographic X-ray mammography is described. It is comprised of a table and fabric slings which permit the examination of a downward, pendant breast of a prone patient by allowing the breast to pass through an aperture in the table into a fluid filled container. The fluid has an X-ray absorption coefficient similar to that of soft human tissue allowing high density resolution radiography and permitting accurate detection of breast tumours. The shape of the equipment and the positioning of the patient allow the detector and X-ray source to rotate 360 0 about a vertical axis through the breast. This permits the use of relatively simple image reconstruction algorithms and a divergent X-ray geometry with multiple detectors. Successive planes of the breast are scanned by translating the detectors and source vertically to produce a three-dimensional image of the breast tissue structure. (U.K.)

  11. Image Quality and Patient Dose Optimisation in Mammography in Slovakia

    International Nuclear Information System (INIS)

    Horvathova, M.; Nikodemova, D.; Prikazska, M.

    2003-01-01

    Breast cancer represents also in Slovakia the greatest cancer risk for women, with great incidence and mortality. Conventional film-screen mammography is still the primary breast imaging modality with increasing number of mammography units and mammography examinations. From the radiation protection point of view achievement of good practice in mammography department by implementation of quality assurance play an important role for reduction of patients doses. Introduction of QA needs trained and experienced staff and requires close collaboration between radiologists, medical physicist and radiographers. At the beginning of nineties at the Institute of Preventive and Clinical Medicine we started with a survey of mean glandular doses at 15 existing mammography units in the country. On the basis of a questionnaire in the year 1991 were performed 10 488 mammography examinations, where due to out of date mammography units the mean glandular dose reached more as 3 mGy. In the following years the claim to the modern mammography units kept growing and in the year 1999 the total number of 63 mammography units were operating in Slovakia providing about 101 471 mammography examinations. According to the alarming increase of the number of mammography examinations it is absolutely necessary to work out criteria and principles for Quality Control at mammography workplaces in our country and make it obligatory for the staff of all mammography units. Summarising the CRP results it can be stated that they: 1) Initiated the suggestion of unified QA/QC criteria in mammography and the urgent need to implement them into the national program of radiology image quality improvement; 2) Remitted on unhomogenity not only in the equipment outfit but also in the procedure of evaluation of the measured parameters and imaging quality; 3) Revealed the shortcomings in the everyday practice of mammography units which can be removed only by comprehensive by training of personal in imaging radiology

  12. Quality control of mammography

    International Nuclear Information System (INIS)

    Hering, K.G.

    1986-01-01

    Random checks of mammograms allow to clearly assess quality controls concerning correct application and operation of the radiographic system indicated by rich contrast in breast tissue images, complete imaging of the mammary parenchyma, freedom from blurs due to motion, efficient breast compression, correct film labelling and perfect maintenance of the film screen system. In addition to these subjective assessments, the following points should be considered when using objective measurement procedures and phantoms: Testing the correct function of X-ray and radiographic equipment by means of test specimens to measure KV standard (KV=Association of German Panel Doctors), mAS and automatic exposure timer; comparing dose and density to initial values and checking film processing by using a sensitometer. Quality assurance handling varies from one KV to the next. That is why the users need to obtain the guidelines of the respective KV relative to radiological quality assurance and to proceed according to these. (orig.) [de

  13. Interdisciplinary group of mammography (IGM). Quality assurance in mammography

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    Assurance quality must be a preoccupation of each day in mammography. To be efficient and of low cost it must be discussed between radiologists and physicists; some countries like Federal Republic of Germany, Belgium, United Kingdom, Scandinavia and Netherlands engaged actions to make assurance quality a daily practice

  14. Traceability and quality control in mammography: measurements and models

    International Nuclear Information System (INIS)

    Peixoto, Jose Guilherme Pereira

    2002-10-01

    The success of a treatment or diagnosis using radiation, depends on the optimization of the dose determination to be administered for the patient and on the beam radiation quality. It is recognized by the international guidelines that it is necessary to improve calibration services for mammography beams in order to improve the quality of clinical diagnosis. Major efforts have been made by several laboratories in order to establish an appropriate and traceable calibration infrastructure and to provide the basis for a quality control program in mammography. The contribution of the radiation metrology network to the mammography services is reviewed in this work. Steps required for the implementation of a mammography calibration system using a constant potential x-ray and a clinical mammography x-ray machine are presented. The various qualities of mammography radiation discussed in this work are in accordance with the IEC 61674 and the AAPM recommendations. This work also presents the methodology and the procedures to maintain and to disseminate the traceability at the x-ray mammography range, describing the interlaboratory comparison performed at LNMRI/IRD/CNEN and at the IPEN/CNEN using the secondary standard ionization chambers traceable with the international standard. It assesses the inter-laboratory comparison consistency and decides whether a questionable value should or not be accepted, using the residual method. This thesis discusses the uncertainties involved in all steps of the calibration chain in accord once with the ISO recommendations. (author)

  15. TL dosimetry for quality control of CR mammography imaging systems

    Science.gov (United States)

    Gaona, E.; Nieto, J. A.; Góngora, J. A. I. D.; Arreola, M.; Enríquez, J. G. F.

    The aim of this work is to estimate the average glandular dose with thermoluminescent (TL) dosimetry and comparison with quality imaging in computed radiography (CR) mammography. For a measuring dose, the Food and Drug Administration (FDA) and the American College of Radiology (ACR) use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, full field digital mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium flourohalideE We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated X-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose greater than 3.0 mGy without demonstrating improved image quality. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement for X-rays with a HVL (0.35-0.38 mmAl) and kVp (24-26) used in quality control procedures with ACR Mammography Accreditation Phantom.

  16. Quality Imaging - Comparison of CR Mammography with Screen-Film Mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Azorin Nieto, J.; Iran Diaz Gongora, J. A.; Arreola, M.; Casian Castellanos, G.; Perdigon Castaneda, G. M.; Franco Enriquez, J. G.

    2006-01-01

    The aim of this work is a quality imaging comparison of CR mammography images printed to film by a laser printer with screen-film mammography. A Giotto and Elscintec dedicated mammography units with fully automatic exposure and a nominal large focal spot size of 0.3 mm were used for the image acquisition of phantoms in screen-film mammography. Four CR mammography units from two different manufacturers and three dedicated x-ray mammography units with fully automatic exposure and a nominal large focal spot size of 0.3 mm were used for the image acquisition of phantoms in CR mammography. The tests quality image included an assessment of system resolution, scoring phantom images, Artifacts, mean optical density and density difference (contrast). In this study, screen-film mammography with a quality control program offers a significantly greater level of quality image relative to CR mammography images printed on film

  17. Quality control: comparison of images quality with screen film system and digital mammography CR

    International Nuclear Information System (INIS)

    Alvarenga, Frederico L.; Nogueira, Maria do Socorro

    2008-01-01

    The mammography screen film system should be used as part of processing chemicals, revelation process, equipment and this system has have a progressive replacing by the digital technology Full Field Digital Mammography FFDM, Computed Radiography (CR) Mammography and hardcopy. This new acquisition process of medical images has improved radiology section; however it is necessary efficient means for evaluating of the quality parameters. It should be considered taking into account the adaptation of the existent equipment and that procedures adopted for the exam, as well the adaptation of the new mammography films, the radiologist view box constitutes a part of the quality control program. This program aims at obtaining radiography with good quality that allows obtaining more information for the diagnosis and decreases the patient dose. For evaluation the quality image, this article is focused on presenting the differences regarding the acquired images through simulator mammography radiographic PMMA (Poly methyl methacrylate) in CR Mammography system and screen film system. The tests were accomplished at the same equipment of Mammography with the Automatic Exposure Control using a tension of 28 kV for both systems. The quality tests evaluated the spatial resolution, the own structures of the phantom, artifacts, optical density and contrast with conventional and laser films by mammography system. The installation for the accomplishment of the test has a quality control program. The evaluation was based on the pattern developed by the competent organ of the State of Minas Gerais. In this study, it was verified that the suitable Phantom Mama used by the Brazilian School of Radiology for conventional mammography did not obtain satisfactory result for Spatial Resolution in the digital mammography system CR. The final aim of this work is to obtain parameters to characterize the reference phantom quality image in an objective way. These parameters will be used to compare

  18. The dose and image quality in mammography in Macedonia

    International Nuclear Information System (INIS)

    Gershan, V.

    2007-01-01

    Complete test of publication follows. Mean Glandular Dose (MGD), dose distribution, phantom and quality of the real mammogram were studied for the first time in Macedonia. The study was conducted to review the condition of mammography equipment, to access the dose and image quality in mammography practices in Macedonia.. The purpose was to find out the weak points in the mammography practices in order to suggest improvements in the practices and establish quality control procedures. Under evaluation were 12 monographic machines. MGD was estimated using Entrance Surface Air KERMA at the breast surface K f measured free in air and appropriate conversion factors. Dose survey was curried by measurement and calculated of the HVLs and radiation output for 25-32 kVp and keeping record of the clinical parameters (breast thickness, kVp, mAs). Image quality was evaluated using the Mammographic Accreditation Phantom Gammex 156, PMMA plates and test tool for film processing.

  19. Quality control tests for conventional mammography

    International Nuclear Information System (INIS)

    Dawod, Alnazer Ahmed Ibrahim

    2014-12-01

    Mammography is this the test that allows the radiologist to look at images of the inside of the breasts. Mammograms help detect breast cancer early successful treatment of breast cancer depends on that early diagnosis. Breast cancer is a very common condition. About one in every nine women develops breast cancer by the age of eighty. In addition to the clinical examination and self-examination, mammography plays important role in the detection of breast cancer before they become clinically visible tumors. The mammography is the most common test for early detection of breast cancer. Quality control techniques that done ensured importance of this programme to produce images with good diagnostic values and help radiologist to diagnose breast discase easily and avoid exposing patient to radiation hazards.(Author)

  20. Quality assurance programme for screen film mammography

    International Nuclear Information System (INIS)

    2009-01-01

    The application of radiation in human health, for both the diagnosis and treatment of disease, is an important component of the work of the IAEA. In the area of diagnostic radiology, this work is focused on quality assurance methods to both the promotion of the effective use of radiation for diagnostic outcome, through achieving and maintaining appropriate image quality, and also on dose determination to allow the monitoring and reduction of dose to the patient. In response to heightened awareness of the importance of patient dose contributed by radiology procedures, the IAEA published Dosimetry in Diagnostic Radiology: An International Code of Practice (Technical Reports Series No. 457) in 2007, to form a basis for patient dose determination for the Member States. Further to this, it is recognized that for complex diagnostic procedures, such as mammography, a detailed guidance document is required to give the professionals in the clinical centre the knowledge necessary to assess the patient dose, as well as to ensure that the procedure gives the maximal patient benefit possible. It is well documented that without the implementation of a quality culture and a systematic quality assurance programme with appropriate education, the detection of breast cancer cannot be made at an early enough stage to allow effective curative treatment to be undertaken. Currently there are a number of established quality assurance protocols in mammography from national and regional institutions, however, many of these protocols are distinctive and so a harmonized approach is required. This will allow the Member States to facilitate quality assurance in mammography in a standardized way which will also facilitate the introduction of national quality assurance programmes that are needed to underpin effective population screening programmes for breast cancer. Development of a quality assurance document for screen film mammography was started in 2005 with the appointment of a drafting

  1. Implementation of the qualities of radiodiagnostic: mammography

    International Nuclear Information System (INIS)

    Pacífico, Leonardo; Magalhães, Luís A.G.; Fernandes, Elisabeth; Peixoto, José Guilherme P.

    2017-01-01

    The objective of the present study was to evaluate the expanded uncertainty and present the result of the internal audit performed at the Laboratory of Radiological Sciences (LCR). The qualities of the mammographic bundles that are references in the LCR calibrations had their uncertainties and conformities with the standard evaluated. The expanded uncertainty was 1.40%, and the result of the internal audit was satisfactory. We conclude that LCR can perform calibrations on mammography qualities for end users. (author)

  2. Implementation of the qualities of radiodiagnostic: mammography

    Energy Technology Data Exchange (ETDEWEB)

    Pacífico, Leonardo; Magalhães, Luís A.G.; Fernandes, Elisabeth, E-mail: leonardocpacifico@gmail.com [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil); Peixoto, José Guilherme P. [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-07-01

    The objective of the present study was to evaluate the expanded uncertainty and present the result of the internal audit performed at the Laboratory of Radiological Sciences (LCR). The qualities of the mammographic bundles that are references in the LCR calibrations had their uncertainties and conformities with the standard evaluated. The expanded uncertainty was 1.40%, and the result of the internal audit was satisfactory. We conclude that LCR can perform calibrations on mammography qualities for end users. (author)

  3. Automated daily quality control analysis for mammography in a multi-unit imaging center.

    Science.gov (United States)

    Sundell, Veli-Matti; Mäkelä, Teemu; Meaney, Alexander; Kaasalainen, Touko; Savolainen, Sauli

    2018-01-01

    Background The high requirements for mammography image quality necessitate a systematic quality assurance process. Digital imaging allows automation of the image quality analysis, which can potentially improve repeatability and objectivity compared to a visual evaluation made by the users. Purpose To develop an automatic image quality analysis software for daily mammography quality control in a multi-unit imaging center. Material and Methods An automated image quality analysis software using the discrete wavelet transform and multiresolution analysis was developed for the American College of Radiology accreditation phantom. The software was validated by analyzing 60 randomly selected phantom images from six mammography systems and 20 phantom images with different dose levels from one mammography system. The results were compared to a visual analysis made by four reviewers. Additionally, long-term image quality trends of a full-field digital mammography system and a computed radiography mammography system were investigated. Results The automated software produced feature detection levels comparable to visual analysis. The agreement was good in the case of fibers, while the software detected somewhat more microcalcifications and characteristic masses. Long-term follow-up via a quality assurance web portal demonstrated the feasibility of using the software for monitoring the performance of mammography systems in a multi-unit imaging center. Conclusion Automated image quality analysis enables monitoring the performance of digital mammography systems in an efficient, centralized manner.

  4. A phantom for quality control in mammography

    International Nuclear Information System (INIS)

    Gambaccini, M.; Rimondi, O.; Marziani, M.; Toti, A.

    1989-01-01

    A phantom for evaluating image quality in mammography has been designed and will be used in the Italian national programme ''Dose and Quality in Mammography''. The characteristics of the phantom are (a) about the same X-ray transmission as a 5 cm 50% fat and 50% water breast for energies between 15 and 50 keV and (b) optimum energies for imaging of the test objects (included in the phantom) in very close agreement with the optimum energies for imaging of calcifications and tumours in a 5 cm 50% fat and 50% water breast. An experimental comparison between the prototype and some commercial phantoms was carried out. Measurements are in progress to test the phantom's ability to evaluate the performances of mammographic systems quantitatively. (author)

  5. Quality Control in Mammography: Image Quality and Patient Doses

    International Nuclear Information System (INIS)

    Ciraj Bjelac, O.; Arandjic, D.; Boris Loncar, B.; Kosutic, D.

    2008-01-01

    Mammography is method of choice for early detection of breast cancer. The purpose of this paper is preliminary evaluation the mammography practice in Serbia, in terms of both quality control indicators, i.e. image quality and patient doses. The survey demonstrated considerable variations in technical parameters that affect image quality and patients doses. Mean glandular doses ranged from 0.12 to 2.8 mGy, while reference optical density ranged from 1.2 to 2.8. Correlation between image contrast and mean glandular doses was demonstrated. Systematic implementation of quality control protocol should provide satisfactory performance of mammography units and maintain satisfactory image quality and keep patient doses as low as reasonably practicable. (author)

  6. Implementation of the qualities of radiodiagnostic: mammography

    Science.gov (United States)

    Pacífico, L. C.; Magalhães, L. A. G.; Peixoto, J. G. P.; Fernandes, E.

    2018-03-01

    The objective of the present study was to evaluate the expanded uncertainty of the mammographic calibration process and present the result of the internal audit performed at the Laboratory of Radiological Sciences (LCR). The qualities of the mammographic beans that are references in the LCR, comprises two irradiation conditions: no-attenuated beam and attenuated beam. Both had satisfactory results, with an expanded uncertainty equals 2,1%. The internal audit was performed, and the degree of accordance with the ISO/IEC 17025 was evaluated. The result of the internal audit was satisfactory. We conclude that LCR can perform calibrations on mammography qualities for end users.

  7. Latin American image quality survey in digital mammography studies

    International Nuclear Information System (INIS)

    Mora, Patricia; Khoury, Helen; Bitelli, Regina; Quintero, Ana Rosa; Garay, Fernando; Garcia Aguilar, Juan; Gamarra, Mirtha; Ubeda, Carlos

    2017-01-01

    Under International Atomic Energy Agency regional programme TSA3 Radiological Protection of Patients in Medical Exposures, Latin American countries evaluated the image quality and glandular doses for digital mammography equipment with the purpose of seeing the performance and compliance with international recommendations. Totally, 24 institutions participated from Brazil, Chile, Costa Rica, El Salvador, Mexico, Paraguay and Venezuela. Signal difference noise ratio results showed for CR poor compliance with tolerances; better results were obtained for full-field digital mammography equipment. Mean glandular dose results showed that the majority of units have values below the acceptable dose levels. This joint Latin American project identified common problems: difficulty in working with digital images and lack of specific training by medical physicists from the region. Image quality is a main issue not being satisfied in accordance with international recommendations; optimisation processes in which the doses are increased should be very carefully done in order to improve early detection of any cancer signs. (authors)

  8. Descriptive study of the quality control in mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Perdigon C, G.M.; Casian C, G.A.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2005-01-01

    The goal of mammography is to provide contrast between a lesion that is possible residing within the breast and normal surrounding tissue. Quality control is essential for maintaining the contrast imaging performance of a mammography system and incorporate tests that are relevant in that they are predictive of future degradation of contrast imaging performance. These tests will also be done at frequency that is high enough to intercept most drifts in quality imaging or performance before they become diagnostically significant. The quality control study has as objective to describe the results of the assessment of quality imaging elements (film optical density, contrast (density difference), uniformity, resolution and noise) of 62 mammography departments without quality control program and comparison these results with a mammography reference department with a quality control program. When comparing the results they allow seeing the clinical utility of to have a quality control program to reduce the errors of mammography interpretation. (Author)

  9. The influence of software filtering in digital mammography image quality

    Science.gov (United States)

    Michail, C.; Spyropoulou, V.; Kalyvas, N.; Valais, I.; Dimitropoulos, N.; Fountos, G.; Kandarakis, I.; Panayiotakis, G.

    2009-05-01

    Breast cancer is one of the most frequently diagnosed cancers among women. Several techniques have been developed to help in the early detection of breast cancer such as conventional and digital x-ray mammography, positron and single-photon emission mammography, etc. A key advantage in digital mammography is that images can be manipulated as simple computer image files. Thus non-dedicated commercially available image manipulation software can be employed to process and store the images. The image processing tools of the Photoshop (CS 2) software usually incorporate digital filters which may be used to reduce image noise, enhance contrast and increase spatial resolution. However, improving an image quality parameter may result in degradation of another. The aim of this work was to investigate the influence of three sharpening filters, named hereafter sharpen, sharpen more and sharpen edges on image resolution and noise. Image resolution was assessed by means of the Modulation Transfer Function (MTF).In conclusion it was found that the correct use of commercial non-dedicated software on digital mammograms may improve some aspects of image quality.

  10. The influence of software filtering in digital mammography image quality

    International Nuclear Information System (INIS)

    Michail, C; Spyropoulou, V; Valais, I; Panayiotakis, G; Kalyvas, N; Fountos, G; Kandarakis, I; Dimitropoulos, N

    2009-01-01

    Breast cancer is one of the most frequently diagnosed cancers among women. Several techniques have been developed to help in the early detection of breast cancer such as conventional and digital x-ray mammography, positron and single-photon emission mammography, etc. A key advantage in digital mammography is that images can be manipulated as simple computer image files. Thus non-dedicated commercially available image manipulation software can be employed to process and store the images. The image processing tools of the Photoshop (CS 2) software usually incorporate digital filters which may be used to reduce image noise, enhance contrast and increase spatial resolution. However, improving an image quality parameter may result in degradation of another. The aim of this work was to investigate the influence of three sharpening filters, named hereafter sharpen, sharpen more and sharpen edges on image resolution and noise. Image resolution was assessed by means of the Modulation Transfer Function (MTF).In conclusion it was found that the correct use of commercial non-dedicated software on digital mammograms may improve some aspects of image quality.

  11. Risks, radiation dose and image quality of mammography

    International Nuclear Information System (INIS)

    Menges, V.

    1979-01-01

    For some time to come, early detection of breast cancer will remain the only way to improve the therapeutical success. Mammography is an absolutely indispensible way to take advantage of this opportunity. Today, mammography is undoubtedly the most reliable method of examination for an early detection of breast cancer. Only mammography can detect carcinomas smaller than the critical tumour size of 1cm. If carried out properly and with present dose levels, it involves hardly any radiation risk. (orig.) [de

  12. Mammography in Norway: Image quality and total performance

    International Nuclear Information System (INIS)

    Olsen, J.B.; Skretting, A.; Widmark, A.

    1997-04-01

    This report describes a method for assessing the total performance in mammography based on Receiver Operating Characteristic (ROC) analysis. In the time period from December 1993 to March 1994 the method was applied to assess the total performance of all the 45 Norwegian mammography laboratories operative at that time. Image quality characteristics in each laboratory was established by use of well-known phantoms

  13. Technical quality control - constancy controls for digital mammography systems

    International Nuclear Information System (INIS)

    Pedersen, K.; Landmark, I.D.; Bredholt, K.; Hauge, I.H.R.

    2009-04-01

    To ensure the quality of mammographic images, so-called constancy control tests are performed frequently. The report contains a programme for constancy control of digital mammography systems, encompassing the mammography unit, computed radiography (CR) systems, viewing conditions and displays, printers, and procedures for data collection for patient dose calculations. (Author)

  14. Our trial to improve patient positioning during mammography

    International Nuclear Information System (INIS)

    Nakayama, Takashi; Kotsuma, Yoshikazu; Hiramatsu, Sawako

    2007-01-01

    For effective breast cancer screening, reading of high-quality mammograms is essential, and for this purpose proper patient positioning during mammography is important. At our Shin-Osaka Mammography Seminar, which includes eight institutions, a physician and nine radiology technicians get together weekly in order to critically review mammogram reading and techniques for obtaining good mammograms. We have recognized that patient positioning has a great effect on mammogram quality, particularly for women in their 40 s who have dense mammary glands, and we have adopted a digital mammography system, or comparative mammography for such patients. Since July 2005, we have critically reviewed positioning every 3 or 4 months with the aim of improving our technique. Eight institutions have participated in this trial, each contributing mammograms taken recently from 20 to 30 consecutive participants, and the grade of positioning has been determined according to the Institutional Mammogram Estimation Standard (6 items, each scoring a maximum of 4 points, total 24 points) proposed by the Central Committee for Quality Control of Mammography Screening. The estimation has been done by both ourselves and committee members. When a total of 20 points or more is obtained and all 6 items score 3 points or more, it is considered that the positioning has been good, and this is termed ''Positioning A'' (P-A). On the other hand, if the total score is less than 20 points, and any one of the 6 items scores less than 3 points, it is considered that positioning has been inadequate, and this is termed ''Positioning-D'' (P-D). At the first review meeting, which was held before our critical study, P-A accounted for 48% of cases, and this had improved to 72% at the second meeting, and to 66% at the third. P-D accounted for 41% of cases at the first meeting, 20% at the second, and 21% at the third. Thus our trial involving discussion between a physician and technicians to critically review good

  15. Reproducibility of Mammography Units, Film Processing and Quality Imaging

    International Nuclear Information System (INIS)

    Gaona, Enrique

    2003-01-01

    The purpose of this study was to carry out an exploratory survey of the problems of quality control in mammography and processors units as a diagnosis of the current situation of mammography facilities. Measurements of reproducibility, optical density, optical difference and gamma index are included. Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is a radiographic examination specially designed for detecting breast pathology. We found that the problems of reproducibility of AEC are smaller than the problems of processors units because almost all processors fall outside of the acceptable variation limits and they can affect the mammography quality image and the dose to breast. Only four mammography units agree with the minimum score established by ACR and FDA for the phantom image

  16. A study of quality assurance in mammography

    International Nuclear Information System (INIS)

    Briquet, Claudia; Mota, Helvecio C.; Costa, Marcos R.

    1997-01-01

    Full text. Nowadays mammography has two definitive important roles: as a complementary tool to confirm clinical findings and for the detection of early breast cancer. To reach and maintain the standards of image quality within the frontiers of reasonable radiation doses, the facilities must follow a QA program. The objective of this study is to accomplish such a program in three school hospitals in Rio de Janeiro. We made assessment of clinical images using the Accreditation American Phantom and measured the patients skin entrance doses with TLD 100. In each facility we evaluated the technical parameters of the mammographic units using a Victoreen 4000 M+ and an evaluation of the compression devices. The 3 hospitals studied use film and screen Min R Kodak and have Kodak processors, none of them dedicated to mammograms. The tube voltage, measured was not significantly different from the indicated values, the variations were lesser than 5%. In one of the hospitals the kVp did not show reproducibility, the coefficient of variation was too high - 1,02. The same facility showed an exposure time with variation of 7% and we asked for corrective action. Measures of HVL showed the same value for the 3 hospitals the compression were adequate. The patients skin entrance doses were measured with TLD 100 and showed the range 3,25 a 10,26 mGy. This range is due to differences in density and thickness of the breast. The doses values were in accordance with the Quality Criteria for Mammography of the Commission of the European Communities

  17. Implementation of Quality Control Protocol in Mammography: A Serbian Experience

    International Nuclear Information System (INIS)

    Ciraj Bjelac, O.; Kosutic, D.; Arandjic, D.; Kovacevic, M.

    2008-01-01

    Mammography is method of choice for early detection of breast cancer. In Serbia, mammography is performed only clinically, although there is a long term plan to introduce mammography as screening method. Currently there are 60 mammography units in practice in Serbia, resulting with 70 000 mammographies annually. The purpose of this paper is preliminary evaluation of the mammography practice in Serbia, having in mind the annual number of examinations and fact that part of examination is performed on women without any clinical signs. For pilot implementation of Quality Control (QC) protocol in mammography, five hospitals with highest workload have been selected, representing the typical mammography practice in Serbia. Developed QC protocol, based on European guidelines for quality assurance in breast cancer screening and diagnosis, actual practice and resources, includes equipment testing and maintenance, staff training and QC management and allocation of responsibilities. Subsequently, it should be applied on the national scale. The survey demonstrated considerable variations in technical parameters that affect image quality and patients doses. Mean glandular doses ranged from 0.12 to 2.8 mGy, while reference optical density ranged from 1.2 to 2.8. Main problems were associated with film processing, viewing conditions and optical density control. The preliminary survey of mammography practice highlighted the need for optimization of radiation protection and training of operating staff, although the survey itself was very valuable learning process for all participants. Furthermore, systematic implementation of QC protocol should provide reliable performance of mammography units and maintain satisfactory image quality and keep patient doses as low as reasonably practical.(author)

  18. Quality control in digital mammography: the noise components

    International Nuclear Information System (INIS)

    Leyton, Fernando; Nogueira, Maria do Socorro; Duran, Maria Paz; Dantas, Marcelino; Ubeda, Carlos

    2011-01-01

    To measure the linearity of the detector and determine the noise components (quantum, electronic and structural noise) that contributed to losing image quality and to determine the signal noise ratio (SNR) and contrast noise ratio (CNR). This paper describes the results of the implementation of a protocol for quality control in digital mammography performed in two direct digital mammography equipment (Hologic, Selenia) in Santiago of Chile. Shows the results of linearity and noise analysis of the images which establishes the main cause of noise in the image of the mammogram to ensure the quality and optimize procedures. The study evaluated two digital mammography's Selenia, Hologic (DR) from Santiago, Chile. We conducted the assessment of linearity of the detector, the signal noise ratio, contrast noise ratio and was determined the contribution of different noise components (quantum, electronics and structural noise). Used different thicknesses used in clinical practice according to the protocol for quality control in digital mammography of Spanish society of medical physics and NHSBSP Equipment Report 0604 Version 3. The Selenia mammography software was used for the analysis of images and Unfors Xi detector for measuring doses. The mammography detector has a linear performance, the CNR and SNR did not comply with the Protocol for the thicknesses of 60 and 70 mm. The main contribution of the noise corresponds to the quantum noise, therefore it is necessary to adjust and optimize the mammography system. (author)

  19. Quality control in digital mammography: the noise components

    Energy Technology Data Exchange (ETDEWEB)

    Leyton, Fernando [Universidade de Tarapaca, Arica (Chile). Centro de Estudios en Ciencias Radiologicas; Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Nogueira, Maria do Socorro, E-mail: mnogue@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Duran, Maria Paz [Clinica Alemana, Santiago (Chile). Dept. de Radiologia; Dantas, Marcelino, E-mail: marcelino@inb.gov.b [Industrias Nucleares do Brasil (INB), Caldas, MG (Brazil). Unidade de Tratamento de Minerios; Ubeda, Carlos, E-mail: cubeda@uta.c [Universidade de Tarapaca, Arica (Chile). Fac. de Ciencias de la Salud

    2011-07-01

    To measure the linearity of the detector and determine the noise components (quantum, electronic and structural noise) that contributed to losing image quality and to determine the signal noise ratio (SNR) and contrast noise ratio (CNR). This paper describes the results of the implementation of a protocol for quality control in digital mammography performed in two direct digital mammography equipment (Hologic, Selenia) in Santiago of Chile. Shows the results of linearity and noise analysis of the images which establishes the main cause of noise in the image of the mammogram to ensure the quality and optimize procedures. The study evaluated two digital mammography's Selenia, Hologic (DR) from Santiago, Chile. We conducted the assessment of linearity of the detector, the signal noise ratio, contrast noise ratio and was determined the contribution of different noise components (quantum, electronics and structural noise). Used different thicknesses used in clinical practice according to the protocol for quality control in digital mammography of Spanish society of medical physics and NHSBSP Equipment Report 0604 Version 3. The Selenia mammography software was used for the analysis of images and Unfors Xi detector for measuring doses. The mammography detector has a linear performance, the CNR and SNR did not comply with the Protocol for the thicknesses of 60 and 70 mm. The main contribution of the noise corresponds to the quantum noise, therefore it is necessary to adjust and optimize the mammography system. (author)

  20. Film quality in film mammography. Pt. 2

    International Nuclear Information System (INIS)

    Friedrich, M.; Weskamp, P.; Freie Univ. Berlin

    1976-01-01

    During consideration of three film mammographic systems, the concept of signal/noise ratio is developed as a quantitative measure of film quality. The ability to recognise detail related to detail size, film blackening and exposure geometry was studied for various systems, and the quality profiles are discussed. There is a considerable difference in quality between industrial films without screens and film-screen combinations; however, exposure geometry during mammography has a considerable effect which tends to reduce the difference. Consequently, detail sizes of 200 μ to 1,000 μ (including the majority of mammographic micro-calcifications) are shown about equally well. Contrast for the lo-dose system is somewhat less than for adequately exposed industrial film. Over-exposure with the lo-dose system, contrary to industrial film, rapidly leads to unsatisfactory results. On the other hand it is often not possible to obtain an adequate exposure when using industrial film. For these reasons it is often an advantage to examine large breasts and the dense breasts of young women with a film-screen combination which requires approximately one eighth of the dose necessary for industrial film. For small or easily compressable breasts best results are obtained, using an adequate exposure by employing industril film; radiation dose it then acceptable. (orig./ORU) [de

  1. Image Quality in Screening Mammography in Croatia

    International Nuclear Information System (INIS)

    Brnic, Z.; Klasic, B.; Popic-Ramac, J.; Ljevar, A.

    2011-01-01

    Mortality reduction through screening mammography (SMG) is possible only with examination of high image quality (IQ), which should be performed with acceptable patient breast radiation dose (BRD). Besides film processing control, equipment assessment with breast phantom and dosimetry, periodical external mammographic IQ assessment (MIQA) is needed, including image labelling (L), breast positioning (BP), exposure (EX) and artefacts (AR) assessment. The nationwide breast cancer screening program (NBSP) has been introduced in Croatia in 2006, and the MIQA is initiated as the first step in establishing quality assurance/quality control (QA/QC) framework in breast imaging in Croatia. The current study was aimed: (1) to provide objective evidence about the technical MIQ in NBSP in Croatia, (2) to compare MIQ between different types of mammographic units (MUs), (3) to identify the common deficiencies, and (4) to propose corrective activities. Mammograms (MGs) for IQA were collected from a total of 84 MUs which participate in NBSP, which represents 70 % of all MUs nationwide: A total of 420 MG examinations were reviewed. Each MU was requested to submit ''what they consider to be their five best representative MGs, each one performed in one of five consecutive workdays''. Mean age of MG machines was 7.76 years (range 2 - 21), with no difference between four MU types. This very first study of MIQ in Croatia corroborated our intuitive impression of inadequate IQ, staff training and equipment in many MUs nationwide. As MIQ strongly influences BC detection rate, suboptimal QA/QC always carries a risk to compromise the success of NBSP. Deficiencies in SMG, especially in ID and BP reflect different level of competency of radiological staff in Croatia. Differences in MIQ in various MU types are determined by their organization, equipment, education, working habits and motivation. More efforts are needed to train both RTs and radiologists to implement and maintain QA/QC in their

  2. Speculation on improving personal dosimetry in mammography

    International Nuclear Information System (INIS)

    Nicoll, J.J.

    1996-01-01

    The increasing importance of radiation protection of the patient in diagnostic radiology has created an interest in the dose individuals receive from X-ray mammography, although this is an area where the most important aspect of protection is based on the inter comparison of machines using phantoms and standard conditions. In 1987 the ICRP established the critical quantity as being the average absorbed dose to the glandular tissue of the breast, and identified a composition of 50% adipose; 50% glandular tissue as a reference. Several authors have published experimental and monte carlo simulation resuluts to enable the determination of this quantity from output, beam quality and compressed breast thickness. Many centres, including ourselves, have studied the distribution of radiation dose on this basis. The result is however dependant on the assumption made about tissue composition. It is apparently common knowledge among pathologists and frequently mentioned in general anatomy texts, that the amount of glandular tissue is independent of breast size; that is larger breasts will have a higher adipose:glandular tissue ratio. Such a systematic variation would lead to an overestimate of the dose being received by women with larger breasts. I will review the availabe pathology and demonstrate the effect of applying the assumed breast composition on our own data. (author)

  3. Does an increase in compression force really improve visual image quality in mammography? – An initial investigation

    International Nuclear Information System (INIS)

    Mercer, C.E.; Hogg, P.; Cassidy, S.; Denton, E.R.E.

    2013-01-01

    Objective: Literature speculates that visual image quality (IQ) and compression force levels may be directly related. This small study investigates whether a relationship exists between compression force levels and visual IQ. Method: To investigate how visual IQ varies with different levels of compression force, 39 clients were selected over a 6 year screening period that had received markedly different amounts of compression force on each of their three sequential screens. Images for the 3 screening episodes for all women were scored visually using 3 different IQ scales. Results: Correlation coefficients between the 3 IQ scales were positive and high (0.82, 0.9 and 0.85). For the scales, the IQ scores their correlation does not vary significantly, even though different compression levels had been applied. Kappa IQ scale 1: 0.92, 0.89, 0.89. ANOVA IQ scale 2: p = 0.98, p = 0.55, p = 0.56. ICC IQ scale 3: 0.97, 0.93, 0.91. Conclusion: For the 39 clients there is no difference in visual IQ when different amounts of compression are applied. We believe that further work should be conducted into compression force and image quality as ‘higher levels’ of compression force may not be justified in the attainment of suitable visual image quality

  4. Mammography

    Science.gov (United States)

    ... breast cancer Whether there is any harm from breast cancer screening, such as side effects from testing or overtreatment of cancer when it's discovered Mammography is performed to screen women to detect early breast cancer when it is ...

  5. Quality assurance and quality control in mammography: A review

    International Nuclear Information System (INIS)

    BenComo, Jose A.

    2000-01-01

    A mammogram is among the most technically demanding radiographic procedures. The early detection of breast cancer relies on the radiologist's ability to perceive subtle changes in the image that are only perceptible with high-quality imaging. Early detection of breast cancer is only as reliable as the mammogram with which a diagnosis is made, and a mammogram is only as accurate as the system that produces it. A quality assurance (QA) program maximizes the likelihood that the mammographic images will provide adequate diagnostic information for the least possible radiation exposure and cost to the patient. The QA program monitors each phase of operation of the imaging facility beginning with the request for an examination and ending with the interpretation of the referring physician and ensures that the imaging equipment used for the examination will yield the information desired. Because image quality is the most important technical aspect of mammography, this review summarizes the most important QA and quality control issues

  6. Physical image quality of computed radiography in mammography system

    International Nuclear Information System (INIS)

    Norriza Mohd Isa; Muhammad Jamal Isa; Wan Muhamad Saridan Wan Hassan; Fatimah Othman

    2013-01-01

    Full-text: Mammography is a screening procedure that mostly used for early detection of breast cancer. In digital imaging system, Computed Radiography is a cost-effective technology that applied indirect conversion detector. The paper presents physical image quality parameter measurements namely modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE) of Computed Radiography in mammography system. MTF was calculated from two different orientations of slanted images of an edge test device and NNPS was estimated using flat-field image. Both images were acquired using a standard mammography beam quality. DQE was determined by applying the MTF and NNPS values into our developed software program. Both orientations have similar DQE characteristics. (author)

  7. Effect of area x-ray beam equalization on image quality and dose in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jerry; Xu Tong; Husain, Adeel; Le, Huy; Molloi, Sabee [Department of Radiological Sciences, University of California, Irvine, CA 92697 (United States)

    2004-08-21

    In mammography, thick or dense breast regions persistently suffer from reduced contrast-to-noise ratio (CNR) because of degraded contrast from large scatter intensities and relatively high noise. Area x-ray beam equalization can improve image quality by increasing the x-ray exposure to under-penetrated regions without increasing the exposure to other breast regions. Optimal equalization parameters with respect to image quality and patient dose were determined through computer simulations and validated with experimental observations on a step phantom and an anthropomorphic breast phantom. Three parameters important in equalization digital mammography were considered: attenuator material (Z = 13-92), beam energy (22-34 kVp) and equalization level. A Mo/Mo digital mammography system was used for image acquisition. A prototype 16 x 16 piston driven equalization system was used for preparing patient-specific equalization masks. Simulation studies showed that a molybdenum attenuator and an equalization level of 20 were optimal for improving contrast, CNR and figure of merit (FOM = CNR{sup 2}/dose). Experimental measurements using these parameters showed significant improvements in contrast, CNR and FOM. Moreover, equalized images of a breast phantom showed improved image quality. These results indicate that area beam equalization can improve image quality in digital mammography.

  8. Quality control for digital mammography: Part II recommendations from the ACRIN DMIST trial

    International Nuclear Information System (INIS)

    Yaffe, Martin J.; Bloomquist, Aili K.; Mawdsley, Gordon E.

    2006-01-01

    The Digital Mammography Imaging Screening Trial (DMIST), conducted under the auspices of the American College of Radiology Imaging Network (ACRIN), is a clinical trial designed to compare the accuracy of digital versus screen-film mammography in a screening population [E. Pisano et al., ACRIN 6652--Digital vs. Screen-Film Mammography, ACRIN (2001)]. Part I of this work described the Quality Control program developed to ensure consistency and optimal operation of the digital equipment. For many of the tests, there were no failures during the 24 months imaging was performed in DMIST. When systems failed, they generally did so suddenly rather than through gradual deterioration of performance. In this part, the utility and effectiveness of those tests are considered. This suggests that after verification of proper operation, routine extensive testing would be of minimal value. A recommended set of tests is presented including additional and improved tests, which we believe meet the intent and spirit of the Mammography Quality Standards Act regulations to ensure that full-field digital mammography systems are functioning correctly, and consistently producing mammograms of excellent image quality

  9. The results of a quality-control programme in mammography

    International Nuclear Information System (INIS)

    Ramsdale, M.L.; Hiles, P.A.

    1989-01-01

    With the introduction of a breast screening programme in the UK, quality assurance in mammography is of paramount importance in assuring optimum imaging performance with low dose. Quality control checks are an essential part of the quality-assurance system. A quality-control programme at a breast screening clinic is described. Daily checks include film sensitometry for X-ray processor control and radiography of a lucite phantom to monitor the consistency of the X-ray machine automatic exposure control. Weekly checks include additional measurements on the performance of the automatic exposure control for different breast thickness and an overall assessment of image quality using a prototype mammography test phantom. The test phantom measures low-contrast sensitivity, high-contrast resolution and small-detail visibility. The results of the quality-control programme are presented with particular attention paid to tolerances and limiting values. (author)

  10. Technical aspects of quality assurance in mammography: Preliminary results from Serbia

    Directory of Open Access Journals (Sweden)

    Živković Monika M.

    2010-01-01

    Full Text Available Mammography is the method of choice for early detection of breast cancer. In Serbia, mammography is performed only clinically, although there is a plan to introduce mammography as a screening method. Currently, there are 60 mammographic units in practice, resulting in 70 000 mammographies annually. The survey was conducted in order to investigate mammographic practice in Serbia, identify weak points and suggest appropriate corrective measures. Basic technical parameters of the X-ray tube and generator, processing, image quality, and patient doses in 20 mammographic units were studied. The survey demonstrated considerable variations in technical parameters that affect image quality, and patients doses. Patient dose levels, in terms of the mean glandular dose, were fairly consistent with current European reference levels: 1.8 (0.40-4.3 mGy. However, due to inappropriate image receptors, image processing and viewing conditions and automatic exposure control adjustment, suboptimal image quality was a common finding. Simple improvements of the radiographic technique and maintenance procedure, along with the rigid implementation of the quality control procedure and training of the operating staff, would improve the performance levels of mammographic practice in Serbia, i. e. result in the production of high quality images with a reasonably low radiation risk to patients.

  11. Mammography

    International Nuclear Information System (INIS)

    1975-01-01

    This patent reveals a method and instrument for the detection and registration of breast cancer with the aid of X-radiation, i.e. mammography. The breast is irradiated with soft X-rays whereby the radiation beam is scanned with a moving 'stripform' screen and whereby the picture from the 'stripform' screen is recorded by a television camera that moves simultaneously with the strip. The image is then projected on a monitor

  12. Exploratory survey of image quality on CR digital mammography imaging systems in Mexico

    International Nuclear Information System (INIS)

    Gaona, E.; Rivera, T.; Arreola, M.; Franco, J.; Molina, N.; Alvarez, B.; Azorín, C.G.; Casian, G.

    2014-01-01

    The purpose of this study was to assess the current status of image quality and dose in computed radiographic digital mammography (CRDM) systems. Studies included CRDM systems of various models and manufacturers which dose and image quality comparisons were performed. Due to the recent rise in the use of digital radiographic systems in Mexico, CRDM systems are rapidly replacing conventional film-screen systems without any regard to quality control or image quality standards. Study was conducted in 65 mammography facilities which use CRDM systems in the Mexico City and surrounding States. The systems were tested as used clinically. This means that the dose and beam qualities were selected using the automatic beam selection and photo-timed features. All systems surveyed generate laser film hardcopies for the radiologist to read on a scope or mammographic high luminance light box. It was found that 51 of CRDM systems presented a variety of image artefacts and non-uniformities arising from inadequate acquisition and processing, as well as from the laser printer itself. Undisciplined alteration of image processing settings by the technologist was found to be a serious prevalent problem in 42 facilities. Only four of them showed an image QC program which is periodically monitored by a medical physicist. The Average Glandular Dose (AGD) in the surveyed systems was estimated to have a mean value of 2.4 mGy. To improve image quality in mammography and make more efficient screening mammographic in early detection of breast cancer is required new legislation. - Highlights: • Radiation dose in CR digital mammography (CRDM) systems was determined. • Image quality related with dose in CR digital mammography (CRDM) systems was analysed. • Image processing artefacts were observed and correlated with dose. • Measured entrance dose by TL phosphors could be good parameter for radiation protection optimization in patient

  13. Health-related quality of life, anxiety and depression related to mammography screening in Norway.

    Science.gov (United States)

    Hafslund, Bjorg; Espehaug, Birgitte; Nortvedt, Monica Wammen

    2012-11-01

    To measure health-related quality of life, anxiety and depression ahead of mammography screening and to assess any differences in health-related quality of life compared to reference population. The study of health-related quality of life among attendees prior to mammography screening has received little attention, and increased knowledge is needed to better understand the overall health benefits of participation. A two-group cross-sectional comparative study was performed. The samples comprised 4,249 attendees to mammography screening and a comparison group of 943 women. We used the SF-36 Health Survey to assess health-related quality of life. Linear regression was used to study any differences between the groups with adjustment for age, level of education, occupation, having children and smoking status. Other normative data were also used. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Attendees scored statistically significant higher on the SF-36 than the comparison group but were in line with normative data. Attendees had anxiety mean 4·1 and depression mean 2·6. The majority of the attendees have a high health-related quality of life, low anxiety and depression ahead of screening. Anxiety and depression were less than shown in normative data from Norway. Despite a high health-related quality of life, low anxiety and depression among the majority, healthcare workers should pay special attention to the few women who are anxious and depressed, and have a lower health-related quality of life. Omitted from mammography screening may be women who are unemployed, have lower socioeconomic status, are anxious and are depressed. Further research should be performed with non-attendees and subgroups to improve the screening programme. It is important to identify which patients have the greatest need for support and caring in an organised mammography screening and who may be overlooked. © 2012 Blackwell Publishing Ltd.

  14. Mammography calibration qualities establishment in a Mo-Mo clinical system

    International Nuclear Information System (INIS)

    Correa, E.L.; Santos, L.R. dos; Vivolo, V.; Potiens, M.P.A.

    2015-01-01

    In this study the mammography calibration qualities were established in a clinical mammography system. The objective is to provide the IPEN instruments calibration laboratory with both mammography calibration methods (using a clinical and an industrial system). The results showed a good behavior of mammography equipment, in terms of kVp, PPV and exposure time. The additional filtration of molybdenum is adequate, air-kerma rates were determined and spectra were obtained. (author)

  15. Mammography calibration qualities establishment in a Mo-Mo clinical system

    Energy Technology Data Exchange (ETDEWEB)

    Correa, E.L.; Santos, L.R. dos; Vivolo, V.; Potiens, M.P.A., E-mail: educorrea1905@gmail.com [Instituto de Pesquisas Energeticas e Nucleres (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    In this study the mammography calibration qualities were established in a clinical mammography system. The objective is to provide the IPEN instruments calibration laboratory with both mammography calibration methods (using a clinical and an industrial system). The results showed a good behavior of mammography equipment, in terms of kVp, PPV and exposure time. The additional filtration of molybdenum is adequate, air-kerma rates were determined and spectra were obtained. (author)

  16. Indicators of image quality and doses in mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Franco E, J.G.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2007-01-01

    Full text: The purpose of the study was to determine the values of the image quality indicators and their relationship with the dose in mammography of screen-film that they allowed the detection of a bigger number of objects in the images obtained with the mannequin (phantom) authorized of the ACR/FDA. The study was carried out in four mammography services in a period of 12 months. The indicators of the image quality are the half optic density (DOM), contrast (differences of densities), the number of observed objects in the images and the dose for image. The minimum acceptable values by the ACR/FDA are a half optical density of 1.4, contrast of 0.4 and the one numbers minimum of objects observed in the image of the mannequin of mammography of 10 (4 fibers, 3 groups of calcifications and 3 masses), with a maximum dose by image of 3 mGy. The found results are half optical density of 1.9, contrast of 0.56 and the average number of objects observed in the images of 12, with a dose in the interval of 1.6 mGy to 2.4 mGy. The doses were measured by thermoluminescent dosimetry and ionization chamber. Once carried out the analysis of the tendencies of the indicators of image quality and their distributions is found that for a p < 0.05, the bigger number of objects observed in the images is in the interval from 1.8 to 1.9 of DOM. When comparing both mammography system, the system screen-film has a lower variability in the distribution of objects associated to a DOM. (Author)

  17. X-ray phase imaging using a X-ray tube with a small focal spot. Improvement of image quality in mammography

    International Nuclear Information System (INIS)

    Honda, Chika; Ohara, Hiromu; Ishisaka, Akira; Shimada, Fumio

    2002-01-01

    Phase contrast X-ray imaging has been studied intensively using X-rays from synchrotron radiation and micro-focus X-ray tubes. However, these studies have revealed the difficulty of this technique's application to practical medical imaging. We have created a phase contrast imaging technique using a molybdenum X-ray tube with a small focal spot size for mammography. We identified the radiographic conditions in phase contrast magnification mammography with a screen-film system, where edge effect due to phase contrast overcomes geometrical unsharpness caused by the 0.1 mm-focal spot of a molybdenum X-ray tube. The edge enhancement due to phase imaging was observed in an image of a plastic tube, and then geometrical configuration of the X-ray tube, the object and the screen-film system was determined for phase imaging of mammography. In order to investigate a potential for medical application of this method, we conducted evaluation of the images of the American Collage of Radiology (ACR) 156 mammography phantom. We obtained higher scores for phase imaging using high speed screen-film systems without any increase of X-ray dose than the score for contract imaging using a standard speed screen-film system. (author)

  18. The results of a quality-control programme in mammography

    International Nuclear Information System (INIS)

    Ramsdale, M.L.; Hiles, P.A.

    1989-01-01

    A quality-control programme at a breast screening clinic is described. Daily checks include film sensitometry for X-ray processor control and radiography of a lucite phantom to monitor the consistency of the X-ray machine automatic exposure control. Weekly checks include additional measurements on the performance of the automatic exposure control for different breast thickness and an overall assessment of image quality using a prototype mammography test phantom. The test phantom measures low-contrast sensitivity, high-control resolution and small-detail visibility. The results of the quality-control programme are presented with particular attention paid to tolerances and limiting values. (author)

  19. Technical and dosimetric aspects of quality control in mammography

    International Nuclear Information System (INIS)

    Zoetelief, J.; Wit, N.J.P. de; Broerse, J.J.

    1989-01-01

    Before screening programmes using mammography are implemented, a cost benefit analysis has to be made and quality-control programme for the technical and dosimetric aspects adopted, including daily checks on film processing and total mammography procedure (radiography of a reference phantom, for which the average density, limiting value ± 0.20%, and focal charge is determined and which allows assessment of physical image quality) The installation of a MAs meter is essential for daily checks and can be used for determination of absorbed dose. Accurate determination of tube voltage (limiting value ±0.5 kV) is essential in regard to absorbed dose variations. Focal spot size should be measured rather than relying on the value specified by the manufacturer. The determination of the focal charge (mAs) value for actual radiographs of female breasts combined with a measurement of compressed breast thickness provides information on absorbed dose values for actual radiographs. An approximately 50 mm thick poly(methyl methacrylate) phantom can be used for determination of absorbed dose in mammography. (author)

  20. Reaching Rural Mammographers for Quality Improvement

    National Research Council Canada - National Science Library

    Urban, Nicole

    1997-01-01

    The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement program (MQIP...

  1. Reaching Rural Mammographers for Quality Improvement

    National Research Council Canada - National Science Library

    Urban, Nicole

    1998-01-01

    The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement. program (MQIP...

  2. Reaching Rural Mammographers for Quality Improvement

    National Research Council Canada - National Science Library

    Urban, Nicole

    1999-01-01

    The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement program (MQIP...

  3. Evaluation of the quality of the mammography study in the radio-diagnostic service of the National Cancer Institute

    International Nuclear Information System (INIS)

    Rubio Laverde, Alba Lucia; Pineros Petersen, Marion; Betancourt Gil, Claudia

    2003-01-01

    The development of mammography quality control programs at radiology services has had an important progress in the last decades, mainly in developed countries. Although breast cancer is one of the leading causes of cancer mortality and incidence in Colombia, quality control programs for mammography screening are just beginning to be considered. This article describes the results of a baseline evaluation aimed at establishing a quality control program at the Radiology Unit of the National Cancer Institute, in Colombia. The mammography equipment, the film processing, and all main physical parameters were checked and compared to international standards. Quality of the image in 301 mammographic X-ray plates was evaluated. In order to implement a good quality control program, the need for acquiring essential instruments, improving physical facilities and starting a continuous training program is imperative

  4. Quality control in diagnostic mammography: myths, realities and their importance in the final image quality

    International Nuclear Information System (INIS)

    Mora Rodriguez, Patricia

    2011-01-01

    Mammography is the most used tool for early detection of breast cancer and reduce mortality from this cause. Studies with ionizing radiation it is important that be justified and provide a quality image to make the diagnosis, to get more benefits and fewer risks. The problem is the difficult to obtain an image of the breast. Therefore, the commitment to quality mammography is to maximize the contrast, definition, resolution and reliability, thus minimizing noise and dose. A mammogram performed without quality don't detect early breast cancer and the study doesn't have sense. Quality mammography requires trained and experienced staff, modern equipment and in good conditions, correct positioning, right technical factors and appropriate viewing conditions. In addition, quality programs are required to reach to ensure quality, control in testing techniques and image quality. (author) [es

  5. Full-field digital mammography versus computed radiology mammography: comparison in image quality and radiation dose

    International Nuclear Information System (INIS)

    Zhao Yongxia; Song Shaojuan; Liu Chuanya; Qi Hengtao; Qin Weichang

    2008-01-01

    Objective: To investigate the differences in image quality and radiation dose between full- field digital mammography (FFDM) system and compute radiology mammography (CRM) system. Methods: The ALVIM mammographic phantom was exposed by FFDM system with automatic exposure control (AEC) and then exposed by CRM system with the unique imaging plank on the same condition. The FFDM system applied the same kV value and the different mAs values (14, 16, 18, 22 and 24 mAs), and the emission skin dose (ESD) and the average gland dose (AGD) were recorded for the above-mentioned exposure factors. All images were read by five experienced radiologists under the same condition and judged based on 5-point scales. And then receive operating characteristic (ROC) curve was drawn and the probability (P det ) values were calculated. The data were statistically processed with ANOVA. Results: The P det values of calcifications and lesion lump were higher with FFDM system than with CRM system at the same dose (1.36 mGy). Especially, for microcalcifications and lesion lump, the largest difference of the P det value was 0.215, and that of lesion lump was 0.245. In comparison with CRM system, the radiation dose of FFDM system could be reduced at the same P det value. The ESD value was reduced by 26%, and the ACD value was reduced by 41%. When the mAs value exceed AEC value, the P det value almost had no change, though the radiation dose was increased. Conclusions: The detection rates of microcalcifications and lesion lump with FFDM system are proven to be superior to CRM system at the same dose. The radiation dose of FFDM system was less than CRM system for the same image quality. (authors)

  6. Descriptive study of the quality control in mammography; Estudio descriptivo del control de calidad en mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Perdigon C, G.M.; Casian C, G.A.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M. [UAM, Xochimilco 14000 Mexico D.F. (Mexico)

    2005-07-01

    The goal of mammography is to provide contrast between a lesion that is possible residing within the breast and normal surrounding tissue. Quality control is essential for maintaining the contrast imaging performance of a mammography system and incorporate tests that are relevant in that they are predictive of future degradation of contrast imaging performance. These tests will also be done at frequency that is high enough to intercept most drifts in quality imaging or performance before they become diagnostically significant. The quality control study has as objective to describe the results of the assessment of quality imaging elements (film optical density, contrast (density difference), uniformity, resolution and noise) of 62 mammography departments without quality control program and comparison these results with a mammography reference department with a quality control program. When comparing the results they allow seeing the clinical utility of to have a quality control program to reduce the errors of mammography interpretation. (Author)

  7. Optimization of image quality and patient dose in mammography

    International Nuclear Information System (INIS)

    Shafqat Faaruq; Jaferi, R.A.; Nafeesa Nazlee

    2007-01-01

    Complete test of publication follows. Optimization of patient dose and image quality can be defined as to get the best image quality with minimum possible radiation dose to the patient by setting various parameters and modes of operation available in mammography machines. The optimization procedures were performed on two mammography units from M/S GE and Metaltronica, available at NORI, using standard mammographic accreditation phantom (Model: BR-156) and acrylic sheets of variable thicknesses. Quality assurance and quality control (QC) tests being the essential part of optimization. The QC tests as recommended by American College of Radiology, were first performed on both machines as well as X-ray film processor. In the second step, different affecting the image quality and radiation dose to patient, like film screen combination (FSC), phantom optical density (PD), kVp, mAs etc, were adjusted for various phantom thicknesses ranging from 3 cm to 6.5 cm in various modes of operation in the machines (semi-auto- and manual in GE, Auto-, semi-auto- and manual mode in Metaltronica). The image quality was studied for these optimized parameters on the basis of the number of test objects of the phantom visible in these images. Finally the linear relationship between mAs and skin entrance dose (mGy) was verified using ionization chamber with the phantom and the actual patients. Despite some practical limitations, the results of the quality assurance tests were within acceptable limits defined by ACR. The dose factor for GE was 68.0 y/mAs, while 76.0 mGy/mAs for Metaltronica at 25 kVp. Before the start of this study the only one mammography unit GE, was routinely used at NORI and normal mode of operation of this unit was semi-auto mode with fixed kVp independent of compressed breast thickness, but in this study it was concluded that selecting kVp according to beast thickness result in an appreciable dose reduction (4-5 times less) without any compromise in image quality. The

  8. Evaluation of physical parameters and implementation of quality control in mammography diagnosed for a pilot of breast cancer screening in the Caja Costarricense de Seguro Social (CCSS)

    International Nuclear Information System (INIS)

    Hernandez Angulo, Carolina Maria

    2012-01-01

    The purpose of mammography has been to provide the contrast between the lesion and adjacent healthy tissue of the breast. The quality control which should be performed in mammography services is essential to obtain the necessary contrast in mammography and thus achieve a prompt detection of breast lesions. The quality control program has helped to obtain exact diagnosis in mammography and has contributed to reduce mortality from breast cancer in Costa Rica. The Caja Costarricense de Seguro Social (CCSS) has sought to improve the quality of mammograms performed in the different health centers by implementing quality control programs in the services. The evaluation of the physical parameters has had as aim to perform an assessment of the equipment used in mammography facilities. The image quality, dosimetry, optical density, performance, accuracy and repeatability of voltage applied to the tube, filtration and Half-value layer in system of screen film mammography have been evaluated. The usefulness of quality control programs and needs of the services to implement a pilot plan for breast screening, can be seen when comparing the obtained results. The protocol of Mammography Quality Control, TECDOC 1517 from the International Atomic Energy Agency (IAEA), is implemented with this project and the associated software in four of the six hospitals evaluated in this study. (author) [es

  9. Mammography

    International Nuclear Information System (INIS)

    Oliveira, S.B.

    1988-01-01

    The mamma anatomy are showed with the main characteristics for the mamography examination. The energy band, the additional filtration, the half-value thickness are also mentioned. The evaluation in the exposure and the doses in the mamography examination are described with a quality control for obtention the best image. (C.G.C.) [pt

  10. Image quality and radiation exposure in digital storage plate mammography with magnification technique

    International Nuclear Information System (INIS)

    Fiedler, E.; Aichinger, U.; Boehner, C.; Schulz-Wendtland, R.; Bautz, W.; Saebel, M.

    1999-01-01

    Purpose: Comparison of image quality between digital phosphor storage plate mammography in magnification technique and a conventional film screen system regarding the special aspect of radiation exposure. Materials and Methods: Radiograms of a RMI-mammography phantom were acquired using a conventional film screen system and two digital storage plate systems. Additionally, the radiograms of one digital system were postprocessed emphasizing contrast and included in the comparison. Results: The detectability of details in storage plate mammographies with magnification technique is almost equal to that of film screen mammographies. Thereby, lower radiation exposures were necessary using the digital systems. Conclusions: Based on these results, storage plate mammography in magnification technique is used in clinical routine at our institution. The correct parameters in image postprocessing are of elementary importance for detail detectability. Future studies must show, whether the lower radiation exposure in digital radiograms of the breast, revealing much higher background noise, will allow the same detail detectability as film screen mammographies. (orig.) [de

  11. Quality assurance and patient dosimetry in mammography: a retrospective

    International Nuclear Information System (INIS)

    Castellano, I.A.; Dance, D.R.; Davis, R.; Evans, S.H.; Jones, C.H.; Parsons, C.A.

    1995-01-01

    The study of the breast using mammography commenced at this major cancer centre in the late 1960s. Clinically useful images were first obtained using a Xerox system in the early 1970s. The development of quality assurance phantoms since this time is described, also research into the evaluation of breast dose and optimisation of the imaging chain. Physical and biological phantoms were used to evaluate available imaging configurations, and examples of the parameters investigated - target material, choice of image receptor - are given. A number of Monte Carlo programs have been developed to quantify image quality parameters and patient dose. They have been used to optimise available imaging configurations for a wide range of breast thicknesses and radiographic parameters. Examples of studies into dose reduction by the addition of filtration, choice of kV p , and the use of grids are given. (Author)

  12. Situational quality evaluation of mammography services at state of Minas Gerais, Brazil

    International Nuclear Information System (INIS)

    Joana, Georgia S.; Oliveira, Mauricio de; Andrade, Mauricio C. de; Cesar, Adriana C.Z.; Peixoto, Joao E.

    2011-01-01

    Breast cancer is the leading cause of cancer deaths in women. Currently, the most effective method for early detection of this cancer is the mammography, and to achieve the standard definition and contrast, the whole system of imaging must operate under optimal conditions. This paper presents the results of the assessment of mammography centers in the state of Minas Gerais, which was held with the aim of supporting the actions of the State Program of Quality Control in Mammography. These results indicated that less than half of mammography achieved the minimum standard of image quality, endorsing the need of a monitoring more efficient and effective, which led to the establishment, in Minas Gerais, of the monthly monitoring of image quality in mammography. (author)

  13. Mammography in Norway: Image quality and total performance; Mammografivirksomhet i Norge: Bildekvalitet og totalytelse

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, J.B.; Skretting, A. [Norske Radiumhospital, Oslo (Norway); Widmark, A. [Statens Straalevern, Oesteraas (Norway)

    1997-04-01

    This report describes a method for assessing the total performance in mammography based on Receiver Operating Characteristic (ROC) analysis. In the time period from December 1993 to March 1994 the method was applied to assess the total performance of all the 45 Norwegian mammography laboratories operative at that time. Image quality characteristics in each laboratory was established by use of well-known phantoms.

  14. Impact of a program of diagnostic imaging quality control in mammography centers of the Federal District, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Rosangela da Silveira; Ferreira, Rubemar de Souza [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN/CNEN-CO), Abadia de Goias, GO (Brazil)]. E-mail: rcorrea@cnen.gov.br; Peixoto, Joao Emilio [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Silver, Lynn Dee [New York Health Department, New York, NY (United States); Dias, Cintia Melazo [Comissao Nacional de Energia Nuclear (Diplan/CNEN), Braslia, DF (Brazil). Distrito do Planalto Central; Nogueira, Maria do Socorro [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Hwang, Suy Ferreira [Centro Regional de Ciencias Nucleares do Nordeste (CRCN/CNEN-NE), Recife, PE (Brazil)

    2008-03-15

    Objective: The present study was aimed at evaluating the quality and the impact of an intervention involving inspection and education in mammography centers of the Federal District, Brazil. Materials and methods: Forty one mammography centers in the Federal District were studied in the period between 2000 and 2002. The intervention involved an initial inspection followed by a training activity and notification of mammography centers by the Federal District Sanitary Vigilance authority. The imaging quality was compared before and after the intervention. Results: None of the 36 centers which completed the study reached more than 90% compliance with the standard imaging quality prior to the interventions, whereas ten were above 90% afterwards. Major improvements were observed in chassis maintenance, breast compression and visualization of microcalcifications. Conclusion: Despite the availability of a great number of mammography centers in the Federal District, most of them did not meet the required quality standards. The intervention has shown to be effective for improving the imaging quality, however a continued action is required to solve the remaining problems and increase the impact of the program. (author)

  15. Quality assurance of mammography training courses via questionnaires. Eighth report

    International Nuclear Information System (INIS)

    Kotsuma, Yoshikazu; Endo, Tokiko; Iwase, Takuji

    2007-01-01

    To maintain a sufficient number of qualified reading doctors for breast cancer mammography screening, we have held training courses across the nation. Grade-up examinations have been carried out for doctors who had failed to attain grade A or B at the training courses. We have evaluated the quality assurance of the examinations via questionnaires and reported the results on 7 previous occasions. In the present investigation, we reviewed all answers obtained from questionnaires at the previous 19 examinations, from the first one (November, 2000) until the last one (March, 2007). There were a total of 3,380 applicants, of whom 402 (11.9%) obtained grade A and 2,008 (59.4%) grade B. Thus a total 2,410 applicants (71.3%) obtained either A or B, and this rate was considerably superior to the 56% obtained in the first three examinations, although the former rate included the results of repeated applicants. These good results may have been due to an increase in the quality of the training courses and may have been affected by conducting the examinations not only in Nagoya but also in Tokyo and Osaka. In a period of about 10 months after April, 2004, the certification standard was increased and a system of certification reappraisal every 5 years was adopted. At that time, more than 75% of all applicants were A- or B-certified doctors at the 9th and 10th examinations, and the good results might have reflected the fact that many doctors tried hard to maintain a high reading ability. In February, 2005, the certification standard reverted to the previous one for various reasons, and the rate of A- or B-certified doctors decreased. In October, 2006, the examination changed from 100 questions concerning one-direction mammography to 50 one-direction questions and 50 two-direction questions, because of the adoption of two-direction mammography to age 40 years. Since it was widely recognized that the second reading at breast cancer screening should be done by A-certified doctors

  16. Advanced Breast Cancer as Indicator of Quality Mammography

    International Nuclear Information System (INIS)

    Gaona, Enrique

    2003-01-01

    Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is the more important screening tool for detecting early breast cancer. Screening mammography involves taking x-rays from two views from each breast, typically from above (cranial-caudal view, CC) and from an oblique or angled view (mediolateral-oblique, MLO). The purpose of this study was to carry out an exploratory survey of the issue of patients with advanced breast cancer who have had a screening mammography. A general result of the survey is that 22.5% of all patients (102) with advanced breast cancer that participated in the study had previous screening mammography. But we should consider that 10% of breast cancers are not detected by mammography. Only 70% of the family doctors prescribed a diagnostic mammography when the first symptoms were diagnosed

  17. Ergonomic strategies to improve radiographers' posture during mammography activities.

    Science.gov (United States)

    Cernean, Nicolai; Serranheira, Florentino; Gonçalves, Pedro; Sá Dos Reis, Cláudia

    2017-08-01

    To identify alternatives for radiographers' postures while performing mammography that can contribute to reduce the risk of work-related musculoskeletal disorders (WRMSDs). Radiographers' postures to positioning craniocaudal (CC) and mediolateral oblique (MLO) views were simulated without any intervention for three scenarios: radiographer/patient with similar statures, radiographer smaller than patient and radiographer taller than patient. Actions were taken to modify the postures: seated radiographer; patient on a step; seated patient; radiographer on a step. All the postures were analysed using kinovea 0.8.15 software and the angles were measured twice and classified according to European standard EN1005-4: 2005. The non-acceptable angles were measured mainly during MLO positioning when radiographer was taller than the patient: 139° and 120° for arm-flexion and abduction, 72° for trunk and -24° for head/neck-flexion. The introduction of alternative postures (radiographer seated), allowed improvements in posture (60° and 99° for arm flexion and abduction, 14° for trunk and 0° for head/neck flexion), being classified as acceptable. The alternative postures simulated have the potential to reduce the risk of developing WRMSDs when radiographers and patients have different statures. • Radiographers' postures in mammography can contribute to work-related musculoskeletal disorders • Non-acceptable posture was identified for MLO breast positioning (radiographer taller than patient) • Adapting posture to patient biotype reduces the WRMSD risk for radiographers.

  18. Optimization in mammography - monthly monitoring of image quality at the state of Minas Gerais, Brazil

    International Nuclear Information System (INIS)

    Joana, Georgia S.; Andrade, Mauricio C. de; Silva, Sabrina D. da; Silva, Rafael R. da; Cesar, Adriana C.Z.; Oliveira, Mauricio de; Peixoto, Joao E.

    2011-01-01

    The State Program of Quality Control in Mammography (PECQMamo) of the state of Minas Gerais was established in 2004 and consists of tests for evaluation of image quality and performance of equipment used in the diagnosis of breast cancer, and evaluation the infrastructure of mammography centers. The monthly monitoring of image quality in mammography is part of this program that has been executed since May 2009 with a character essentially educational. In the assessment of individual services that participate in the monthly monitoring, there was an increased percentage of average annual compliance from 2009 to 2010 in all 85 services with the exception of one service. Therefore, evolution of the performance of the services evaluated, since the program began, shows a positive impact on the numbers, confirming the relevance of this type of operation of Sanitary Surveillance in the area of quality in mammography. (author)

  19. Glandular dose and image quality control in mammography facilities with computerized radiography systems

    International Nuclear Information System (INIS)

    Dantas, Marcelino Vicente de Almeida

    2010-01-01

    Breast cancer is the most common cancer among women, and early detection is critical to its diagnosis and treatment. To date, the most effective method for early detection of breast cancer has been x-ray mammography for which the screen/film (SF) technique has been the gold standard. However, even though SF combinations have been improved and optimized over the years for breast imaging, there are some critical limitations, including a narrow exposure range, image artifacts, film processing problems, and inflexibility in image processing and film management. In recent years, digital mammography has been introduced in cancer screening programmes with the screen/film techniques gradually being phased out. Computed radiography (CR), also commonly known as photostimulable phosphor (PSP) imaging or storage phosphor, employs reusable imaging plates and associated hardware and software to acquire and to display digital projection radiographs. In this work, a protocol model was tested for performing image quality control and average glandular dose (AGD) evaluation in 19 institutions with computed radiography systems for mammography. The protocol was validated through tests at the Laboratorio de Radioprotecao Aplicada a Mamografia (LARAM) from the Centro de Desenvolvimento da Tecnologia Nuclear (CDTN). The image quality visual evaluation of CDMAM phantom showed that 53% of the facilities were able to produce images of excellent quality. Furthermore, the automated evaluation of image quality, using the analyze software cdcom.exe, showed that 57% of the images were considered to be of good quality. The detector linearity test showed that the CR response is very linear, where 95% of facilities evaluated were considered to be compliant. For the image noise was found that only 20% of facilities are in agreement with the parameters established for this test. The average glandular doses, which patients may be getting to perform an examination, were below the action levels

  20. Quality assurance in mammography and the DQM program

    International Nuclear Information System (INIS)

    Rimondi, O.; Giambaccini, M.; Marziani, M.

    1991-01-01

    The aim of the optimization program for mammography (DQM) in Italy is to achieve the best compromise between image quality and dose to patient. 272 centers agreed to the second phase of the program, from February 1987 to January 1990. Exposure, half-value layer (HVL) and focal spot size were measured according to the same methods employed in the first phase of the DQM program (1985), while image quality was evaluated by means of a new performance phantom. The average exposure was 0.96 R (2.48x10 -4 C/Kg); in 173 (64.3%) centers exposure was 5 R (12.9x10 -4 C/Kg). In every center the average whole-breast dose to a reference organ (5cm thick, composed of 50% fat +50% water) was calculated on the basis of entrance exposure, HVL, and focus-skin distance; in 63.2% of the centers doses <0.15 cGy were employed. The results allowed dose and image quality to be correlated in order to divide the centers (using a film-screen system) into groups with a different efficiency level: in 101 centers dose and image quality were good, in 64 centers too high a dose was employed, 66 centers image quality was poor, and in 38 centers dose was too high and image quality was poor. It must be stressed that the DQM program can play its role only if each center carries out its Quality Assurance activity after the methods recommended by the World Health Organization

  1. Impact of an evaluation quality program of mammography service of Distrito Federal - Brasil

    International Nuclear Information System (INIS)

    Correa, Rosangela da Silveira

    2002-01-01

    Cancer is the second cause of death for Brazilian women and breast cancer is the most common neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to be effective, the mammography must be of good quality. This study sought to evaluate the quality of these services in the Federal District and the impact of an intervention involving inspection and education. The universe of 41 mammography services in the Federal District was studied between June and August 2001. Two instruments were used 1) a proposed evaluation protocol of the National Agency for Health Surveillance (ANVISA) and 2) a protocol for evaluation of image quality and care. The intervention included the initial inspection, a training activity, and a formal notification by the health authorities of the Federal District. Image quality was compared before and after the intervention. The existing infrastructure in the DF is of good quality, but the services have low productivity, they do not treat patients sent by the public health system, they have an inadequate geographic distribution with most in the central neighborhood, and the low income female population has restricted access to early detection of cancer. Of the 36 services who completed the study, none was above 90% conformity in image quality before the interventions, whereas 10 were above 90% afterwards. The greatest improvements were in chassis maintenance (services without chassis with defects went from 10 to 25), breast compression (services in conformity went from 7 to 20) and visualization of micro calcifications (32 services in conformity before and 35 afterwards). The results of the ANVISA protocol bore no relation to final image quality, a central issue for early cancer detection. In spite of the existence of many services, most were not of quality and population access was restricted. The intervention under study was shown to be effective for improving quality, nevertheless

  2. Digital mammography

    International Nuclear Information System (INIS)

    Bick, Ulrich; Diekmann, Felix

    2010-01-01

    This state-of-the-art reference book provides in-depth coverage of all aspects of digital mammography, including detector technology, image processing, computer-aided diagnosis, soft-copy reading, digital workflow, and PACS. Specific advantages and disadvantages of digital mammography in comparison to screen-film mammography are thoroughly discussed. By including authors from both North America and Europe, the book is able to outline variations in the use, acceptance, and quality assurance of digital mammography between the different countries and screening programs. Advanced imaging techniques and future developments such as contrast mammography and digital breast tomosynthesis are also covered in detail. All of the chapters are written by internationally recognized experts and contain numerous high-quality illustrations. This book will be of great interest both to clinicians who already use or are transitioning to digital mammography and to basic scientists working in the field. (orig.)

  3. Image quality and dose in mammography in 17 countries in Africa, Asia and Eastern Europe: Results from IAEA projects

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, Olivera; Avramova-Cholakova, Simona; Beganovic, Adnan; Economides, Sotirios; Faj, Dario; Gershan, Vesna; Grupetta, Edward; Kharita, M.H.; Milakovic, Milomir; Milu, Constantin; Muhogora, Wilbroad E.; Muthuvelu, Pirunthavany; Oola, Samuel; Setayeshi, Saeid

    2012-01-01

    Purpose: The objective is to study mammography practice from an optimisation point of view by assessing the impact of simple and immediately implementable corrective actions on image quality. Materials and methods: This prospective multinational study included 54 mammography units in 17 countries. More than 21,000 mammography images were evaluated using a three-level image quality scoring system. Following initial assessment, appropriate corrective actions were implemented and image quality was re-assessed in 24 units. Results: The fraction of images that were considered acceptable without any remark in the first phase (before the implementation of corrective actions) was 70% and 75% for cranio-caudal and medio-lateral oblique projections, respectively. The main causes for poor image quality before corrective actions were related to film processing, damaged or scratched image receptors, or film-screen combinations that are not spectrally matched, inappropriate radiographic techniques and lack of training. Average glandular dose to a standard breast was 1.5 mGy (mean and range 0.59–3.2 mGy). After optimisation the frequency of poor quality images decreased, but the relative contributions of the various causes remained similar. Image quality improvements following appropriate corrective actions were up to 50 percentage points in some facilities. Conclusions: Poor image quality is a major source of unnecessary radiation dose to the breast. An increased awareness of good quality mammograms is of particular importance for countries that are moving towards introduction of population-based screening programmes. The study demonstrated how simple and low-cost measures can be a valuable tool in improving of image quality in mammography

  4. Quality assurance and quality control in mammography: a review of available guidance worldwide.

    Science.gov (United States)

    Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos

    2013-10-01

    Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources. •An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.

  5. Software to implement the IAEA-TECDOC 1517: quality control in mammography

    International Nuclear Information System (INIS)

    Mora Rodriguez, Patricia

    2011-01-01

    Mammography quality control is presented; also, guidelines for establishing a quality control program through tests to be performed, equipment, frequencies and tolerances. The work is intended for radiologists, medical physicists and technologists. Also examples of data collection sheets, minimum equipment list and overview of a quality control program are included. Two projects (RLA/9/057 and RLA/9/067) raised the goal of developing a software that allows a simple and effective way to automate the evidence contained in the TECDOC. The V1 is presented in the IRPA 12 (2008), which was tested in some countries to detect problems in their use and include possible improvements. However, the final revised version for distribution in member countries was get in 2010. The way of work on the project is described and who has worked. Also, a complete program, its importance and the projection of the Universidad de Costa Rica to work with the same. (author) [es

  6. Feasibility study on an integrated AEC-grid device for the optimization of image quality and exposure dose in mammography

    Science.gov (United States)

    Kim, Kyo-Tae; Yun, Ryang-Young; Han, Moo-Jae; Heo, Ye-Ji; Song, Yong-Keun; Heo, Sung-Wook; Oh, Kyeong-Min; Park, Sung-Kwang

    2017-10-01

    Currently, in the radiation diagnosis field, mammography is used for the early detection of breast cancer. In addition, studies are being conducted on a grid to produce high-quality images. Although the grid ratio of the grid, which affects the scattering removal rate, must be increased to improve image quality, it increases the total exposure dose. While the use of automatic exposure control is recommended to minimize this problem, existing mammography equipment, unlike general radiography equipment, is mounted on the back of a detector. Therefore, the device is greatly affected by the detector and supporting device, and it is difficult to control the exposure dose. Accordingly, in this research, an integrated AEC-grid device that simultaneously performs AEC and grid functions was used to minimize the unnecessary exposure dose while removing scattering, thereby realizing superior image quality.

  7. Preliminary report of an intervention to improve mammography skills of radiologists

    International Nuclear Information System (INIS)

    D'Orsi, C.J.; Karellas, A.; Costanza, M.E.; Gaw, V.P.

    1989-01-01

    This paper presents a preliminary report of an intervention to improve mammography skills of radiologists. Although implementation of the screening guidelines has not occurred as readily as had been anticipated, use of mammograms is increasing. As the demand for this relatively new technology increases, both the availability of the test and the quality of the test done are valid concerns. Until recently, few radiology training programs provided trainees with opportunities to develop these skills. As a result, few radiologists who have been in practice more than five years have had formal training in the interpretation of mammograms. Thus providing practicing radiologists with the opportunities to develop skills in mammographic interpretation will serve to increase both availability and quality of mammographic exams

  8. Contrast-enhanced Spectral Mammography: Modality-Specific Artifacts and Other Factors Which May Interfere with Image Quality.

    Science.gov (United States)

    Bhimani, Chandni; Li, Luna; Liao, Lydia; Roth, Robyn G; Tinney, Elizabeth; Germaine, Pauline

    2017-01-01

    Contrast-enhanced spectral mammography (CESM) uses full field digital mammography with the added benefit of intravenous contrast administration to significantly reduce false-positive and false-negative results and improve specificity while maintaining high sensitivity. For CESM to fulfill its purpose, one should be aware of possible artifacts and other factors which may interfere with image quality, and attention should be taken to minimize these factors. This pictorial demonstration will depict types of artifacts detected and other factors that interfere with image acquisition in our practice since CESM implementation. Many of the artifacts and other factors we have encountered while using CESM have simple solutions to resolve them. The illustrated artifacts and other factors interfering with image quality will serve as a useful reference to anyone using CESM. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  9. Eight years of quality control in Bulgaria: impact on mammography practice.

    Science.gov (United States)

    Avramova-Cholakova, S; Lilkov, G; Kaneva, M; Terziev, K; Nakov, I; Mutkurov, N; Kovacheva, D; Ivanova, M; Vasilev, D

    2015-07-01

    The requirements for quality control (QC) in diagnostic radiology were introduced in Bulgarian legislation in 2005. Hospital medical physicists and several private medical physics groups provide QC services to radiology departments. The aim of this study was to analyse data from QC tests in mammography and to investigate the impact of QC introduction on mammography practice in the country. The study was coordinated by the National Centre of Radiobiology and Radiation Protection. All medical physics services were requested to fill in standardised forms with information about most important parameters routinely measured during QC. All QC service providers responded. Results demonstrated significant improvement of practice since the introduction of QC, with reduction of established deviations from 65 % during the first year to 7 % in the last year. The systems that do not meet the acceptability criteria were suspended from use. Performance of automatic exposure control and digital detectors are not regularly tested because of the absence of requirements in the legislation. The need of updated guidance and training of medical physicists to reflect the change in technology was demonstrated. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Quality control for the mammography screening program in Serbia: Physical and technical aspects

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, O.; Bozovic, P.; Lazarevic, D.; Arandjic, D.; Kosutic, D.

    2012-01-01

    Breast cancer is the major cause of mortality among female population in Serbia. It is presumed that the introduction of screening programme will reduce mortality and therefore, 47 new mammography units were installed for the purpose of population-based screening program in 2011. In parallel, Quality assurance and Quality control (QC) in mammography has received increasing attention as an essential element of the successful breast cancer campaign that is for the first time initialed in Serbia. The purpose of this study is to investigate the need for and the possible implementation of the comprehensive QC programme for the mammography screening in Serbia, with special focus on physical and technical aspect. In the first phase, a QC protocols containing list of parameters, methodology, frequency of tests and reference values for screen-film, computed radiography and full-filed digital mammography) units, were developed. The second phase is focused on the initial implementation of these protocols. The paper presents results of tests of the selected parameters in 35 mammography units, with special emphasis on patient dose and image quality descriptors. After initial implementation at the beginning of the population based breast cancer screening campaign, it is essential to establish system of regular and periodic QC equipment monitoring and to ensure high quality mammograms with minimal possible radiation dose to population included in the screening. (authors)

  11. Image quality in conventional film screen system, digital phosphor storage plate mammography in magnification technique and digital mammography in CCD-technique

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Aichinger, U.; Boehner, C.; Dobritz, M.; Bautz, W.; Saebel, M.

    2000-01-01

    Purpose: Comparison of image quality between conventional film screen system, digital phosphor storage plate mammography in magnification technique and digital mammography in CCD-technique. Materials and Methods: Radiograms of a RMI-mammography phantom were acquired using a conventional film screen system, two digital storage plate systems and two digital systems in CCD-technique. Additionally, the radiograms of one digital phosphor storage plate system were post-processed emphasizing contrast and included in the comparison. Results: The detectability of details was the best with the digital mammography in CCD-technique in comparison with the conventional film screen technique resp. digital phosphor storage plate in magnification technique. Conclusions: Based on these results there is the possibility to replace the conventional film screen system by further studies - this has to be confirmed. (orig.) [de

  12. Image quality of mammography in Croatian nationwide screening program: Comparison between various types of facilities

    International Nuclear Information System (INIS)

    Brnić, Zoran; Blašković, Darko; Klasić, Branimir; Ramač, Jelena Popić; Flegarić-Bradić, Mirjana; Štimac, Damir; Lubina, Ivan Zvonimir; Brnić, Vedran; Faj, Dario

    2012-01-01

    Purpose: The study was aimed to provide objective evidence about the mammographic image quality in Croatia, to compare it between different types of MG facilities and to identify the most common deficiencies and possible reasons as well as the steps needed to improve image quality. Materials and methods: A total of 420 mammographic examinations collected from 84 mammographic units participating in the Croatian nationwide breast cancer screening program were reviewed in terms of four image quality categories: identification of patient and examination, breast positioning and compression, exposure and contrast, and artifacts. Those were rated using image evaluating system based on American College of Radiology and European Commission proposals. The results were compared among different types of mammographic units, and common image quality deficiencies were identified. Results: Total image quality scores of 12.8, 16.1, 13.0 and 13.7 were found for general hospitals, university hospitals, private clinics and public healthcare centres, respectively. Average score for all mammographic units was 13.5 (out of 25 points). University hospitals were significantly better than all other mammography units in overall image quality, which was mostly contributed by better breast positioning practices. Private clinics showed the worst results in identification, exposure, contrast and artifacts. Conclusions: Serious deficiencies in identification and breast positioning, which might compromise breast cancer screening outcome, were detected in our material. They occur mainly due to subjective reasons and could be corrected through additional staff training and improvement of working discipline.

  13. Development of special ionization chambers for a quality control program in mammography

    International Nuclear Information System (INIS)

    Silva, Jonas Oliveira da

    2013-01-01

    Mammography is an imaging method that uses X-rays. The use of ionization chambers in mammography quality control programs presents an essential role which is to verify whether the parameters of the patient exposure are correct. However, the commercial ionization chambers for dosimetry in mammography represent a high cost for small and medium size clinics that wish to have this equipment or for professionals that work with quality control programs. The innovative feature of this work was to develop ionization chambers for this purpose. In this work ionization chambers for X radiation beams in the mammography energy range were designed, constructed and characterized. The ionization chambers were tested in standard X radiation beams at the LCI/IPEN. The main characterization tests performed with the ionization chambers were: saturation curve, linearity of response, angular and energy dependence. The response stability tests of the ionization chambers were also conducted at the LCI, presenting results within 2.0 % for long-term stability. The results of the remaining tests are in accordance with international standards. These ionization chambers were also submitted to quality control tests of mammography equipment: linearity of the air kerma rates, determination of half-value layers and mean glandular doses. The results for air kerma rate linearity were less than 10 %, as recommended in international standards. The mean glandular dose obtained with the developed chambers presented values comparable to those of commercial ionization chambers tested, with an estimated variation within international standards. (author)

  14. Specialized software for optimization of the quality control of the mammography units

    International Nuclear Information System (INIS)

    Stoeva, M.; Vassileva, J.

    2004-01-01

    Quality control is essential to ensure the equipment used is reliable and consistent in order to maintain radiation does as low as reasonably achievable whilst optimizing image quality and performance in mammography. The effectiveness of mammographic screening is highly dependent on the consistent production of high quality diagnostic images. Mammography is highly dependent on the equipment status, which requires an effective Quality Control (QC) program to provide tools for continuous assessment of the equipment performance and also data storage and analysis of the protocols' data. The objective of this paper is to present the specialized software for Quality Control of the Mammography Units, as tool providing additional functionality for optimizations of the Mammography QC data storage and management. The PC program was developed according to the requirements stated in the European protocol for Quality Control of the Mammography Screening and the data collected as a result of its application in several Bulgarian hospitals. The Structured Analysis method was used in order to perform a case, which resulted in the development of the specialized software with a database module, providing the following functionality: Data Storage, Preliminary Data Processing and Post-Processing, Manual Data Entry, Data Import from XLS format, Data Export to XLS format, Printing, Data Filters, Automated Calculation, Automated Graphical Representation, Archiving The development of specialized QC software with a database for mammography units facilitates the process of QC data storage and handling and minimizes the errors. The electronic format for data storage is especially useful in case of long-term storage and periodical data analysis/access. The integrated data processing functionality and the automated import/export features based on standard platform increase the compatibility of the data. (authors)

  15. Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

    Science.gov (United States)

    Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

    2018-05-01

    The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  16. Studies of dose optimization and image quality in technological transition in mammography; Estudos de otimizacao de dose e qualidade de imagem em processos de transicao tecnologica em mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Furquim, Tania C.; Nersissian, Denise Y., E-mail: tfurquim@iee.usp.b [Universidade de Sao Paulo (IEE/USP), SP (Brazil). Inst. de Eletrotecnica e Energia

    2011-07-01

    The introduction of new technologies in mammography may improve image quality; however, it may unnecessarily increase doses if optimization processes are not studied. In this work, radiation doses of the moment of transition of conventional to digital mammography have been analyzed. The presented data have been acquired from 2005 to 2009, in hospitals and clinics of Sao Paulo city, to 4 conventional and 5 digital equipment. The results show that even after optimization processes, new technologies still impart higher doses. Thus, individualized studies are needed when technological transitions occur, in order to maintain image quality without significant dose increase. (author)

  17. Assessment of image quality and patient doses in mammography in Tanzania

    International Nuclear Information System (INIS)

    Muhogora, W.E.; Lema, U.S.; Lyimo, R.; Dharsee, J.D.

    2008-01-01

    Full text: The objective of this work was to investigate on pilot scale the potential for optimization of screen-film based mammography practice in Tanzania. Two hospitals participated in the study and were Samaritan (with Siemens unit, model MAMMOMAT 5427901X059) and AgaKhan Medical Centre (with a Philips unit, model MD 4000). Image quality assessment was done by the radiologist at the hospital in two phases each of 2 weeks by scoring the images with assistance of image quality criteria supplied by IAEA. The causes for poor image quality were also identified. A quality assurance (QA) program was then implemented and corrective actions applied based on image quality assessment and equipment performance. In the second phase, image quality assessment was repeated followed by the estimation of entrance surface air kerma (ESAK) on 4.5 cm PMMA. The results show that the magnitude of poor image quality was up to 50% for Siemens in the first phase and decreased up to 30% after implementation of QA programme. With Philips unit, the magnitude of poor image quality was up to 70% and decreased up to 39% after implementation of QA programme. Generally, the main causes of poor images at all hospitals were over and under exposure, artefacts and breast misplacement. Others were unsharpness of skin structure (rosette from pores) along pectoral muscle, unsharpness of vascular structure (seen through most dense parenchyma), media breast tissue, and vessels and fibrous strands, pectoral muscle margin. Major image quality improvement in terms of percentage points were 10 (over or under exposure), 11 (artefacts) and 9 (skin structure (rosettes from pores-visually not sharp). However, the influence of some causes could not be reduced with QA program, presumably due to skill or equipment related reasons. The ESAK was determined to be 7.1 mGy (30 kVp, Mo/Mo) for Siemens and 3.1 mGy (28 kVp, Mo/Mo) for Philips unit. The ESAK values were well below the recommended diagnostic reference level

  18. Radiation doses and some aspects of image quality in mammography facilities in New Zealand

    International Nuclear Information System (INIS)

    Williamson, B.D.P.; Poletti, J.L.

    1990-02-01

    Until recently, mammography in New Zealand was performed largely with adapted conventional x-ray machines with tungsten anode x-ray tubes. Over the last several years these have virtually all been replaced by dedicated mammography machines with molybdenum anode x-ray tubes. To assess current trends in radiation doses to patients and central aspects of image quality, some 37 mammography x-ray machines were surveyed during 1988-89. The mean glandular dose per film for 30 and 45 mm thick breast-equivalent phantoms was determined using thermoluminescent dosimetry. Imagings of simulated microcalcifications (specks) and a contrast-detail phantom were assessed. Accuracy of calibration of the x-ray machines and quality of film processing were also tested. Details of the survey results are given. Mean glandular tissue doses per cranio-caudal films were generally well within the recommended guidelines. Mammography facilities differed in their ability to delete simulated calcification specks. Mammographic equipment was found to be generally well adjusted. Speed and contrast of film processing were found to vary widely implying that this is a major cause of the variations in dose and image quality. An annex outlines a quality assurance programme for maintenance of optimal physical image quality and control of radiation doses. 55 refs., 21 tabs., 17 figs., 2 ills

  19. XERG-mammography system: a solution to the dose-quality problem

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, M

    1981-05-01

    The XERG (Xonics-Electron-Radio-Graphy) system is the first ionographic system (High-Pressure-Gas-Iono-graphy) suitable for clinical application which became available for testing. The basic principle, the function and imaging qualities of the XERG system are described and first clinical experiences reported. The XERG mammogram is a transparent X-ray negative image, the image quality of which is characterized by good general image contrast, a moderate edge-effect and a high quantum-noise level but giving an extremely low dose rate (4.5% compared to screenless mammography film). Although the XERG quality is not satisfactory in contact technique, it yields results which are equal in quality, when using a 1.5-fold magnification technique, to the results obtained with screenless film mammography at one-tenth of the dose, and is superior to any commercially available film-screen system. Hence, in our opinion, the XERG mammography system is a step forward towards high-quality low-dose mammography.

  20. Position paper: recommendations for a digital mammography quality assurance program V4.0.

    Science.gov (United States)

    Heggie, J C P; Barnes, P; Cartwright, L; Diffey, J; Tse, J; Herley, J; McLean, I D; Thomson, F J; Grewal, R K; Collins, L T

    2017-09-01

    In 2001 the ACPSEM published a position paper on quality assurance in screen film mammography which was subsequently adopted as a basis for the quality assurance programs of both the Royal Australian and New Zealand College of Radiologists (RANZCR) and of BreastScreen Australia. Since then the clinical implementation of digital mammography has been realised and it has become evident that existing screen-film protocols were not appropriate to assure the required image quality needed for reliable diagnosis or to address the new dose implications resulting from digital technology. In addition, the advantages and responsibilities inherent in teleradiology are most critical in mammography and also need to be addressed. The current document is the result of a review of current overseas practice and local experience in these areas. At this time the technology of digital imaging is undergoing significant development and there is still a lack of full international consensus about some of the detailed quality control (QC) tests that should be included in quality assurance (QA) programs. This document describes the current status in digital mammography QA and recommends test procedures that may be suitable in the Australasian environment. For completeness, this document also includes a review of the QA programs required for the various types of digital biopsy units used in mammography. In the future, international harmonisation of digital quality assurance in mammography and changes in the technology may require a review of this document. Version 2.0 represented the first of these updates and key changes related to image quality evaluation, ghost image evaluation and interpretation of signal to noise ratio measurements. In Version 3.0 some significant changes, made in light of further experience gained in testing digital mammography equipment were introduced. In Version 4.0, further changes have been made, most notably digital breast tomosynthesis (DBT) testing and QC have

  1. Implantation and application of a quality control program in a mammography service

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Camilly A.; Almeida, Claudio D.; Coutinho, Celia M.C., E-mail: camilly@bolsista.ird.gov.br, E-mail: claudio@ird.gov.br, E-mail: celia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    The objective of this work is to adapt and implement a technical program of quality control, on a mammography service within a university hospital. After the training of the technical staff of the Service to perform the tests, a series of evaluations was performed and some preliminary results were obtained such as the creation of habits to visually monitor and evaluate mammography and make decisions for solve the problems. They also identified the need to change the image plates for present non removable artifacts after cleaning.

  2. Implantation and application of a quality control program in a mammography service

    International Nuclear Information System (INIS)

    Santos, Camilly A.; Almeida, Claudio D.; Coutinho, Celia M.C.

    2013-01-01

    The objective of this work is to adapt and implement a technical program of quality control, on a mammography service within a university hospital. After the training of the technical staff of the Service to perform the tests, a series of evaluations was performed and some preliminary results were obtained such as the creation of habits to visually monitor and evaluate mammography and make decisions for solve the problems. They also identified the need to change the image plates for present non removable artifacts after cleaning

  3. Quality assurance for screening mammography data collection systems in 22 countries.

    NARCIS (Netherlands)

    Klabunde, C.N.; Sancho-Garnier, H.; Broeders, M.E.A.C.; Thoresen, S.; Rodrigues, V.J.; Ballard-Barbash, R.

    2001-01-01

    OBJECTIVES: To document the mammography data that are gathered by the organized screening programs participating in the International Breast Cancer Screening Network (IBSN), the nature of their procedures for data quality assurance, and the measures used to assess program performance and impact.

  4. Evaluation of the image quality criteria and study of doses in a mammography department

    International Nuclear Information System (INIS)

    Alcantara, Marcela Costa

    2009-01-01

    The mammographic image quality criteria published by European Commission were implemented in three mammography equipment of a same radiology department in a hospital of Sao Paulo city. Among the mammography equipment, two use the screen-film system and one of them uses the indirect digital system. During the data collection, it was noted the need to conduct a study about image rejection in each mammography equipment. Therefore, this study was realized and, after that, the results in each mammography equipment of image rejection and image percentage that present each quality criterion it were compared. At the same time of this studies, it was realized other study about surface entrance dose and average glandular dose. These doses it was estimated based on different methods published by different groups of researcher, for all combinations anode filter available in the equipment. To estimate the surface entrance dose following the methodology published in Avenue's' guide and the average glandular dose following the Wu' methodology, it was developed a phantom, in different thicknesses of acrylic, to simulate a breast. Finally, the image quality it was associated with the dose received by patient. The digital equipment shows better results in the evaluation of quality criteria, lower rate of image rejection and lower values of average glandular dose and surface entrance dose in all methods studied. But it is not sufficient, because is not adequate for patients with great breast. (author)

  5. A special ionisation chamber for quality control of diagnostic and mammography X ray equipment

    International Nuclear Information System (INIS)

    Costa, A.M.; Caldas, L.V.E.

    2003-01-01

    A quality control program for X ray equipment used for conventional radiography and mammography requires the constancy check of the beam qualities in terms of the half-value layers. In this work, a special double-faced parallel-plate ionisation chamber was developed with inner electrodes of different materials, in a tandem system. Its application will be in quality control programs of diagnostic and mammography X ray equipment for confirmation of half-value layers previously determined by the conventional method. Moreover, the chamber also may be utilised for measurements of air kerma values (and air kerma rates) in X radiation fields used for conventional radiography and mammography. The chamber was studied in relation to the characteristics of saturation, ion collection efficiency, polarity effects, leakage current, and short-term stability. The energy dependence in response of each of the two faces of the chamber was determined over the conventional radiography and mammography X ray ranges (unattenuated beams). The different energy responses of the two faces of the chamber allowed the formation of a tandem system useful for the constancy check of beam qualities. (author)

  6. A special ionisation chamber for quality control of diagnostic and mammography X ray equipment.

    Science.gov (United States)

    Costa, A M; Caldas, L V E

    2003-01-01

    A quality control program for X ray equipment used for conventional radiography and mammography requires the constancy check of the beam qualities in terms of the half-value layers. In this work, a special double-faced parallel-plate ionisation chamber was developed with inner electrodes of different materials, in a tandem system. Its application will be in quality control programs of diagnostic and mammography X ray equipment for confirmation of half-value layers previously determined by the conventional method. Moreover, the chamber also may be utilised for measurements of air kerma values (and air kerma rates) in X radiation fields used for conventional radiography and mammography. The chamber was studied in relation to the characteristics of saturation, ion collection efficiency, polarity effects, leakage current, and short-term stability. The energy dependence in response of each of the two faces of the chamber was determined over the conventional radiography and mammography X ray ranges (unattenuated beams). The different energy response of the two faces of the chamber allowed the formation of a tandem system useful for the constancy check of beam qualities.

  7. Clinical evaluation of a new set of image quality criteria for mammography

    International Nuclear Information System (INIS)

    Grahn, A.; Hemdal, B.; Andersson, I.; Ruschin, M.; Thilander-Klang, A.; Boerjesson, S.; Tingberg, A.; Mattsson, S.; Haakansson, M.; Baath, M.; Maansson, L. G.; Medin, J.; Wanninger, F.; Panzer, W.

    2005-01-01

    The European Commission (EC) quality criteria for screen-film mammography are used as a tool to asses image quality. A new set of criteria was developed and initially tested in a previous study. In the present study, these criteria are further evaluated using screen-film mammograms that have been digitised, manipulated to simulated different image quality level and reprinted on film. Expert radiologists have evaluated these manipulated to simulate different image quality levels and reprinted on film. Expert radiologists have evaluated these manipulated images using both the original (EC) and the new criteria. A comparison of three different simulated dose levels that the new criteria yield a larger separation of image criteria scores than the old ones. These results indicated that the new set of image quality criteria has a higher discriminative power than the old set and thus seems to be more suitable for evaluation of image quality in mammography. (authors)

  8. Evaluation of quality in Service of Mammography of the State of Pernambuco

    International Nuclear Information System (INIS)

    Menezes, Claudio J.M.; Hwang, Suy F.; Peixoto, Joao Emilio

    2001-01-01

    The cancer of breast is what more contributes to mortality among women in the world. In 2000, it is considered that happened about 28.300 new cases and 8.200 death in Brazil. Thus, programs of precocious detection have been transmitted and driven the professionals of health and the population, where the used method and indicated for the diagnosis it is the mammography. However, to be capable to detect small lesions, still without clinical expression, the Service of Mammography should have mechanisms that guarantee the quality and effectiveness of the exam, assuring the great levels of sensibility and of specific. That work has as objective to evaluate the quality of the Services of Mammography of the State of Pernambuco, seeking to adapt them to the effective norms, guaranteeing like this the success of programs of precocious detection. Results show that 55% of the Services present problems in the envisage of the bunch of ray-X, 57% of the apparels do not present system of automatic control of the exhibition (CAE) regulated or it does not exist, by force of compression of 37% of the apparels they were out of the interval of tolerance (11 to 18 kg) and 36% of the processor were just in conformity with the operation patterns for mammography. Of the one of the 31 Services evaluated 3 they were just totally approved, while 10 did not present minimum quality for the diagnosis. (author)

  9. Daily quality control in computed radiography mammography using the manufacturer phantom

    International Nuclear Information System (INIS)

    Jakubiak, Rosangela R.; Messias, Pricila C.; Oliveira, Carlla M.

    2011-01-01

    The quality control (QC) in mammography system involves a large amount of test tools, which implies a large space for storage and a high number of exposure. This work describes a QC system using a phantom, Fuji Computed Radiography (FCR) One Shot Phantom M Plus, that evaluates several parameters with just one exposure. The software offers tests with annual, semi-annual, quarterly, weekly and daily periodicity, and analyzes the conformities of the mammography equipment, image plate and cassettes. Because of the high number of tests, it was evaluated the daily test only for seven months in two mammography equipment. The test, through the software and its image, allows the analysis of ten parameters in QC. The evaluation of these parameters was realized by the average of the values provided by the software. Only one of the evaluated items showed not conformity, but this was observed and the necessary corrections were realized. The monitoring of use of FCR Mammography QC software with the FCR One Shot Phantom M Plus was realized and through this we could investigate that the quality program provided by the system is appropriate for the radiology services that has the Fuji Computed Radiography system. (author)

  10. Development of techniques and methods for evaluation of quality of scanned image in mammography

    International Nuclear Information System (INIS)

    Carmo Santana, P. do; Nogueira, M.S.

    2008-01-01

    Cancer is the second cause of death in the Brazilian female population and breast cancer is the most frequent neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to be effective, the mammography must be of good quality. The Brazilian College of Radiology (CBR), the National Agency for Health Surveillance (ANVISA) and international bodies recommend standards of practice for mammography. Due to the risk of ionizing radiation, techniques that minimize dose and optimize image quality are essential to ensure that all women are submitted to mammography procedures of high quality for the detection of breast cancer. In this research were analyzed components of the image treatment via digital and developed methods and techniques of analysis aiming the detection of structures for medical diagnosis, decreasing variations due to subjectivity. It used free software Image J, to make the evaluations of the information contained in the scanned images. We use the scanned images of calibration of a simulated breast to calibrate the program Image J. Thus, it was able to correctly convert the values of the scale of shades of gray in optical density values of presenting the standard deviation for each measure held. Applying the test t-student noticed that the values obtained with the digital system to the level of contrast and spatial resolution are consistent with the results obtained so subjective, since there was no significant difference (p <0.05) for all comparisons evaluated. Since then, this methodology is recommended in routine evaluations of services of mammography. (author)

  11. Do shorter wavelengths improve contrast in optical mammography?

    International Nuclear Information System (INIS)

    Taroni, P; Pifferi, A; Torricelli, A; Spinelli, L; Danesini, G M; Cubeddu, R

    2004-01-01

    The detection of tumours with time-resolved transmittance imaging relies essentially on blood absorption. Previous theoretical and phantom studies have shown that both contrast and spatial resolution of optical images are affected by the optical properties of the background medium, and high absorption and scattering are generally beneficial. Based on these observations, wavelengths shorter than presently used (680-780 nm) could be profitable for optical mammography. A study was thus performed analysing time-resolved transmittance images at 637, 656, 683 and 785 nm obtained from 26 patients bearing 16 tumours and 15 cysts. The optical contrast proved to increase upon decreasing wavelengths for the detection of cancers in late-gated intensity images, with higher gain in contrast for lesions of smaller size (<1.5 cm diameter). For cysts either a progressive increase or decrease in contrast with wavelength was observed in scattering images

  12. Evaluation of an improved algorithm for producing realistic 3D breast software phantoms: Application for mammography

    International Nuclear Information System (INIS)

    Bliznakova, K.; Suryanarayanan, S.; Karellas, A.; Pallikarakis, N.

    2010-01-01

    Purpose: This work presents an improved algorithm for the generation of 3D breast software phantoms and its evaluation for mammography. Methods: The improved methodology has evolved from a previously presented 3D noncompressed breast modeling method used for the creation of breast models of different size, shape, and composition. The breast phantom is composed of breast surface, duct system and terminal ductal lobular units, Cooper's ligaments, lymphatic and blood vessel systems, pectoral muscle, skin, 3D mammographic background texture, and breast abnormalities. The key improvement is the development of a new algorithm for 3D mammographic texture generation. Simulated images of the enhanced 3D breast model without lesions were produced by simulating mammographic image acquisition and were evaluated subjectively and quantitatively. For evaluation purposes, a database with regions of interest taken from simulated and real mammograms was created. Four experienced radiologists participated in a visual subjective evaluation trial, as they judged the quality of the simulated mammograms, using the new algorithm compared to mammograms, obtained with the old modeling approach. In addition, extensive quantitative evaluation included power spectral analysis and calculation of fractal dimension, skewness, and kurtosis of simulated and real mammograms from the database. Results: The results from the subjective evaluation strongly suggest that the new methodology for mammographic breast texture creates improved breast models compared to the old approach. Calculated parameters on simulated images such as β exponent deducted from the power law spectral analysis and fractal dimension are similar to those calculated on real mammograms. The results for the kurtosis and skewness are also in good coincidence with those calculated from clinical images. Comparison with similar calculations published in the literature showed good agreement in the majority of cases. Conclusions: The

  13. Survey of mammography practice in Croatia: Equipment performance, image quality and dose

    International Nuclear Information System (INIS)

    Faj, D.; Stimac, D.; Ivezic, Z.; Kasabasic, M.; Ivkovic, A.; Posedel, D.; Kubelka, D.; Ilakovac, V.; Brnic, Z.; Bjelac, O.C.

    2008-01-01

    A national audit of mammography equipment performance, image quality and dose has been conducted in Croatia. Film-processing parameters, optical density (OD), average glandular dose (AGD) to the standard breast, viewing conditions and image quality were examined using TOR(MAM) test object. 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 phantom ranged from 24 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 to 2.3 mGy with a mean of 1.1 mGy. Besides clinical conditions, the authors have imaged the standard phantom in the referent conditions with 28 kV and OD as close as possible to 1.5. Then, AGD ranged from 0.5 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 most of the viewing boxes with luminance between 1000 and 2000 cd per m 2 . 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 analysed. 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. (authors)

  14. A Study on the Improvement of Safety Testing Standards and Methods for Mammography

    International Nuclear Information System (INIS)

    Choi, Seon Hyeong; Jung, Ah Young; Yong, Hwan Seok; Kim, Do Wan; Jang, Gi Won; Cha, Sang Hoon; Jo, Sang Won; Park, Ji Koon

    2012-01-01

    To establish the improved national safety testing standards and methods for mammography. We investigated and compared the current status of mammographic equipment installation with the national and international safety and quality control programs and methods. We established and verified the draft for safety testing standards and methods. We propose that the investigations of the conductor system, hardware leakage radiation profile, illumination intensity test, comparison between X-ray and light photon exposure, X-ray dose exposure on the chest wall, compression equipment size, timing equipment, and the average effective radiation dose, should all be maintained as they are in the present state without any changes. However, the exposure radiation dose reproducibility, kVp and mAs, and the half value layer tests should be reconsidered and revised. Moreover, compression pressure and autonomic exposure control system (AEC) tests should be included as new criteria. Other parameter controls included in the phantom image analysis which overlap with total quality assurance should be excluded. We recommend that AEC and compression pressure tests should be included as new criteria and the methods for the exposure radiation dose reproducibility, kVp, and mAs, and half value layer tests should be reconsidered and revised.

  15. Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria

    OpenAIRE

    Lalji, U. C.; Jeukens, C. R. L. P. N.; Houben, I.; Nelemans, P. J.; van Engen, R. E.; van Wylick, E.; Beets-Tan, R. G. H.; Wildberger, J. E.; Paulis, L. E.; Lobbes, M. B. I.

    2015-01-01

    Objective Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image. The LE appears similar to a full-field digital mammogram (FFDM). Our aim was to evaluate LE CESM image quality by comparing it to FFDM using criteria defined by the European Reference Organization for Quality Assured Breast Screening and Diagnostic Services (EUREF). Methods A total of 147 cases with both FFDM and LE images were independently scored by two experienced r...

  16. Quality control, mean glandular dose estimate and room shielding calculation in mammography

    International Nuclear Information System (INIS)

    Rakotomalala, H.M.

    2014-01-01

    This study focuses in the importance of Radiation Protection in mammography. A good control of the radiological risk depends on the dose optimization, room shielding calculation and the quality of equipment. The work was carried out in the three private medical centers called A, B, and C. Dosimetry estimates were made on the equipment of the three centers. Values has been compared with the Diagnostic Reference Levels established by the International Atomic Energy Agency (IAEA). Conformity control of the radiological devices has also been done with the Mammographic Quality Control Kit of the INSTN-Madagascar. Verifications of shields of the room containing the mammography equipment were done by theoretical calculations using the method provided by NCRP 147. [fr

  17. Software application for quality control protocol of mammography systems

    International Nuclear Information System (INIS)

    Kjosevski, Vladimir; Gershan, Vesna; Ginovska, Margarita; Spasevska, Hristina

    2010-01-01

    Considering the fact that the Quality Control of the technological process of the mammographic system involves testing of a large number of parameters, it is clearly evident that there is a need for using the information technology for gathering, processing and storing of all the parameters that are result of this process. The main goal of this software application is facilitation and automation of the gathering, processing, storing and presenting process of the data related to the qualification of the physical and technical parameters during the quality control of the technological process of the mammographic system. The software application along with its user interface and database has been made with the Microsoft Access 2003 application which is part of the Microsoft Office 2003 software packet and has been chosen as a platform for developing because it is the most commonly used office application today among the computer users in the country. This is important because it will provide the end users a familiar environment to work in, without the need for additional training and improving the computer skills that they posses. Most importantly, the software application is easy to use, fast in calculating the parameters needed and it is an excellent way to store and display the results. There is a possibility for up scaling this software solution so it can be used by many different users at the same time over the Internet. It is highly recommended that this system is implemented as soon as possible in the quality control process of the mammographic systems due to its many advantages.(Author)

  18. The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI.

    Science.gov (United States)

    Lobbes, Marc B I; Lalji, Ulrich C; Nelemans, Patty J; Houben, Ivo; Smidt, Marjolein L; Heuts, Esther; de Vries, Bart; Wildberger, Joachim E; Beets-Tan, Regina G

    2015-01-01

    Background - Contrast-enhanced spectral mammography (CESM) is a promising new breast imaging modality that is superior to conventional mammography for breast cancer detection. We aimed to evaluate correlation and agreement of tumor size measurements using CESM. As additional analysis, we evaluated whether measurements using an additional breast MRI exam would yield more accurate results. Methods - Between January 1(st) 2013 and April 1(st) 2014, 87 consecutive breast cancer cases that underwent CESM were collected and data on maximum tumor size measurements were gathered. In 57 cases, tumor size measurements were also available for breast MRI. Histopathological results of the surgical specimen served as gold standard in all cases. Results - The Pearson's correlation coefficients (PCC) of CESM versus histopathology and breast MRI versus histopathology were all >0.9, p1 cm between the two imaging modalities and histopathological results, we did not observe any advantage of performing an additional breast MRI after CESM in any of the cases. Conclusion - Quality of tumor size measurement using CESM is good and matches the quality of these measurement assessed by breast MRI. Additional measurements using breast MRI did not improve the quality of tumor size measurements.

  19. The outcome of a quality-controlled mammography screening program: Experience from a population-based study in Taiwan

    Directory of Open Access Journals (Sweden)

    Huay-Ben Pan

    2014-10-01

    Conclusion: From the outcome review of this national mammography screening, there is still room to ameliorate our performance through comprehensive and continued education, to improve the competence of cancer detection and decrease false negative (FN cases.

  20. Implantation of radiation qualities for mammography in accordance with the IEC 61627 and TRS 457 criteria

    International Nuclear Information System (INIS)

    Pires, Evandro J.; David, Mariano G.; Almeida, Carlos Eduardo de

    2009-01-01

    In this work it is discussed the technical conditions of the implantation of radiation qualities adequate for dosemeter applied to mammography at the Radiological Science Laboratory (RSL) of the University of State of Rio de Janeiro, Brazil. It performed tests for evaluation the homogeneity of the radiation field, the scattering, the half-layers and the system stability. The test results point for adequacy of the laboratory installed at the LCR for calibration of the mentioned dosemeters in seven qualities of radiation and the expanded uncertainty with better capacity of measurement at those qualities was of ±1.8% (k = 2)

  1. [Quality assurance of fine-needle aspiration cytology of the organized mammography screening].

    Science.gov (United States)

    Bak, Mihály; Konyár, Eva; Schneider, Ferenc; Bidlek, Mária; Szabó, Eva; Nyári, Tibor; Godény, Mária; Kásler, Miklós

    2010-08-08

    The National Public Health Program has established the organized mammography screening in Hungary. The aim of our study was to determine the quality assurance of breast aspiration cytology. Cytology results were rated to 5 categories (C1, C2, C3, C4 and C5). All cytology reports were compared with the final histology diagnosis. 1361 women had aspiration cytology diagnosis performed from a total of 47718 mammography non-negative lesions. There were 805 (59.1%) benign and 187 (13.7%) malignant alterations. Sensitivity was 91%, specificity 88%, positive predictive value 96.6% and negative predictive value turned to be 71% (pauditing values of fine needle aspiration cytology in our laboratory meet, or in certain aspects exceed the proposed minimum threshold values.

  2. Study about diagnostic quality in a public-center of mammography of Santa Fe, Argentina

    International Nuclear Information System (INIS)

    Lescano, R.; Kiguen, J.; Gaitan, L.; Caspani, C.

    2001-01-01

    The objective is to apply a method that allows us to evaluate the diagnostic quality of a public-center of mammography and to validate it. The representative centers of a social class were grouped; this one is evaluated measuring the mechanics, electrics, dosimetrics and personal parameters of the process to get the mammography diagnostic. The original study and the respective report was submitted to the valuation of a panel of experts, who evaluated image, techniques and diagnostics. The equipment and techniques used are described in this case. The judgment of the ACR and the Argentine legislation are applied. The dosimetric results of the mammography practice serve to determine the local reference levels. The people who intervened in the diagnosis are evaluated, as well as the services that can influence it. Seeking the parametric sensibility in relationship with the succeeded and precocious diagnosis, the success of it is confirmed by the panel of experts. We conclude by indicating that the success percentage in the diagnosis is about 98,36%, that there is 100% of coincidence among the perception and the value of the study quality. The valuation of the image reaches 69,2% of the maximum score, and the placement technique, 73,9%. The parametric sensibilities of the principal variables are discussed. (author)

  3. Image quality control of mammography equipment -Mammography System MX-300- of the Teachers Hospital of UNSA and dose measurement in breasts with radiographic films

    International Nuclear Information System (INIS)

    Quispe F, L. K.; Vega R, J.

    2015-10-01

    This work is part of medical imaging for the evaluation of quality. Will have an accredited breast phantom Rmi-156 that allows evaluating the image quality of mammography equipment and through a series of techniques and processes that will submit to mammography films we obtain characteristic curves, which allows to evaluate different parameters that will serve for our study. Images were acquired with different k Vp and m As of the equipment, also with different thicknesses of the breast phantom. Also we want to use the lowest possible dose for obtaining our images. In this paper we develop a simple protocol that aims to unify the conditions under which are acquired the images for later evaluation. By obtaining these characteristic curves demonstrate that the Kodak film is the most suitable for our study because it requires lower dose for obtaining our images. (Author)

  4. Investigation of actual conditions of mammography in Kagoshima prefecture

    International Nuclear Information System (INIS)

    Baba, Natsuki; Tanimoto, Eriko; Kobayashi, Yasuhiro; Kuma, Kouji

    2009-01-01

    We surveyed the actual conditions of mammography with regard to image quality and radiation dose at 44 facilities in Kagoshima prefecture in 1999. In April 2004, guidelines for mammography newly included the standard of digital mammography. From September to October 2005, the survey was conducted at 48 facilities, and the results of the survey were compared with that in 1999. We visited 44 of the 48 facilities, and visually evaluated the image quality of mammograms for RMI156 and clinical mammograms. In addition, we measured average mammary gland dose at each facility. The number of the mammography device that satisfied the specified guideline criterion was larger than that in 1999. Image quality for the RMI156 mammograms improved. However, the results of the present survey revealed several problems. First, the number of facilities that had quality control instruments for mammography are few. Second, radiological technologists, medical doctors, and nurses did not share knowledge or information regarding mammography. Finally, there were differences in devices and image quality for mammography among the facilities. We achieved an understanding of the actual conditions of mammography in Kagoshima prefecture by visiting many facilities, evaluating image quality, and communicating with many staff members. Our results may be useful for the development of mammography examinations. (author)

  5. Screen film vs full-field digital mammography: image quality, detectability and characterization of lesions

    International Nuclear Information System (INIS)

    Obenauer, S.; Luftner-Nagel, S.; Heyden, D. von; Baum, F.; Grabbe, E.; Munzel, U.

    2002-01-01

    The objective of this study was to compare screen-film mammography (SFM) to full-field digital mammography (FFDM) regarding image quality as well as detectability and characterization of lesions using equivalent images of the same patient acquired with both systems. Two mammography units were used, one with a screen-film system (Senographe DMR) and the other with a digital detector (Senographe 2000D, both GEMS). Screen-film and digital mammograms were performed on 55 patients with cytologically or histologically proven tumors on the same day. Together with these, 75 digital mammograms of patients without tumor and the corresponding previous screen-film mammograms not older than 1.5 years were reviewed by three observers in a random order. Contrast, exposure, and the presence of artifacts were evaluated. Different details, such as the skin, the retromamillary region, and the parenchymal structures, were judged according to a three-point ranking scale. Finally, the detectability of microcalcifications and lesions were compared and correlated to histology. Image contrast was judged to be good in 76%, satisfactory in 20%, and unsatisfactory in 4% of screen-film mammograms. Digital mammograms were judged to be good in 99% and unsatisfactory in 1% of cases. Improper exposure of screen-film system occurred in 18% (10% overexposed and 8% underexposed). Digital mammograms were improperly exposed in 4% of all cases but were of acceptable quality after post-processing. Artifacts, most of them of no significance, were found in 78% of screen-film and in none of the digital mammograms. Different anatomical regions, such as the skin, the retromamillary region, and dense parenchymal areas, were better visualized in digital than in screen-film mammography. All malignant tumors were seen by the three radiologists; however, digital mammograms allowed a better characterization of these lesions to the Breast Imaging Reporting and Data System (BI-RADSZZZ;) categories (FFDM better than

  6. Detection and optimization of image quality and dose in digital mammography systems

    International Nuclear Information System (INIS)

    Semturs, F.

    2015-01-01

    Background and purpose: During the last few years, mammography institutes have replaced their conventional mammography systems (FSM) with digital mammography systems (FFDM). This happened mainly in direction to digital computed radiography systems (FFDM-CR), where the mammography device could be kept in operation. Consequently also the AEC-parameters have not been changed and therefore the same dose as for FFM was used. Following the main theme of the thesis "Optimization of image quality and dose", also measurements with such CR-Systems have been performed in relation to image quality and dose behavior. Optimization in this context means - in following the ALARA principle - the reduction of dose while ensuring required clinical image quality. With other words - image quality is of higher value compared to dose. Considering this, it has been found out through measurements during this thesis, that FFDM-CR Systems need considerable more dose for achieving image quality comparable with FFM. On the other hand, it has been shown with measurements during this thesis, that the newest FFDM-CR technology (needle structure) supports dose reduction (optimization) to a certain degree without compromising image quality. Dose increase, as recommended in this thesis, could also increase the danger of more radiation induced carcinoma. There are several studies (which are also discussed in this thesis), which show that the benefit of not missing cancers because of higher dose dramatically overrides any health concerns. Such an optimization of image quality and dose is now described in more detail by comparing the new CR needle technology with the older power based CR technology. Material and Methods: The image quality and dose behavior for multiple breast thicknesses (simulated with PMMA slabs) of a CR needle crystal detector system is optimized by considering also different beam qualities. Technical image quality is determined with a low contrast phantom (CDMAM phantom) and from

  7. Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria.

    Science.gov (United States)

    Lalji, U C; Jeukens, C R L P N; Houben, I; Nelemans, P J; van Engen, R E; van Wylick, E; Beets-Tan, R G H; Wildberger, J E; Paulis, L E; Lobbes, M B I

    2015-10-01

    Contrast-enhanced spectral mammography (CESM) examination results in a low-energy (LE) and contrast-enhanced image. The LE appears similar to a full-field digital mammogram (FFDM). Our aim was to evaluate LE CESM image quality by comparing it to FFDM using criteria defined by the European Reference Organization for Quality Assured Breast Screening and Diagnostic Services (EUREF). A total of 147 cases with both FFDM and LE images were independently scored by two experienced radiologists using these (20) EUREF criteria. Contrast detail measurements were performed using a dedicated phantom. Differences in image quality scores, average glandular dose, and contrast detail measurements between LE and FFDM were tested for statistical significance. No significant differences in image quality scores were observed between LE and FFDM images for 17 out of 20 criteria. LE scored significantly lower on one criterion regarding the sharpness of the pectoral muscle (p < 0.001), and significantly better on two criteria on the visualization of micro-calcifications (p = 0.02 and p = 0.034). Dose and contrast detail measurements did not reveal any physical explanation for these observed differences. Low-energy CESM images are non-inferior to FFDM images. From this perspective FFDM can be omitted in patients with an indication for CESM. • Low-energy CESM images are non-inferior to FFDM images. • Micro-calcifications are significantly more visible on LE CESM than on FFDM. • There is no physical explanation for this improved visibility of micro-calcifications. • There is no need for an extra FFDM when CESM is indicated.

  8. A new test phantom with different breast tissue compositions for image quality assessment in conventional and digital mammography

    International Nuclear Information System (INIS)

    Pachoud, Marc; Lepori, D; Valley, Jean-Francois; Verdun, Francis R

    2004-01-01

    Our objective is to describe a new test phantom that permits the objective assessment of image quality in conventional and digital mammography for different types of breast tissue. A test phantom, designed to represent a compressed breast, was made from tissue equivalent materials. Three separate regions, with different breast tissue compositions, are used to evaluate low and high contrast resolution, spatial resolution and image noise. The phantom was imaged over a range of kV using a Contour 2000 (Bennett) mammography unit with a Kodak MinR 2190-MinR L screen-film combination and a Senograph 2000D (General Electric) digital mammography unit. Objective image quality assessments for different breast tissue compositions were performed using the phantom for conventional and digital mammography. For a similar mean glandular dose (MGD), the digital system gives a significantly higher contrast-to-noise ratio (CNR) than the screen-film system for 100% glandular tissue. In conclusion, in mammography, a range of exposure conditions is used for imaging because of the different breast tissue compositions encountered clinically. Ideally, the patient dose-image quality relationship should be optimized over the range of exposure conditions. The test phantom presented in this work permits image quality parameters to be evaluated objectively for three different types of breast tissue. Thus, it is a useful tool for optimizing the patient dose-image quality relationship

  9. Effect of image quality on calcification detection in digital mammography.

    Science.gov (United States)

    Warren, Lucy M; Mackenzie, Alistair; Cooke, Julie; Given-Wilson, Rosalind M; Wallis, Matthew G; Chakraborty, Dev P; Dance, David R; Bosmans, Hilde; Young, Kenneth C

    2012-06-01

    This study aims to investigate if microcalcification detection varies significantly when mammographic images are acquired using different image qualities, including: different detectors, dose levels, and different image processing algorithms. An additional aim was to determine how the standard European method of measuring image quality using threshold gold thickness measured with a CDMAM phantom and the associated limits in current EU guidelines relate to calcification detection. One hundred and sixty two normal breast images were acquired on an amorphous selenium direct digital (DR) system. Microcalcification clusters extracted from magnified images of slices of mastectomies were electronically inserted into half of the images. The calcification clusters had a subtle appearance. All images were adjusted using a validated mathematical method to simulate the appearance of images from a computed radiography (CR) imaging system at the same dose, from both systems at half this dose, and from the DR system at quarter this dose. The original 162 images were processed with both Hologic and Agfa (Musica-2) image processing. All other image qualities were processed with Agfa (Musica-2) image processing only. Seven experienced observers marked and rated any identified suspicious regions. Free response operating characteristic (FROC) and ROC analyses were performed on the data. The lesion sensitivity at a nonlesion localization fraction (NLF) of 0.1 was also calculated. Images of the CDMAM mammographic test phantom were acquired using the automatic setting on the DR system. These images were modified to the additional image qualities used in the observer study. The images were analyzed using automated software. In order to assess the relationship between threshold gold thickness and calcification detection a power law was fitted to the data. There was a significant reduction in calcification detection using CR compared with DR: the alternative FROC (AFROC) area decreased from

  10. Effect of image quality on calcification detection in digital mammography

    International Nuclear Information System (INIS)

    Warren, Lucy M.; Mackenzie, Alistair; Cooke, Julie; Given-Wilson, Rosalind M.; Wallis, Matthew G.; Chakraborty, Dev P.; Dance, David R.; Bosmans, Hilde; Young, Kenneth C.

    2012-01-01

    Purpose: This study aims to investigate if microcalcification detection varies significantly when mammographic images are acquired using different image qualities, including: different detectors, dose levels, and different image processing algorithms. An additional aim was to determine how the standard European method of measuring image quality using threshold gold thickness measured with a CDMAM phantom and the associated limits in current EU guidelines relate to calcification detection. Methods: One hundred and sixty two normal breast images were acquired on an amorphous selenium direct digital (DR) system. Microcalcification clusters extracted from magnified images of slices of mastectomies were electronically inserted into half of the images. The calcification clusters had a subtle appearance. All images were adjusted using a validated mathematical method to simulate the appearance of images from a computed radiography (CR) imaging system at the same dose, from both systems at half this dose, and from the DR system at quarter this dose. The original 162 images were processed with both Hologic and Agfa (Musica-2) image processing. All other image qualities were processed with Agfa (Musica-2) image processing only. Seven experienced observers marked and rated any identified suspicious regions. Free response operating characteristic (FROC) and ROC analyses were performed on the data. The lesion sensitivity at a nonlesion localization fraction (NLF) of 0.1 was also calculated. Images of the CDMAM mammographic test phantom were acquired using the automatic setting on the DR system. These images were modified to the additional image qualities used in the observer study. The images were analyzed using automated software. In order to assess the relationship between threshold gold thickness and calcification detection a power law was fitted to the data. Results: There was a significant reduction in calcification detection using CR compared with DR: the alternative FROC

  11. Effect of image quality on calcification detection in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Lucy M.; Mackenzie, Alistair; Cooke, Julie; Given-Wilson, Rosalind M.; Wallis, Matthew G.; Chakraborty, Dev P.; Dance, David R.; Bosmans, Hilde; Young, Kenneth C. [National Co-ordinating Centre for the Physics of Mammography, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2 7XX, United Kingdom and Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, GU2 7XH (United Kingdom); Jarvis Breast Screening and Diagnostic Centre, Guildford GU1 1LJ (United Kingdom); Department of Radiology, St. George' s Healthcare NHS Trust, Tooting, London SW17 0QT (United Kingdom); Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, United Kingdom and NIHR Cambridge Biomedical Research Centre, Cambridge CB2 0QQ (United Kingdom); Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15210 (United States); National Co-ordinating Centre for the Physics of Mammography, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2 7XX, United Kingdom and Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH (United Kingdom); University Hospitals Leuven, Herestraat 49, 3000 Leuven (Belgium); National Co-ordinating Centre for the Physics of Mammography, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2 7XX, United Kingdom and Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2012-06-15

    Purpose: This study aims to investigate if microcalcification detection varies significantly when mammographic images are acquired using different image qualities, including: different detectors, dose levels, and different image processing algorithms. An additional aim was to determine how the standard European method of measuring image quality using threshold gold thickness measured with a CDMAM phantom and the associated limits in current EU guidelines relate to calcification detection. Methods: One hundred and sixty two normal breast images were acquired on an amorphous selenium direct digital (DR) system. Microcalcification clusters extracted from magnified images of slices of mastectomies were electronically inserted into half of the images. The calcification clusters had a subtle appearance. All images were adjusted using a validated mathematical method to simulate the appearance of images from a computed radiography (CR) imaging system at the same dose, from both systems at half this dose, and from the DR system at quarter this dose. The original 162 images were processed with both Hologic and Agfa (Musica-2) image processing. All other image qualities were processed with Agfa (Musica-2) image processing only. Seven experienced observers marked and rated any identified suspicious regions. Free response operating characteristic (FROC) and ROC analyses were performed on the data. The lesion sensitivity at a nonlesion localization fraction (NLF) of 0.1 was also calculated. Images of the CDMAM mammographic test phantom were acquired using the automatic setting on the DR system. These images were modified to the additional image qualities used in the observer study. The images were analyzed using automated software. In order to assess the relationship between threshold gold thickness and calcification detection a power law was fitted to the data. Results: There was a significant reduction in calcification detection using CR compared with DR: the alternative FROC

  12. Comparison between the implementation of quality criteria of radiographic image in conventional and digital mammography equipments

    International Nuclear Information System (INIS)

    Alcantara, M.C.; Sordi, G.M.A.A.; Caldas, L.V.E.; Furquim, T.A.C.

    2008-01-01

    The mammographic examination needs a strict quality control. A publication of the European Commission provides guidelines on quality criteria for the images of the breast, quantifying the quality obtained in the image. Following the recommendations of the European Commission, two kinds of mammographic equipments, at a same institution, were evaluated to compare the quality of the conventional and digital images. Besides of that, the Average Glandular Dose (AGD) and the Entrance Surface Dose (ESD) were measured by using an ionization chamber (Radcal, 6M) in the radiation beams of each equipment. The digital equipment fulfills more quality criteria than the conventional equipment, provided ESD values, AGD values and a rejection index lower than the conventional equipment. Therefore, the digital mammography can be considered more adequate than the conventional one, both for criteria analyses and for dose optimization. (author)

  13. Regulation EM-GT-8. Guidance for quality control of mammography equipment

    International Nuclear Information System (INIS)

    2015-01-01

    Objective: To provide practical guidance of technical procedures for carrying out quality control in mammography equipment. Scope: This guide applies to mammography equipment. A number of methods which require the appointed instrumentation described, some of which can be implemented in radiology services own country given the low complexity of themselves and others that require specific equipment and can be performed by specialized groups external to these units. The guide does not constitute a mandatory, however, the parameters evaluated according to the tests described therein and their tolerances form the basis of regulations that establish the CCEEM about these teams. Overview: The success of mammographic studies depends on obtaining high-quality images combined with a low rate of patient dose. To ensure this objective the establishment of quality assurance programs on all aspects involving these services is necessary. This guide provides a number of quality control procedures aimed at x-ray equipment, which must be performed at least on an annual basis or when some maintenance occurs at x-ray equipment.

  14. Correlation between the physical performances measured from detectors and the diagnostic image quality in digital mammography

    International Nuclear Information System (INIS)

    Perez-Ponce, H.

    2009-05-01

    In digital mammography two approaches exist to estimate image quality. In the first approach, human observer assesses the lesion detection in mammograms. Unfortunately, such quality assessment is subject to interobserver variability, and requires a large amount of time and human resources. In the second approach, objective and human-independent parameters relating to image spatial resolution and noise (MTF and NPS) are used to evaluate digital detector performance; even if these parameters are objective, they are not directly related to lesion detection. A method leading to image quality assessment which is both human independent, and directly related to lesion detection is very important for the optimal use of mammographic units. This Ph.D thesis presents the steps towards such a method: the computation of realistic virtual images using an 'X ray source/digital detector' model taking into account the physical parameters of the detector (spatial resolution and noise measurements) measured under clinical conditions. From results obtained in this work, we have contributed to establish the link between the physical characteristics of detectors and the clinical quality of the image for usual exposition conditions. Furthermore, we suggest the use of our model for the creation of virtual images, in order to rapidly determine the optimal conditions in mammography, which usually is a long and tedious experimental process. This is an essential aspect to be taken into account for radioprotection of patients, especially in the context of organized mass screening of breast cancer. (author)

  15. Image quality of digital mammography images produced using wet and dry laser imaging systems

    International Nuclear Information System (INIS)

    Al Khalifah, K.; Brindhaban, A.; AlArfaj, R.; Jassim, O.

    2006-01-01

    Introduction: A study was carried out to compare the quality of digital mammographic images printed or processed by a wet laser imaging system and a dedicated mammographic dry laser imaging system. Material and methods: Digital images of a tissue equivalent breast phantom were obtained using a GE Senographe 2000D digital mammography system and different target/filter combinations of the X-ray tube. These images were printed on films using the Fuji FL-IM D wet laser imaging system and the Kodak DryView 8600 dry laser imaging system. The quality of images was assessed in terms of detectability of microcalcifications and simulated tumour masses by five radiologists. In addition, the contrast index and speed index of the two systems were measured using the step wedge in the phantom. The unpaired, unequal variance t-test was used to test any statistically significant differences. Results: There were no significant (p < 0.05) differences between the images printed using the two systems in terms of microcalcification and tumour mass detectability. The wet system resulted in slightly higher contrast index while the dry system showed significantly higher speed index. Conclusion: Both wet and dry laser imaging systems can produce mammography images of good quality on which 0.2 mm microcalcifications and 2 mm tumour masses can be detected. Dry systems are preferable due to the absence of wet chemical processing and solid or liquid chemical waste. The wet laser imaging systems, however, still represent a useful alternative to dry laser imaging systems for mammography studies

  16. Measurement of glanduler tissue dose and image quality on mammography investigation at different exposure parameters and systems

    International Nuclear Information System (INIS)

    Akyol, O.

    2004-01-01

    There are many protocols suggested different international organization regarding to routine quality control and acceptance test methods of mammography systems. Users may select the most appropriate method for their routine practices according to infrastructure they have. However if there is a need for national authority to establish protocol for licesing of invidual users or in case of a screening studies for a large populations. Use of standard protocol became is important. Currently, there are more than 550 mamography system use in Turkey. However users implementing neither quality controlnor acceptance on the other hand even the national authorities. The purpose this thesis is to establishment a standard protocol than can be used for quality control and routine tests on mammography systems. This procedures were implented for 18 different mammography systems instoled at different places in Ankara

  17. Characterization of microcalcification: can digital monitor zooming replace magnification mammography in full-field digital mammography?

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Kwak, Jin Young; Son, Eun Ju; Youk, Ji Hyun; Choi, Seon Hyeong; Oh, Ki Keun; Han, Mooyoung

    2009-01-01

    The aim of this study was to compare the diagnostic accuracy and image quality of microcalcifications in zoomed digital contact mammography with digital magnification mammography. Three radiologists with different levels of experience in mammography reviewed 120 microcalcification clusters in 111 patients with a full-field digital mammography system relying on digital magnification mammogram (MAG) images and zoomed images from contact mammography (ZOOM) using commercially available zooming systems on monitors. Each radiologist estimated the probability of malignancy and rated the image quality and confidence rate. Performance was evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) analysis. All three radiologists rated MAG images higher than ZOOM images for sensitivity with statistical significance (average value, 92% vs. 87%, P<0.05) and performance by ROC analysis improved with MAG imaging. The confidence rate for diagnosis decision and the assessment of lesion characteristics were also better in MAG images than in ZOOM images with statistical significance (P<0.0001). Digital magnification mammography can enhance diagnostic performance when characterizing microcalcifications. Images zoomed from digital contact mammography cannot serve as an alternative to direct magnification digital mammography. (orig.)

  18. Plans of the German Radiology Society and the Professional Association for Quality Assurance in Mammography

    International Nuclear Information System (INIS)

    Heywang-Koebrunner, S.H.

    2001-01-01

    A high level of quality is an unequivocal prerequisite for obtaining the highest possible accuracy in symptomatic patients and for reproducing the results concerning mortality reduction, which were obtained in large screening trials. Present deficiencies in Germany are due to legal regulations, which have not been updated and which are thus below European standard. Furthermore, the quality assurance program has not proven sufficiently effective for mammography. In order to promote mammographic quality assurance, the German Roentgen Society proposes an accreditation program. The accreditation, which concerns (A.) mammographic technique and positioning and (B.) mammographic reporting is not obligatory, but will allow acquisition of special official certificates, which may support the patients to find doctors who perform and read mammograms with high quality and expertise. The accreditation shall be performed by personel and/or institutions who are specifically trained surveyed. (orig.) [de

  19. An alternative method for noise analysis using pixel variance as part of quality control procedures on digital mammography systems.

    NARCIS (Netherlands)

    Bouwman, R.; Young, K.; Lazzari, B.; Ravaglia, V.; Broeders, M.J.M.; Engen, R. van

    2009-01-01

    According to the European Guidelines for quality assured breast cancer screening and diagnosis, noise analysis is one of the measurements that needs to be performed as part of quality control procedures on digital mammography systems. However, the method recommended in the European Guidelines does

  20. A comparison of digital mammography detectors and emerging technology

    International Nuclear Information System (INIS)

    Diffey, J.L.

    2015-01-01

    The overall diagnostic accuracy of digital mammography in the context of screening has been shown to be similar or slightly better than screen-film mammography. However, digital mammography encompasses both Computed Radiography (CR) and integrated Digital Radiography (DR) and there is increasing evidence to suggest that differences in detector technology are associated with variations in cancer detection rate, dose and image quality. These differences are examined in detail. Although digital mammography offers many advantages compared to screen-film, there are still some limitations with its use as a screening tool and reduced cancer detection in dense breasts remains an issue. Digital mammography detectors have paved the way for emerging technologies which may offer improvements. Taking the definition of mammography to only include X-ray imaging of the breast, this article focuses on tomosynthesis, contrast-enhanced digital mammography, stereoscopic mammography and dedicated breast computed tomography. Advanced software applications such as Computed Aided Detection (CAD) and quantitative breast density assessment are also presented. The benefits and limitations of each technique are discussed. - Highlights: • Digital detector technology affects cancer detection rate, dose and image quality. • Digital detectors have facilitated new technologies such as tomosynthesis. • 3-D techniques reduce superimposition and increase cancer detection in dense breasts. • Contrast-enhanced mammography demonstrates improved sensitivity and specificity.

  1. A phantom using titanium and Landolt rings for image quality evaluation in mammography

    International Nuclear Information System (INIS)

    De las Heras Gala, Hugo; Schöfer, Felix; Tiller, Britta; Chevalier, Margarita; Zwettler, Georg; Semturs, Friedrich

    2013-01-01

    A phantom for image quality evaluation of digital mammography systems is presented and compared to the most widely used phantoms in Europe and the US. The phantom contains objects for subjective detection of Landolt rings (four-alternative, forced-choice task) and for objective calculation of signal-difference-to-noise ratios (SDNR), both in a titanium background within a 12-step wedge. Evaluating phantom images corresponding to exposures between 15 and 160 mAs (average glandular dose between 0.2 and 2 mGy), the resulting scores were compared to the scores obtained following the European EPQC and American College of Radiology (ACR) protocols. Scores of the Landolt test equal to 19 and 8.5 and SDNR equal to 20 and 11 were found to be equivalent to the acceptable limiting values suggested by EPQC and ACR. In addition, the Landolt and SDNR tests were shown to take into account the anatomical variations in thickness and tissue density within the breast. The simplified evaluation method presented was shown to be a sensitive, efficient and reliable alternative for image quality evaluation of mammography systems. (fast track communication)

  2. A phantom using titanium and Landolt rings for image quality evaluation in mammography

    Science.gov (United States)

    de las Heras, Hugo; Schöfer, Felix; Tiller, Britta; Chevalier, Margarita; Zwettler, Georg; Semturs, Friedrich

    2013-04-01

    A phantom for image quality evaluation of digital mammography systems is presented and compared to the most widely used phantoms in Europe and the US. The phantom contains objects for subjective detection of Landolt rings (four-alternative, forced-choice task) and for objective calculation of signal-difference-to-noise ratios (SDNR), both in a titanium background within a 12-step wedge. Evaluating phantom images corresponding to exposures between 15 and 160 mAs (average glandular dose between 0.2 and 2 mGy), the resulting scores were compared to the scores obtained following the European EPQC and American College of Radiology (ACR) protocols. Scores of the Landolt test equal to 19 and 8.5 and SDNR equal to 20 and 11 were found to be equivalent to the acceptable limiting values suggested by EPQC and ACR. In addition, the Landolt and SDNR tests were shown to take into account the anatomical variations in thickness and tissue density within the breast. The simplified evaluation method presented was shown to be a sensitive, efficient and reliable alternative for image quality evaluation of mammography systems.

  3. Development of a methodology for automated assessment of the quality of digitized images in mammography

    International Nuclear Information System (INIS)

    Santana, Priscila do Carmo

    2010-01-01

    The process of evaluating the quality of radiographic images in general, and mammography in particular, can be much more accurate, practical and fast with the help of computer analysis tools. The purpose of this study is to develop a computational methodology to automate the process of assessing the quality of mammography images through techniques of digital imaging processing (PDI), using an existing image processing environment (ImageJ). With the application of PDI techniques was possible to extract geometric and radiometric characteristics of the images evaluated. The evaluated parameters include spatial resolution, high-contrast detail, low contrast threshold, linear detail of low contrast, tumor masses, contrast ratio and background optical density. The results obtained by this method were compared with the results presented in the visual evaluations performed by the Health Surveillance of Minas Gerais. Through this comparison was possible to demonstrate that the automated methodology is presented as a promising alternative for the reduction or elimination of existing subjectivity in the visual assessment methodology currently in use. (author)

  4. Introduction of computed radiography in two mammography services: image quality and dose analysis

    International Nuclear Information System (INIS)

    Jakubiak, Rosangela R.; Gamba, Humberto R.; Ramos, Maria M.; Faversani, Gislene G.; Peixoto, Joao E.

    2008-01-01

    This study has evaluated the impact of the introduction of CR technology in the routine of two mammography services operating with Lorad Affinity X-ray units and CR Fuji Profect One system. Mean glandular dose was determined to set Automatic Exposure Control parameters according to optimal image quality. Reject analysis of patient images was made to establish the overall impact in routine work. As regards to dose evaluation, the results show that in 44% of mammography exams the MGD were above action levels. It is due to inadequate AEC adjustment and insufficient training of the staff in operating CR systems. In addition, common errors with screen/film systems like wrong breast positing and selection of exposure parameters, as well as X-ray unit failures like insufficient anti scatter grid movement still occurs. This is an indication that ongoing efforts should be concentrated in the constancy of AEC adjustment for CR image plates and staff training. Until now, brazilian health authorities did not implement any program to evaluate digital systems performance, but efforts are being done in order to provide guidelines to breast screening aiming the control of breast dose compatible with optimal image quality. (author)

  5. Controle de qualidade e artefatos em mamografia Quality control and artifacts in mammography

    Directory of Open Access Journals (Sweden)

    Flávio Augusto Ataliba Caldas

    2005-08-01

    Full Text Available A mamografia, na atualidade, é o método mais efetivo de diagnóstico precoce do câncer de mama. Um exame com alto padrão de qualidade pode visualizar, em 85% a 90% dos casos, um tumor com mais de dois anos de antecedência de ocorrer acometimento ganglionar, em mulheres com mais de 50 anos de idade. A diferença radiográfica entre o tecido normal e o doente é extremamente tênue, logo, a alta qualidade do exame é indispensável para alcançar resolução de alto contraste que permita essa diferenciação. Para alcançar alto padrão é imperativo que o exame mamográfico siga protocolos rígidos e pré-estabelecidos. Os artefatos são defeitos no processamento do filme que comprometem o resultado final da imagem, podendo resultar em informações perdidas ou mascaradas. Há numerosos tipos de artefatos derivados de diversas fontes na aquisição da imagem, como o processador, o desempenho do técnico de radiologia, o mamógrafo ou o paciente, todos resultando na degradação da imagem obtida. O presente artigo tem o objetivo de revisar métodos eficazes no controle de qualidade do exame mamográfico e analisar os artefatos mais importantes na prática diária, com ilustrações e dicas de como evitá-los.Currently, mammography is the most effective method for an early diagnosis of breast cancer. In 85% to 90% of the cases, a high quality mammography allows the visualization of a tumor more than two years before the occurrence of lymph nodes involvement in women over 50 years of age. The radiological appearance of a normal and a sick tissue is very similar, therefore, a high quality of the scan is essential to obtain high contrast resolution to allow distinguishing them. Strict and preestablished protocols must be followed during mammography in order to reach high quality standards. Artifacts are defects occurred during film processing that interfere in the quality of the final image and can result in loss or masked information. Several

  6. Mammography accreditation program

    Energy Technology Data Exchange (ETDEWEB)

    Wilcox, P.

    1993-12-31

    In the mid-1980`s, the movement toward the use of dedicated mammography equipment provided significant improvement in breast cancer detection. However, several studies demonstrated that this change was not sufficient to ensure optimal image quality at a low radiation dose. In particular, the 1985 Nationwide Evaluation of X-ray Trends identified the wide variations in image quality and radiation dose, even from dedicated units. During this time period, the American Cancer Society (ACS) launched its Breast Cancer Awareness Screening Campaign. However, there were concerns about the ability of radiology to respond to the increased demand for optimal screening examinations that would result from the ACS program. To respond to these concerns, the ACS and the American College of Radiology (ACR) established a joint committee on mammography screening in 1986. After much discussion, it was decided to use the ACR Diagnostic Practice Accreditation Program as a model for the development of a mammography accreditation program. However, some constraints were required in order to make the program meet the needs of the ACS. This voluntary, peer review program had to be timely and cost effective. It was determined that the best way to address these needs would be to conduct the program by mail. Finally, by placing emphasis on the educational nature of the program, it would provide an even greater opportunity for improving mammographic quality. The result of this effort was that, almost six years ago, in May 1987, the pilot study for the ACR Mammography Accreditation Program (MAP) began, and in August of that year, the first applications were received. In November 1987, the first 3-year accreditation certificates were awarded.

  7. Mammography accreditation program

    International Nuclear Information System (INIS)

    Wilcox, P.

    1993-01-01

    In the mid-1980's, the movement toward the use of dedicated mammography equipment provided significant improvement in breast cancer detection. However, several studies demonstrated that this change was not sufficient to ensure optimal image quality at a low radiation dose. In particular, the 1985 Nationwide Evaluation of X-ray Trends identified the wide variations in image quality and radiation dose, even from dedicated units. During this time period, the American Cancer Society (ACS) launched its Breast Cancer Awareness Screening Campaign. However, there were concerns about the ability of radiology to respond to the increased demand for optimal screening examinations that would result from the ACS program. To respond to these concerns, the ACS and the American College of Radiology (ACR) established a joint committee on mammography screening in 1986. After much discussion, it was decided to use the ACR Diagnostic Practice Accreditation Program as a model for the development of a mammography accreditation program. However, some constraints were required in order to make the program meet the needs of the ACS. This voluntary, peer review program had to be timely and cost effective. It was determined that the best way to address these needs would be to conduct the program by mail. Finally, by placing emphasis on the educational nature of the program, it would provide an even greater opportunity for improving mammographic quality. The result of this effort was that, almost six years ago, in May 1987, the pilot study for the ACR Mammography Accreditation Program (MAP) began, and in August of that year, the first applications were received. In November 1987, the first 3-year accreditation certificates were awarded

  8. Tomosynthesis and contrast-enhanced digital mammography: recent advances in digital mammography

    International Nuclear Information System (INIS)

    Diekmann, Felix; Bick, Ulrich

    2007-01-01

    Digital mammography is more and more replacing conventional mammography. Initial concerns about an inferior image quality of digital mammography have been largely overcome and recent studies even show digital mammography to be superior in women with dense breasts, while at the same time reducing radiation exposure. Nevertheless, an important limitation of digital mammography remains: namely, the fact that summation may obscure lesions in dense breast tissue. However, digital mammography offers the option of so-called advanced applications, and two of these, contrast-enhanced mammography and tomosynthesis, are promising candidates for improving the detection of breast lesions otherwise obscured by the summation of dense tissue. Two techniques of contrast-enhanced mammography are available: temporal subtraction of images acquired before and after contrast administration and the so-called dual-energy technique, which means that pairs of low/high-energy images acquired after contrast administration are subtracted. Tomosynthesis on the other hand provides three-dimensional information on the breast. The images are acquired with different angulations of the X-ray tube while the object or detector is static. Various reconstruction algorithms can then be applied to the set of typically nine to 28 source images to reconstruct 1-mm slices with a reduced risk of obscuring pathology. Combinations of both advanced applications have only been investigated in individual experimental studies; more advanced software algorithms and CAD systems are still in their infancy and have only undergone preliminary clinical evaluation. (orig.)

  9. A study of some technical essentials of X-ray mammography

    International Nuclear Information System (INIS)

    Cao Houde; Jiang Qin

    2000-01-01

    Objective: To improve the quality of mammography and diagnostic accuracy by analyzing and studying some of the technical essentials of X-ray mammography. Methods: The mammography quality of 21 hospitals were investigated. The image quality of normal intensifying screen-film combination was tested and compared with computerized mammography. The filming positions and operating skills were studied. Results: The important mammography details that were displayed have low conformity with the diagnostic requirements, mainly due to non-conformity of these equipment to the requirements. The optimal pressure suitable for mammography of the Chinese women was around 12 kg. Conclusion: Necessary attention must be paid to the improvement of imaging features of these equipment. The improved operating skills will greatly raise the detecting percentage of pathological changes of breasts

  10. Experience with digital mammography

    Directory of Open Access Journals (Sweden)

    G. P. Korzhenkova

    2011-01-01

    Full Text Available The use of digital techniques in mammography has become a last step for completing the process of digitization in diagnostic imaging. It is assumed that such a spatial decision will be required for digital mammography, as well as for high-resolution intensifying screen-film systems used in conventional mammography and that the digital techniques will be limited by the digitizer pixel size on detecting minor structures, such as microcalcifications. The introduction of digital technologies in mammography involves a tight control over an image and assures its high quality.

  11. Situational quality evaluation of mammography services at state of Minas Gerais, Brazil; Avaliacao situacional da qualidade dos servicos de mamografia do estado de Minas Gerais, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Joana, Georgia S.; Oliveira, Mauricio de; Andrade, Mauricio C. de; Cesar, Adriana C.Z., E-mail: georgia.santos@saude.mg.gov.b, E-mail: mauricio.cavalcanti@saude.mg.gov.b, E-mail: adrianac@saude.mg.gov.b, E-mail: mauricio.oliveira@saude.mg.gov.b [Secretaria de Estado da Saude de Minas Gerais (SVS/SES-MG), Belo Horizonte, MG (Brazil). Superintendencia de Vigilancia Sanitaria; Oliveira, Marcio A.; Nogueira, Maria do S., E-mail: marcio.alves@saude.mg.gov.b, E-mail: mnogue@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Peixoto, Joao E. [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    Breast cancer is the leading cause of cancer deaths in women. Currently, the most effective method for early detection of this cancer is the mammography, and to achieve the standard definition and contrast, the whole system of imaging must operate under optimal conditions. This paper presents the results of the assessment of mammography centers in the state of Minas Gerais, which was held with the aim of supporting the actions of the State Program of Quality Control in Mammography. These results indicated that less than half of mammography achieved the minimum standard of image quality, endorsing the need of a monitoring more efficient and effective, which led to the establishment, in Minas Gerais, of the monthly monitoring of image quality in mammography. (author)

  12. Picture quality in mammography, and interrelation of radiation exposure. Invisible patient care

    International Nuclear Information System (INIS)

    Katsura, Takahide; Yamamoto, Y.

    2006-01-01

    In these days when there are rumors about medical radiation exposure, it is the greatest keyword which it was inflicted with to radioactive ray's worker to secure radiation exposure reduction. I assume International Atomic Energy Agency (IAEA) BSS (Basic Safety Standards) guidance level, the medical radiation exposure reduction targeted value by JART (Japan Association of Radiological Technologists) a reasonable standard and, besides, must be able to tie equality and high quality medical care to an offer of security for a patient by getting rid of a difference in each institution. In mammography that needs is high in cancer death rate high rank of a woman as a background, authorization engineer system and institution authorization system establish it with a made guideline by a mammography precision management central committee, and not only an offer of a high quality picture depicting a minute mental change caused by a disease but also consideration of radiation exposure with the photography is done. Radiation exposure dose of radioactivity reduction by operation of a picture is nominated for possibility in digital system, but that radiation exposure dose of radioactivity increase than S/F system is felt uneasy about because actually I aim at the institution authorization acquisition. Maintain the high quality picture and to consider radiation exposure reduction are real invisible patient care, and I report the picture quality and interrelation of radiation exposure, and also speak a consideration method of the picture of the always equal tolerance level/tolerance level of the radiation exposure that a gap is not over in each institution. (author)

  13. Mammography with and without radiolucent positioning sheets : Comparison of projected breast area, pain experience, radiation dose and technical image quality

    NARCIS (Netherlands)

    Timmers, Janine; ten Voorde, Marloes; van Engen, Ruben E.; van Landsveld-Verhoeven, Cary; Pijnappel, Ruud; Droogh-de Greve, Kitty; den Heeten, Gerard J.; Broeders, Mireille J. M.

    2015-01-01

    Purpose: To compare projected breast area, image quality, pain experience and radiation dose between mammography performed with and without radiolucent positioning sheets. Methods: 184 women screened in the Dutch breast screening programme (May-June 2012) provided written informed consent to have

  14. Mammography with and without radiolucent positioning sheets: Comparison of projected breast area, pain experience, radiation dose and technical image quality

    NARCIS (Netherlands)

    Timmers, Janine; ten Voorde, Marloes; van Engen, Ruben E.; van Landsveld-Verhoeven, Cary; Pijnappel, Ruud; Droogh-de Greve, Kitty; den Heeten, Gerard J.; Broeders, Mireille J. M.

    2015-01-01

    To compare projected breast area, image quality, pain experience and radiation dose between mammography performed with and without radiolucent positioning sheets. 184 women screened in the Dutch breast screening programme (May-June 2012) provided written informed consent to have one additional image

  15. A review of methods of clinical image quality evaluation in mammography

    International Nuclear Information System (INIS)

    Li Yanpeng; Poulos, Ann; McLean, Donald; Rickard, Mary

    2010-01-01

    Purpose: Consistency in evaluation of mammography images in research and clinical practice is dependent on a standardised clinical image quality evaluation system. Currently two such systems are available-one developed by the American College of Radiology (ACR) and the other by the European Commission (EU guidelines). The purpose of this study was to review mammography clinical evaluation methods in research studies and their adherence to these systems. Method: A total of 23 research articles were reviewed from the period 2000-2006, 11 of these studies used digital images. The focus of the review was the criteria and rating scales used. Results: Only 5 studies used either the ACR (3) or EU guidelines (2). The remainder included aspects of these systems together with a range of other criteria and rating scales. Variation was found in the categories of criteria used, number of criteria, the descriptors of the criteria and the instructions used to evaluate the criteria. Instructions were frequently not specific and open to individual interpretation. Although breast density is an important criterion of image quality and contributes to perception of breast lesions, inclusion of this criterion was not universal, and even when used the area of breast density to be evaluated was not identified, thus enhancing inter-observer variability. Scales that were absolute or relative were used for evaluation, all of which incorporated inconsistent numbers of steps. Conclusion: Low adherence to ACR and EU Guidelines has resulted in considerable variation in the evaluation methods used in research studies. The implications of this variability are considerable both for evaluation of image quality in research outcomes and clinical practice.

  16. Influence of different anode/filter combination on radiation dose and image quality in digital mammography

    International Nuclear Information System (INIS)

    Liu Jie; Liu Peifang; Zhang Lianlian; Ma Wenjuan

    2013-01-01

    Objective: To explore the effect of different anode/filter combination on radiation dose and image quality in digital mammography, so as to choose optimal anode/filter combination to reduce radiation injury without scarifying image quality. Methods: Mammography accredition phantoms with the thickness from 1.6 cm to 8.6 cm were used to simulate human breast tissue. The same exposure conditions, pressure, compression thickness. and different anode/filter combination were employed under the automatic and manual exposure modes. The image kV, mAs, pressure, filter, average glandular dose (ACD), contrast to noise ratio (CNR) were recorded and the figure of merit (FOM) was calculated. SPSS 17.0 and one-way analysis of variance were used in the statistical analysis. Results: As the phantom thickness increase, the ACD values which were acquired with Mo/Mo, Mo/Rh, and W/Ag three different anode/filter combinations were increased, but CNR and FOM values were decreased, ACD, CNR, and FOM values which were acquired in the phantom with different thickness, and three different anode/filter combinations were statistically different (P=0.000, respectively). The ACD values of Mo/Mo were lowest. For 1.6 cm-2.6 cm phantom thicknesses, the FOMs of Mo/Rh were lowest, and for 3.6 cm-8.6 cm phantom thicknesses, the FOMs of W/Ag were lowest. Conclusion: Phantom thickness in 1.6 cm-2.6 cm and 3.6 cm-8.6 cm. Mo/Rh combination and W/Ag combination respectively can achieve the highest FOM, and can provide the best imaging quality with low radiation dose. (authors)

  17. Mammography practice in Serbia: Evaluation and optimisation of image quality and the technical aspects of the mammographic imaging chain

    International Nuclear Information System (INIS)

    Kosutic, D.; Ciraj-Bjelac, O.; Arandjic, D.

    2010-01-01

    The purpose of this work was to assess mammography practice in Serbia and its appropriateness for both diagnostic service and potential screening by implementing quality control (QC) protocol in three large teaching hospitals. Corrective actions were suggested, accordingly. In addition to technical aspects of QC, image quality was assessed using image grading before and after the introduction of corrective measures. The survey demonstrated considerable variations in technical parameters that affect image quality and patients doses. Average glandular doses ranged from 1.8 to 2.8 mGy, while reference optical density (OD) ranged from 1.0 to 2.6. Image grading resulted in a very high percentage of images with poor quality (12-70% for cranio-caudal projection and 8-66% for medio-lateral oblique projection). Main problems were associated with film processing, viewing conditions and OD control. Following introduction of corrective measures, the image grading results were improved in some hospitals, so the percentage of images without any remarks has been increased. (authors)

  18. Improved scintimammography using a high-resolution camera mounted on an upright mammography gantry

    Energy Technology Data Exchange (ETDEWEB)

    Itti, Emmanuel; Patt, Bradley E.; Diggles, Linda E.; MacDonald, Lawrence; Iwanczyk, Jan S.; Mishkin, Fred S.; Khalkhali, Iraj E-mail: nephrad@aol.com

    2003-01-21

    {sup 99m}Tc-sestamibi scintimammography (SMM) is a useful adjunct to conventional X-ray mammography (XMM) for the assessment of breast cancer. An increasing number of studies has emphasized fair sensitivity values for the detection of tumors >1 cm, compared to XMM, particularly in situations where high glandular breast densities make mammographic interpretation difficult. In addition, SMM has demonstrated high specificity for cancer, compared to various functional and anatomic imaging modalities. However, large field-of-view (FOV) gamma cameras are difficult to position close to the breasts, which decreases spatial resolution and subsequently, the sensitivity of detection for tumors <1 cm. New dedicated detectors featuring small FOV and increased spatial resolution have recently been developed. In this setting, improvement in tumor detection sensitivity, particularly with regard to small cancers is expected. At Division of Nuclear Medicine, Harbor-UCLA Medical Center, we have performed over 2000 SMM within the last 9 years. We have recently used a dedicated breast camera (LumaGEM) featuring a 12.8x12.8 cm{sup 2} FOV and an array of 2x2x6 mm{sup 3} discrete crystals coupled to a photon-sensitive photomultiplier tube readout. This camera is mounted on a mammography gantry allowing upright imaging, medial positioning and use of breast compression. Preliminary data indicates significant enhancement of spatial resolution by comparison with standard imaging in the first 10 patients. Larger series will be needed to conclude on sensitivity/specificity issues.

  19. Correlation study of effect of additional filter on radiation dose and image quality in digital mammography

    International Nuclear Information System (INIS)

    Liu Jie; Liu Peifang; Wang Hongbin; Zhang Shuping; Liu Xueou

    2012-01-01

    Objective: To explore the effect of different additional filters on radiation dose and image quality in digital mammography. Methods: Hologic company's Selenia digital mammography machine and the post-processing workstations and 5 M high resolution medical monitor were used in this study. Mammography phantoms with the thickness from 1.6 cm to 8.6 cm were used to simulate human breast tissue. The same exposure conditions, pressure, compression thickness, the anode were employed with the additional filters of Mo and Rh under the automatic and manual exposure mode. The image kV, mAs, pressure, filter, average glandular dose (AGD), entrance surface dose (ESD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image score according to ACR criteria were recorded for the two additional filters. Paired sample t test was performed to compare the indices of Mo and Rh groups by using SPSS 17.0. Results: AGD and ESD of Rh and Mo group were both higher with the increase of the thickness of all the phantoms. AGD, ESD and their increased value of Rh filter(1.484 ± 1.041, 7.969 ± 7.633, 0.423 ± 0.190 and 3.057 ± 2.139) were lower than those of Mo filter (1.915 ± 1.301, 12.516 ± 11.632, 0.539 ±0.246 and 4.731 ± 3.294), in all the phantoms with different thickness (t values were 4.614, 3.209, 3.396 and 3.605, P<0.05). SNR, CNR, and image score of Rh and Mo group both decreased with the increase of the thickness of all the phantoms. There were no statistical difference (P>0.05). Conclusions: Compared with Mo filter, Rh filter could reduce the radiation dose, and this advantage is more obvious in the thicker phantom when the same image quality is required. (authors)

  20. Design and Construction of a Test Phantom for Screen/Film Mammography Quality Control

    International Nuclear Information System (INIS)

    Galvan, Hector; Grabski, Varlen; Ruiz, Cesar; Brandan, Maria-Ester; Villasenor, Yolanda

    2006-01-01

    A 10 x 10 x 4 cm Lucite phantom for quality control tests in mammography has been designed and built. It contains internal elements to quantify contrast and resolution, a mixture of talc and Lucite fibers to simulate the breast architecture, a 9-step aluminum wedge to verify the constancy of the film developing process, and metallic foils to evaluate kVp. Associated with an ionization chamber, the mean glandular dose can be evaluated. Its performance has been compared against the phantom accredited by the American College of Radiology. For a series of kV, both phantoms OD are similar within 5%. The step wedge can detect developer temperature changes of ±1 deg. C. Relative metal foils/acrylic OD permits to calculate kVp with precision of ±0.43 kV. Radiological measurements have been interpreted by numerical calculations

  1. Experience with the european quality assurance guidelines for digital mammography systems in a national screening programme

    International Nuclear Information System (INIS)

    McCullagh, J.; Keavey, E.; Egan, G.; Phelan, N.

    2013-01-01

    The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software. (authors)

  2. Impact on dose and image quality of a software-based scatter correction in mammography.

    Science.gov (United States)

    Monserrat, Teresa; Prieto, Elena; Barbés, Benigno; Pina, Luis; Elizalde, Arlette; Fernández, Belén

    2017-01-01

    Background In 2014, Siemens developed a new software-based scatter correction (Progressive Reconstruction Intelligently Minimizing Exposure [PRIME]), enabling grid-less digital mammography. Purpose To compare doses and image quality between PRIME (grid-less) and standard (with anti-scatter grid) modes. Material and Methods Contrast-to-noise ratio (CNR) was measured for various polymethylmethacrylate (PMMA) thicknesses and dose values provided by the mammograph were recorded. CDMAM phantom images were acquired for various PMMA thicknesses and inverse Image Quality Figure (IQF inv ) was calculated. Values of incident entrance surface air kerma (ESAK) and average glandular dose (AGD) were obtained from the DICOM header for a total of 1088 pairs of clinical cases. Two experienced radiologists compared subjectively the image quality of a total of 149 pairs of clinical cases. Results CNR values were higher and doses were lower in PRIME mode for all thicknesses. IQF inv values in PRIME mode were lower for all thicknesses except for 40 mm of PMMA equivalent, in which IQF inv was slightly greater in PRIME mode. A mean reduction of 10% in ESAK and 12% in AGD in PRIME mode with respect to standard mode was obtained. The clinical image quality in PRIME and standard acquisitions resulted to be similar in most of the cases (84% for the first radiologist and 67% for the second one). Conclusion The use of PRIME software reduces, in average, the dose of radiation to the breast without affecting image quality. This reduction is greater for thinner and denser breasts.

  3. Accelerate Water Quality Improvement

    Science.gov (United States)

    EPA is committed to accelerating water quality improvement and minimizing negative impacts to aquatic life from contaminants and other stressors in the Bay Delta Estuary by working with California Water Boards to strengthen water quality improvement plans.

  4. Digital mammography--DQE versus optimized image quality in clinical environment: an on site study

    Science.gov (United States)

    Oberhofer, Nadia; Fracchetti, Alessandro; Springeth, Margareth; Moroder, Ehrenfried

    2010-04-01

    The intrinsic quality of the detection system of 7 different digital mammography units (5 direct radiography DR; 2 computed radiography CR), expressed by DQE, has been compared with their image quality/dose performances in clinical use. DQE measurements followed IEC 62220-1-2 using a tungsten test object for MTF determination. For image quality assessment two different methods have been applied: 1) measurement of contrast to noise ratio (CNR) according to the European guidelines and 2) contrast-detail (CD) evaluation. The latter was carried out with the phantom CDMAM ver. 3.4 and the commercial software CDMAM Analyser ver. 1.1 (both Artinis) for automated image analysis. The overall image quality index IQFinv proposed by the software has been validated. Correspondence between the two methods has been shown figuring out a linear correlation between CNR and IQFinv. All systems were optimized with respect to image quality and average glandular dose (AGD) within the constraints of automatic exposure control (AEC). For each equipment, a good image quality level was defined by means of CD analysis, and the corresponding CNR value considered as target value. The goal was to achieve for different PMMA-phantom thicknesses constant image quality, that means the CNR target value, at minimum dose. All DR systems exhibited higher DQE and significantly better image quality compared to CR systems. Generally switching, where available, to a target/filter combination with an x-ray spectrum of higher mean energy permitted dose savings at equal image quality. However, several systems did not allow to modify the AEC in order to apply optimal radiographic technique in clinical use. The best ratio image quality/dose was achieved by a unit with a-Se detector and W anode only recently available on the market.

  5. Quality control methodology and implementation of X-radiation standards beams, mammography level, following the standard IEC 61267

    International Nuclear Information System (INIS)

    Correa, Eduardo de Lima

    2010-01-01

    In this work it was developed and applied a quality control program of the X radiation system (160 kV, constant potential, target of tungsten) of the Calibration Laboratory of IPEN(LCI) in the energy range relative to mammography beams (from 25 kV to 35 kV). The X radiation standards beams, level mammography, using molybdenum and aluminum as additional filtration, were established after the application of this quality control program following national and international recommendations. The reference ionization chamber has traceability to PTB and was regularly submitted to quality control tests for evaluation and analysis of its performance. The radiation qualities emerging from the X-radiation assembly (RQR-M), based on a phantom made up of an aluminum added filter (RQA-M), narrow beam condition (RQN-M) and broad beam condition (RQB-M), following the recommendations of the international standard IEC 61267 (2005) and the IAEA code of practice, TRS 457 (2007) were established. For the implantation of RQN-M and RQB-M radiation qualities, two mammography phantoms were developed. The half-value layers found are those presented by the German primary laboratory PTB, and varied from 0.35 to 1.21 mm Al. The air kerma rates were obtained for all the 15 implanted qualities. (author)

  6. Image Quality and Radiation Dose Assessment of a Digital Mammography System

    International Nuclear Information System (INIS)

    Isa, N. M.; Hassan, W. M. S. W.; Abdullah, W. A. K. W.; Othman, F.; Ramli, A. A. M.

    2010-01-01

    Image quality and radiation dose of a direct amorphous selenium digital mammography system were considered in terms of contrast to noise ratio (CNR) and average glandular dose (AGD). They were measured for various qualities and breast phantom thicknesses with different types of breast tissue composition to determine optimal radiation quality and dose. Three sets of breast tissue equivalent slabs (30%:70%, 50%:50% and 70%:30% glandular-adipose) with thickness of 2 cm to 7 cm and 0.2 mm aluminum foil were used to provide certain CNR. Two different combinations of anode/ilter material and a wide range of tube voltages were employed for each phantom thickness. Phantom images with grid were acquired using automatic exposure control (AEC) mode for each thickness. Phantom images without grid were also obtained in manual exposure mode by selecting the same anode/filter combination and kVp as the image obtained with grid at the same thickness, but varying mAs of 10 to 200 mAs. Optimization indicated that relatively high energy beam qualities should be used with a greater dose to compensate for lower energy x-rays. The results also indicate that current AEC setting for a fixed detector is not optimal.

  7. Dose reduction in mammography as a consequence of quality assurance programme

    International Nuclear Information System (INIS)

    Staniszewska, M. A.; Jankowski, J.

    2003-01-01

    Mammography became one of more frequent radiological examinations in the most of European countries. This is accepted as a sensitive method for detection of early breast cancers. On the other hand, this is the special imaging technique, where reliability of result is strongly influenced by technical conditions. Hence, the exposure parameters should have been chosen in dependence on image recording system. In opposite, an informative quality of the produced image is not sufficient for a true clinical diagnosis. Thus, optimisation of the practice is not achieved and a benefit for patient is none. Implementation of Quality Assurance programme can prevent the situation: systematic quality control of mammographic x-ray units allows finding the technical and methodological incorrectness. If these findings are followed by the appropriate remedial actions, the main aim will be achieved, i.e. good quality of image with reasonable low doses to patients. This approach was verified on 15 mammographic units in Lodz, covered by full cycle of quality control programme. Doses were measured during CC projection for over 100 patients. Quality of image was evaluated for RMI 156 accreditation phantom as a standard object. The main technical incorrectness was found for automatic exposure control system, and especially for compensation of object thickness. The available remedial actions allowed reducing the doses to patients by 21% (on average). Additionally, after the remedial action quality of phantom image was found better for 3 facilities where primary had been below the acceptance level. The main points of Quality Assurance programme are available for most of x-ray diagnostic facilities and should have been obligatory. (authors)

  8. Development of test objects for image quality evaluation of digital mammography

    International Nuclear Information System (INIS)

    Pinto, Vitor Nascimento de Carvalho

    2013-01-01

    Mammography is the image exam called 'gold standard' for early detection of breast cancer. 111 Brazil, more than eight million mammograms are carried out per year. With the advancement of technology, the digital systems CR and DR for this diagnostic modality have been increasingly implemented, replacing the conventional screen-film system, which brought environmental problems, like the disposal of chemical waste, and is also responsible for the rejection of radiographic films with processing artifacts. Digital systems, besides not experiencing the problem of environmental pollution, are still capable of image processing, allowing a much lower rejection rate when compared to the conventional system. Moreover, the determination of an accurate diagnosis is highly dependent on the image quality of the examination. To ensure the reliability of the images produced by these systems, it is necessary to evaluate them on a regular basis. Unfortunately, there is no regulation in Brazil about the Quality Assurance of these systems. The aim of this study was to develop a set of test objects that allow the evaluation of some parameters of image quality of these systems, such as field image uniformity, the linearity between the air Kerma incident on detector and the mean pixel value (MPV) of the image, the spatial resolution of the system through the modulation transfer function (MTF) and also to suggest an object to be applied in the evaluation of contrast-to-noise ratio (CNR) and signal-difference-to-noise ratio (SDNR). In order to test the objects. 10 mammography centers were evaluated, seven with CR systems and three with the DR systems. To evaluate the linearity, besides the test objects high sensitivity dosimeters were necessary to be used, namely LiF:Mg,Cu,P TL dosimeters. The use of these dosimeters was recommended in order to minimize the time required to perform the tests and to decrease the number of exposures needed. For evaluation of digital images in DICOM format

  9. Influence of different exposure modes on image quality and radiation dose in digital mammography

    International Nuclear Information System (INIS)

    Liu Jie; Wang Xia; Li Xiaokang; Liu Peifang

    2013-01-01

    Objective: To evaluate the effect of different exposure modes on radiation dose and image quality in digital mammography, and to explore how to reduce patient's radiation injury by choosing proper exposure mode and exposure conditions without sacrifice image quality. Methods: A breast phantom was exposed by using automatic exposure mode (60 mAs, 28 k/V) and manual exposure modes (37.5 to 70 mAs range, 24 to 32 kV range) respectively. Same oppression thickness and pressure were set for all modes. The average glandular dose (AGD), entrance surface dose (ESD), and image quality score according to American College of Radiology (ACR) criteria were recorded for each image. Kruskal Wallis test was used to compare the image quality scores between automatic and manual modes. All statistic analyses were performed by using SPSS17.0. Results: Compared to automatic exposure mode (60 mAs, 28 k/V), the overall score of image quality of manual modes (45 to 70 mAs range, 26 to 32 kV range) had no significant difference. Both ESD and ACD decreased 26.1% and increased 15.4% when the tube loading was changed from 60 mAs to 45 mAs and 70 mAs respectively. The ESD and ACD decreased 22.6%, 28.2% and increased 47.0%, 62.7% when the tube voltage was changed from 28 kV to 26 kV and 32 kV respectively. Conclusion: When the image quality reaches to a certain level, it will not be raised by a higher photographic condition. Without sacrifice image quality, the tube loading and tube voltage can be manually decreased to reduce radiation dose. (authors)

  10. Teaching quality improvement.

    Science.gov (United States)

    Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

    2010-08-01

    Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

  11. Continuous quality improvement

    International Nuclear Information System (INIS)

    Bourne, P.B.

    1985-01-01

    This paper describes the various statistical tools used at the Hanford Engineering Development Laboratory to achieve continuous quality improvement in the development of Breeder Reactor Technology and in reactor operations. The role of the quality assurance professionals in this process, including quantifiable measurements using actual examples, is provided. The commitment to quality improvement through top management involvement is dramatically illustrated

  12. Image quality, threshold contrast and mean glandular dose in CR mammography

    International Nuclear Information System (INIS)

    Jakubiak, R R; Gamba, H R; Neves, E B; Peixoto, J E

    2013-01-01

    In many countries, computed radiography (CR) systems represent the majority of equipment used in digital mammography. This study presents a method for optimizing image quality and dose in CR mammography of patients with breast thicknesses between 45 and 75 mm. Initially, clinical images of 67 patients (group 1) were analyzed by three experienced radiologists, reporting about anatomical structures, noise and contrast in low and high pixel value areas, and image sharpness and contrast. Exposure parameters (kV, mAs and target/filter combination) used in the examinations of these patients were reproduced to determine the contrast-to-noise ratio (CNR) and mean glandular dose (MGD). The parameters were also used to radiograph a CDMAM (version 3.4) phantom (Artinis Medical Systems, The Netherlands) for image threshold contrast evaluation. After that, different breast thicknesses were simulated with polymethylmethacrylate layers and various sets of exposure parameters were used in order to determine optimal radiographic parameters. For each simulated breast thickness, optimal beam quality was defined as giving a target CNR to reach the threshold contrast of CDMAM images for acceptable MGD. These results were used for adjustments in the automatic exposure control (AEC) by the maintenance team. Using optimized exposure parameters, clinical images of 63 patients (group 2) were evaluated as described above. Threshold contrast, CNR and MGD for such exposure parameters were also determined. Results showed that the proposed optimization method was effective for all breast thicknesses studied in phantoms. The best result was found for breasts of 75 mm. While in group 1 there was no detection of the 0.1 mm critical diameter detail with threshold contrast below 23%, after the optimization, detection occurred in 47.6% of the images. There was also an average MGD reduction of 7.5%. The clinical image quality criteria were attended in 91.7% for all breast thicknesses evaluated in both

  13. Pilot program of quality control in mammography and conventional equipment in the Antioquia Department

    International Nuclear Information System (INIS)

    Martinez, P.; Puerta, J.A.; Morales, J.; Beltran, C.C.

    2006-01-01

    The Sectional Health Division of Antioquia and the National University of Colombia- Medellin Headquarters formalized an agreement for the realization of the quality control of thirty mammographs and twenty-five conventional X-ray equipment located in the one metropolitan area of Medellin, and ten municipalities of the nine regions in that the antioquen county is divided. The National University of Colombia- Headquarters Medellin possesses a program for the formation in quality control and radiological protection at master level in physics for that which endowed a radiodiagnostic laboratory for these purposes. In the Antioquia department only exists an institution, the San Vicente of Paul University Hospital that possesses a quality control program in radiodiagnostic; this hospital given its great volume of studies in radiodiagnostic has a medical physicist and of that instrumental necessary to maintain the program. The quality control programs have not been implemented in the rest of health institutions, public or private, big or small, until the moment. The project then allowed to carry out an initial evaluation of the pertinent parameters of the quality control of the facilities like its are those that refer to the state of the x-ray generator, the disposition of the installation, the dark room, the film processor and negatoscopies room; these its were carried out with base in the protocol produced in the ARCAL XLIX project in which participated six Latin American countries. The dose average in mammography, following the proposed course in the ARCAL LXXV, where its participate eleven Latin American countries was also evaluated. This study pilot serves like reference of the current state of the regional radiodiagnostic services, with base in this sampling that is representative. The obtained data gave the necessary information so that the Sectional Division of Health of Antioquia can generate tending actions to the implementation of quality guarantee programs and

  14. Impact of an evaluation quality program of mammography service of Distrito Federal - Brasil; Impacto de um programa de avaliacao da qualidade dos servicos de mamografia do Distrito Federal

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Rosangela da Silveira

    2002-07-01

    Cancer is the second cause of death for Brazilian women and breast cancer is the most common neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to be effective, the mammography must be of good quality. This study sought to evaluate the quality of these services in the Federal District and the impact of an intervention involving inspection and education. The universe of 41 mammography services in the Federal District was studied between June and August 2001. Two instruments were used 1) a proposed evaluation protocol of the National Agency for Health Surveillance (ANVISA) and 2) a protocol for evaluation of image quality and care. The intervention included the initial inspection, a training activity, and a formal notification by the health authorities of the Federal District. Image quality was compared before and after the intervention. The existing infrastructure in the DF is of good quality, but the services have low productivity, they do not treat patients sent by the public health system, they have an inadequate geographic distribution with most in the central neighborhood, and the low income female population has restricted access to early detection of cancer. Of the 36 services who completed the study, none was above 90% conformity in image quality before the interventions, whereas 10 were above 90% afterwards. The greatest improvements were in chassis maintenance (services without chassis with defects went from 10 to 25), breast compression (services in conformity went from 7 to 20) and visualization of micro calcifications (32 services in conformity before and 35 afterwards). The results of the ANVISA protocol bore no relation to final image quality, a central issue for early cancer detection. In spite of the existence of many services, most were not of quality and population access was restricted. The intervention under study was shown to be effective for improving quality, nevertheless

  15. A study on the image quality of mammography and the average glandular dose

    International Nuclear Information System (INIS)

    Lee, In Ja; Kim, Hak Sung; Kim, Sung Soo; Huh, Joon

    2002-01-01

    We came to the following conclusion as the results of experiment on the image quality of mammography and the average glandular dose using 4 apparatuses at 3 hospital in Seoul. Whereas the measurement of half value layer showed no differences among the apparatuses, the measurement by an attenuation curve method showed some differences by 5.9%. There were 9.1% differences in the measurement by aluminum conversion method. The basic density of an automatic exposure control unit must be D = 1.40, but there was no automatic exposure unit adjusted precisely at any hospital. The unit at the B hospital exceeded the allowable limit by ± 0.15. In the photographing using an automatic exposure control unit and the management of an automatic film processor using a sensitometer, most automatic film processors were well kept. But in some cases the mean value of a fluctuation coefficient exceeded the allowable limit. There is a need for more cautious management. The image quality of breast phantom photography was affected by the screen/film system among the hospital. The average glandular dose at a breast of 4.2 cm thickness depended on the tube voltage, In the case of Mo/Mo, it was measured 0.26 ∼ 1.39 mGy less than ACR standard 3.0 mGy

  16. Defects of a mammography quality control phantom visualized by synchrotron radiation imaging

    International Nuclear Information System (INIS)

    Imamura, Keiko; Fukuda, Mamoru; Ehara, Norishige; Miyamoto, Keiko; Kanemaki, Yoshihide; Ogata, Haruki; Nakajima, Yasuo

    2002-01-01

    Synchrotron radiation (SR) imaging of an RMI 156 mammography quality control phantom, serial number 156-15330, revealed some defects which degraded the visibility of calcification specks. SR imaging was performed at SPring-8, in Harima, Japan by using a monochromatic energy of 20 keV with a field-of-view of 24 X 24 mm. Different kinds of images were obtained by changing sample-to-detector distances; absorption images and refraction-enhanced images. Specks were embedded in a wax matrix and were imaged as black in an absorption image. In a refraction-enhanced image, they were imaged as a black region with white margins. Foreign objects with opposite contrast were detected near, or overlapped with, some specks. As they were depicted as white in the absorption image and as white with a black margin in the refraction-enhanced image, it seemed that they had low X-ray attenuation and a low refraction index compared with the surrounding wax. They might presumable be air bubbles. Visibility of specks in an absorption image was seriously interfered with when those object(s) overlapped with specks. This kind of defect may cause a difficulty in meeting quality assurance specifications when a facility inadvertently purchases defective phantoms. (author)

  17. Screen-film mammography

    International Nuclear Information System (INIS)

    Logan, W.W.; Janus, J.A.

    1987-01-01

    The development of screen-film mammography has resulted in the re-emergence of confidence, rather than fear, in mammography. When screen-film mammography is performed with state-of-the-art dedicated equipment utilizing vigorous breast compression and a ''soft'' x-ray beam for improved contrast, screen-film images are equivalent or superior to those of reduced-dose xeromammography and superior to those of nonscreen film mammography. Technological aids for conversion from xeromammographic or nonscreen film mammographic techniques to screen-film techniques have been described. Screen-film mammography should not be attempted until dedicated equipment has been obtained and the importance of vigorous compression has been understood

  18. An alternative method for noise analysis using pixel variance as part of quality control procedures on digital mammography systems

    International Nuclear Information System (INIS)

    Bouwman, R; Broeders, M; Van Engen, R; Young, K; Lazzari, B; Ravaglia, V

    2009-01-01

    According to the European Guidelines for quality assured breast cancer screening and diagnosis, noise analysis is one of the measurements that needs to be performed as part of quality control procedures on digital mammography systems. However, the method recommended in the European Guidelines does not discriminate sufficiently between systems with and without additional noise besides quantum noise. This paper attempts to give an alternative and relatively simple method for noise analysis which can divide noise into electronic noise, structured noise and quantum noise. Quantum noise needs to be the dominant noise source in clinical images for optimal performance of a digital mammography system, and therefore the amount of electronic and structured noise should be minimal. For several digital mammography systems, the noise was separated into components based on the measured pixel value, standard deviation (SD) of the image and the detector entrance dose. The results showed that differences between systems exist. Our findings confirm that the proposed method is able to discriminate systems based on their noise performance and is able to detect possible quality problems. Therefore, we suggest to replace the current method for noise analysis as described in the European Guidelines by the alternative method described in this paper.

  19. Indicators of image quality and doses in mammography; Indicadores de calidad de imagen y dosis en mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Franco E, J.G. [UAM-X, Calz. del Hueso 1100, 04960 Mexico D.F. (Mexico); Azorin N, J.; Diaz G, J.A.I. [CICATA-IPN, 11500 Mexico D.F. (Mexico); Arreola, M. [Shands Hospital at UF, PO Box 100374, Gainesville FL 32610-0374 (United States)

    2007-07-01

    Full text: The purpose of the study was to determine the values of the image quality indicators and their relationship with the dose in mammography of screen-film that they allowed the detection of a bigger number of objects in the images obtained with the mannequin (phantom) authorized of the ACR/FDA. The study was carried out in four mammography services in a period of 12 months. The indicators of the image quality are the half optic density (DOM), contrast (differences of densities), the number of observed objects in the images and the dose for image. The minimum acceptable values by the ACR/FDA are a half optical density of 1.4, contrast of 0.4 and the one numbers minimum of objects observed in the image of the mannequin of mammography of 10 (4 fibers, 3 groups of calcifications and 3 masses), with a maximum dose by image of 3 mGy. The found results are half optical density of 1.9, contrast of 0.56 and the average number of objects observed in the images of 12, with a dose in the interval of 1.6 mGy to 2.4 mGy. The doses were measured by thermoluminescent dosimetry and ionization chamber. Once carried out the analysis of the tendencies of the indicators of image quality and their distributions is found that for a p < 0.05, the bigger number of objects observed in the images is in the interval from 1.8 to 1.9 of DOM. When comparing both mammography system, the system screen-film has a lower variability in the distribution of objects associated to a DOM. (Author)

  20. Collaborative quality improvement.

    Science.gov (United States)

    Luckenbaugh, Amy N; Miller, David C; Ghani, Khurshid R

    2017-07-01

    Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care. Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes. The largest regional collaborative in urology is the Michigan Urological Surgery Improvement Collaborative (MUSIC). Recent efforts by this group have been focused at understanding variation in care, improving patient selection for treatment, reducing treatment morbidity and measuring and optimizing technical skill. The American Urological Association has also recently launched a national quality registry (AQUA), with an initial focus on prostate cancer care. By understanding factors that result in exemplary performance, quality improvement collaboratives are able to develop best practices around areas of care with high variation that have the potential to improve outcomes and reduce costs. These developments have been made possible by the unique model offered by the collaborative structure with the goal of improving patient care at a population level.

  1. Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting.

    Science.gov (United States)

    Tennant, S L; James, J J; Cornford, E J; Chen, Y; Burrell, H C; Hamilton, L J; Girio-Fragkoulakis, C

    2016-11-01

    To assess the diagnostic accuracy of contrast-enhanced spectral mammography (CESM), and gauge its "added value" in the symptomatic setting. A retrospective multi-reader review of 100 consecutive CESM examinations was performed. Anonymised low-energy (LE) images were reviewed and given a score for malignancy. At least 3 weeks later, the entire examination (LE and recombined images) was reviewed. Histopathology data were obtained for all cases. Differences in performance were assessed using receiver operator characteristic (ROC) analysis. Sensitivity, specificity, and lesion size (versus MRI or histopathology) differences were calculated. Seventy-three percent of cases were malignant at final histology, 27% were benign following standard triple assessment. ROC analysis showed improved overall performance of CESM over LE alone, with area under the curve of 0.93 versus 0.83 (p<0.025). CESM showed increased sensitivity (95% versus 84%, p<0.025) and specificity (81% versus 63%, p<0.025) compared to LE alone, with all five readers showing improved accuracy. Tumour size estimation at CESM was significantly more accurate than LE alone, the latter tending to undersize lesions. In 75% of cases, CESM was deemed a useful or significant aid to diagnosis. CESM provides immediately available, clinically useful information in the symptomatic clinic in patients with suspicious palpable abnormalities. Radiologist sensitivity, specificity, and size accuracy for breast cancer detection and staging are all improved using CESM as the primary mammographic investigation. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. A comparison of digital and screen-film mammography using quality control phantoms

    International Nuclear Information System (INIS)

    Undrill, Peter E.; O'Kane, Arlene D.; Gilbert, Fiona J.

    2000-01-01

    AIM: To compare the performance of a direct digital mammography system with normal-view and magnified-view conventional screen-film methods using quality control phantoms. MATERIALS AND METHODS: Using a Siemens Mammomat [reg] 3000 and an Opdima [reg] digital spot imaging and biopsy attachment, film and direct digital images of two phantoms [DuPont and TOR (MAM)] were obtained under normal operating conditions. These were assessed by three groups of observers with differing expertise -- radiologists, radiographers and medical physicists. Each observer was asked to compare the direct digital image with films taken in standard view and magnified view, providing scores for object visibility and confidence. For the digital images, observers were allowed to vary the image presentation parameters. RESULTS: Both phantoms showed that overall the direct digital view and the magnified view film performed significantly better (P < 0.05) than standard view film. For certain small or low contrast objects the differences became very highly significant (P < 0.001). CONCLUSION: Only the TOR (MAM) phantom showed any significant difference between digital and magnified modalities, with magnified views performing better for fine, faint filaments and digital acquisition better for low contrast objects. Almost no difference existed between the three observer groups. Undrill, P.E. (2000). Clinical Radiology 53, 782-790

  3. Assessment of automatic exposure control performance in digital mammography using a no-reference anisotropic quality index

    Science.gov (United States)

    Barufaldi, Bruno; Borges, Lucas R.; Bakic, Predrag R.; Vieira, Marcelo A. C.; Schiabel, Homero; Maidment, Andrew D. A.

    2017-03-01

    Automatic exposure control (AEC) is used in mammography to obtain acceptable radiation dose and adequate image quality regardless of breast thickness and composition. Although there are physics methods for assessing the AEC, it is not clear whether mammography systems operate with optimal dose and image quality in clinical practice. In this work, we propose the use of a normalized anisotropic quality index (NAQI), validated in previous studies, to evaluate the quality of mammograms acquired using AEC. The authors used a clinical dataset that consists of 561 patients and 1,046 mammograms (craniocaudal breast views). The results show that image quality is often maintained, even at various radiation levels (mean NAQI = 0.14 +/- 0.02). However, a more careful analysis of NAQI reveals that the average image quality decreases as breast thickness increases. The NAQI is reduced by 32% on average, when the breast thickness increases from 31 to 71 mm. NAQI also decreases with lower breast density. The variation in breast parenchyma alone cannot fully account for the decrease of NAQI with thickness. Examination of images shows that images of large, fatty breasts are often inadequately processed. This work shows that NAQI can be applied in clinical mammograms to assess mammographic image quality, and highlights the limitations of the automatic exposure control for some images.

  4. Improvements of an objective model of compressed breasts undergoing mammography: Generation and characterization of breast shapes.

    Science.gov (United States)

    Rodríguez-Ruiz, Alejandro; Feng, Steve Si Jia; van Zelst, Jan; Vreemann, Suzan; Mann, Jessica Rice; D'Orsi, Carl Joseph; Sechopoulos, Ioannis

    2017-06-01

    To develop a set of accurate 2D models of compressed breasts undergoing mammography or breast tomosynthesis, based on objective analysis, to accurately characterize mammograms with few linearly independent parameters, and to generate novel clinically realistic paired cranio-caudal (CC) and medio-lateral oblique (MLO) views of the breast. We seek to improve on an existing model of compressed breasts by overcoming detector size bias, removing the nipple and non-mammary tissue, pairing the CC and MLO views from a single breast, and incorporating the pectoralis major muscle contour into the model. The outer breast shapes in 931 paired CC and MLO mammograms were automatically detected with an in-house developed segmentation algorithm. From these shapes three generic models (CC-only, MLO-only, and joint CC/MLO) with linearly independent components were constructed via principal component analysis (PCA). The ability of the models to represent mammograms not used for PCA was tested via leave-one-out cross-validation, by measuring the average distance error (ADE). The individual models based on six components were found to depict breast shapes with accuracy (mean ADE-CC = 0.81 mm, ADE-MLO = 1.64 mm, ADE-Pectoralis = 1.61 mm), outperforming the joint CC/MLO model (P ≤ 0.001). The joint model based on 12 principal components contains 99.5% of the total variance of the data, and can be used to generate new clinically realistic paired CC and MLO breast shapes. This is achieved by generating random sets of 12 principal components, following the Gaussian distributions of the histograms of each component, which were obtained from the component values determined from the images in the mammography database used. Our joint CC/MLO model can successfully generate paired CC and MLO view shapes of the same simulated breast, while the individual models can be used to represent with high accuracy clinical acquired mammograms with a small set of parameters. This is the first

  5. Image quality and patient exposure in mammography, tomography, angiography, and bone radiography

    International Nuclear Information System (INIS)

    Haus, A.G.; Rossmann, K.; Doi, K.; Chiles, J.T.

    1975-01-01

    In diagnostic radiology, the physical factors affecting image quality and patient exposure are complex and must be studied for each individual procedure. They are a function of recording system unsharpness, geometric unsharpness, image noise, and of the shape, size, and absorption properties of the anatomic part radiographed and the lesion to be detected. The choice of recording system has a significant effect on image quality, and the speed of the recording system is directly related to patient exposure for each procedure. In this presentation, the complexities involved in the selection of recording systems for four radiologic procedures are discussed. We describe in detail our most recent work on mammography with the Lo-Dose system, whereby a significant reduction in exposure may not reduce, but may even increase the diagnostic accuracy by reducing geometric unsharpness. We also describe several examples: (a) in tomography, image resolution is not decreased and diagnostic certainty is affected by a change from a medium-speed screen to a high-speed screen recording system (patient exposure is reduced by a factor of 2); (b) in fine-detail skeletal radiography, the diagnostic information is increased significantly by a change from a conventional screen-film technique to a non-screen technique with fine-grain film and optical magnification, but at the cost of increased patient exposure; and (c) in cerebral angiography, diagnostic information can be increased by use of a screen-film recording system of higher resolution, but lower speed for imaging of small blood vessels. Modulation Transfer Functions and clinical examples are used to illustrate each procedure. (U.S.)

  6. Image quality and patient exposure in mammography, tomography, angiography and bone radiography

    International Nuclear Information System (INIS)

    Haus, A.G.; Rossmann, K.; Doi, K.; Chiles, J.T.

    1975-01-01

    In diagnostic radiology, the physical factors affecting image quality and patient exposure are complex and must be studied for each individual procedure. They are a function of recording system unsharpness, geometric unsharpness, image noise, and of the shape, size, and absorption properties of the anatomic part radiographed and the lesion to be detected. The choice of recording system has a significant effect on image quality, and the speed of the recording system is directly related to patient exposure for each procedure. This paper discusses the complexities involved in the selection of recording systems for four radiologic procedures. The authors describe in detail their most recent work on mammography with the Lo-Dose system, whereby a significant reduction in exposure may not reduce, but may even increase, the diagnostic accuracy by reducing geometric unsharpness. We also describe several examples: (a) in tomography, image resolution is not decreased and diagnostic certainty is affected by a change from a medium-speed screen to a high-speed screen recording system (patient exposure is reduced by a factor of 2); (b) in fine-detail skeletal radiography, the diagnostic information is increased significantly by a change from a conventional screen-film technique to a non-screen technique with fine-grain film and optical magnification, but at the cost of increased patient exposure; and (c) in cerebral angiography, diagnostic information can be increased by use of a screen-film recording system of higher resolution, but lower speed for imaging of small blood vessels. Modulation transfer functions and clinical examples are used to illustrate each procedure. (author)

  7. Improving breast cancer classification with mammography, supported on an appropriate variable selection analysis

    Science.gov (United States)

    Pérez, Noel; Guevara, Miguel A.; Silva, Augusto

    2013-02-01

    This work addresses the issue of variable selection within the context of breast cancer classification with mammography. A comprehensive repository of feature vectors was used including a hybrid subset gathering image-based and clinical features. It aimed to gather experimental evidence of variable selection in terms of cardinality, type and find a classification scheme that provides the best performance over the Area Under Receiver Operating Characteristics Curve (AUC) scores using the ranked features subset. We evaluated and classified a total of 300 subsets of features formed by the application of Chi-Square Discretization, Information-Gain, One-Rule and RELIEF methods in association with Feed-Forward Backpropagation Neural Network (FFBP), Support Vector Machine (SVM) and Decision Tree J48 (DTJ48) Machine Learning Algorithms (MLA) for a comparative performance evaluation based on AUC scores. A variable selection analysis was performed for Single-View Ranking and Multi-View Ranking groups of features. Features subsets representing Microcalcifications (MCs), Masses and both MCs and Masses lesions achieved AUC scores of 0.91, 0.954 and 0.934 respectively. Experimental evidence demonstrated that classification performance was improved by combining image-based and clinical features. The most important clinical and image-based features were StromaDistortion and Circularity respectively. Other less important but worth to use due to its consistency were Contrast, Perimeter, Microcalcification, Correlation and Elongation.

  8. Improving Indoor Air Quality

    Science.gov (United States)

    Usually the most effective way to improve indoor air quality is to eliminate individual sources of pollution or to reduce their emissions. Some sources, like those that contain asbestos, can be sealed or enclosed.

  9. Quality improvement - the future begins

    International Nuclear Information System (INIS)

    Boissy, G.J.

    1987-01-01

    The comprehensive quality improvement program of the Florida Power and Light Co. is described: management commitment, quality improvement process, quality improvement teams, policy development, and quality in daily work are discussed

  10. Continuous quality improvement

    NARCIS (Netherlands)

    Rohlin, Madeleine; Schaub, Rob M.H.; Holbrook, Peter; Leibur, Edvitar; Lévy, Gérard; Roubalikova, Lenka; Nilner, Maria; Roger-Leroi, Valerie; Danner, Gunter; Iseri, Haluk; Feldman, Cecile

    2002-01-01

    Versch. in: Eur J Dent Educ; 6 (Suppl. 3): 67–77 Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of

  11. Quality evaluation of mammography systems: identification of the best region by the transfer function method

    International Nuclear Information System (INIS)

    Schiabel, H.; Frere, A.F.

    1992-01-01

    The evaluation of mammography systems behaviour, using the conventional analysis method of transfer function is discussed. An investigation for evaluating the behaviour of modulation transfer function on several direction of orifices in the radiation field is also presented. (C.G.C.)

  12. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    designer to identify clear targets for design improvement and to measure the effectiveness of any new solution, whilst attention to QFD ensures customer requirements are still being satisfied.Often, SME's are not aware of many of the best design practices and so are not able to meet the demand......This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...

  13. Improvements of an objective model of compressed breasts undergoing mammography: Generation and characterization of breast shapes

    NARCIS (Netherlands)

    Rodriguez Ruiz, A.; Feng, S.S.J.; Zelst, J.C.M. van; Vreemann, S.; Mann, J.R.; D'Orsi, C.J.; Sechopoulos, I.

    2017-01-01

    PURPOSE: To develop a set of accurate 2D models of compressed breasts undergoing mammography or breast tomosynthesis, based on objective analysis, to accurately characterize mammograms with few linearly independent parameters, and to generate novel clinically realistic paired cranio-caudal (CC) and

  14. Development of special ionization chambers for a quality control program in mammography; Desenvolvimento de camaras de ionizacao especiais para controle de qualidade em mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Jonas Oliveira da

    2013-07-01

    Mammography is an imaging method that uses X-rays. The use of ionization chambers in mammography quality control programs presents an essential role which is to verify whether the parameters of the patient exposure are correct. However, the commercial ionization chambers for dosimetry in mammography represent a high cost for small and medium size clinics that wish to have this equipment or for professionals that work with quality control programs. The innovative feature of this work was to develop ionization chambers for this purpose. In this work ionization chambers for X radiation beams in the mammography energy range were designed, constructed and characterized. The ionization chambers were tested in standard X radiation beams at the LCI/IPEN. The main characterization tests performed with the ionization chambers were: saturation curve, linearity of response, angular and energy dependence. The response stability tests of the ionization chambers were also conducted at the LCI, presenting results within 2.0 % for long-term stability. The results of the remaining tests are in accordance with international standards. These ionization chambers were also submitted to quality control tests of mammography equipment: linearity of the air kerma rates, determination of half-value layers and mean glandular doses. The results for air kerma rate linearity were less than 10 %, as recommended in international standards. The mean glandular dose obtained with the developed chambers presented values comparable to those of commercial ionization chambers tested, with an estimated variation within international standards. (author)

  15. Quality assurance programme in mammography of the Sociedad Espanola de Diagnosticos por Imagen de la Mama (SEDIM)

    International Nuclear Information System (INIS)

    Fernandez, B.; Gonzalez, C.; Hernando, I.; Iribar, M.; Lopez, J.A.; Salvador, R.; Vega, A.; Vizcaino

    2001-01-01

    The European Union Council Directive 97/43/Euratom of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure has been partially transposed to the Spanish national law by the Real Decreto 1976/1999, which establishes the quality criteria in Diagnostic Radiology. A key instrument in this legal regulation is the so-called Quality Assurance Program (QAP) which has to be implemented in each Diagnostic Radiology unit. The Spanish Breast Imaging Diagnostic Society (Sociedad Espanola de Diagnostico por Imagen de la Mama, SEDIM) has proposed a reference QAP to be used as a guide in all the mammography units in the country. Its main issues are displayed in the present paper. The SEDIM QAP includes some items related to justification and optimization of mammography exams as well as a proposal for the assignment of functions and responsibilities. A guide for the image and technical parameters quality evaluation is also included. Some keys on equipment acquisition, maintenance and on continuing education and information management can also be found in that document. (author)

  16. Use of different simulators to quality evaluation of image quality in digital mammography; Utilizacao de diferentes simuladores na avaliacao da qualidade da imagem em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Leslie S.; Coutinho, Celia M.C., E-mail: leslie@ird.gov.br, E-mail: celia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Magalhaes, Luis A.G.; Almeida, Carlos Eduardo de, E-mail: luisalexandregm@hotmail.com, E-mail: cea71@yahoo.com.br [Universidade do Estado do Rio de Janeiro (LCR/UERJ), Rio de Janeiro, RJ (Brazil). Laboratorio de Ciencias Radiologicas

    2013-11-01

    In this study, the digital images were acquired with different exposure simulators to evaluate the quality of the image, noting the tumor mass detection, microcalcification fiber and representing regions of interest during mammography. The technical parameters of exposure depends on the thickness and composition of the breast, thus affecting the dose and image quality. The simulators were used: ACR, SBP 1054, BREAST PHANTOM CIRS and for evaluation of image quality, as well as measures kerma incident on the entrance surface (Ki) and calculating the mean glandular dose (MGD)

  17. Should processed or raw image data be used in mammographic image quality analyses? A comparative study of three full-field digital mammography systems

    International Nuclear Information System (INIS)

    Borg, Mark; Badr, Ishmail; Royle, Gary

    2015-01-01

    The purpose of this study is to compare a number of measured image quality parameters using processed and unprocessed or raw images in two full-field direct digital units and one computed radiography mammography system. This study shows that the difference between raw and processed image data is system specific. The results have shown that there are no significant differences between raw and processed data in the mean threshold contrast values using the contrast-detail mammography phantom in all the systems investigated; however, these results cannot be generalised to all available systems. Notable differences were noted in contrast-to-noise ratios and in other tests including: response function, modulation transfer function, noise equivalent quanta, normalised noise power spectra and detective quantum efficiency as specified in IEC 62220-1-2. Consequently, the authors strongly recommend the use of raw data for all image quality analyses in digital mammography. (authors)

  18. Automated Area Beam Equalization Mammography for Improved Imaging of Dense Breasts

    National Research Council Canada - National Science Library

    Molloi, Sabee

    2005-01-01

    ...) because of degraded contrast from large scatter intensities and relatively high noise. Area x-ray beam equalization can improve image quality by increasing the x-ray exposure to underpenetrated regions without increasing the exposure to the breast regions...

  19. A socioecological approach to improving mammography rates in a tribal community.

    Science.gov (United States)

    English, Kevin C; Fairbanks, Jo; Finster, Carolyn E; Rafelito, Alvin; Luna, Jolene; Kennedy, Marianna

    2008-06-01

    This article highlights the processes and intermediate outcomes of a pilot project to increase mammography rates of women in an American Indian tribe in New Mexico. Using a socioecological framework and principles of community-based participatory research, a community coalition was able to (a) bolster local infrastructure to increase access to mammography services; (b) build public health knowledge and skills among tribal health providers; (c) identify community-specific knowledge, attitudes, and beliefs related to breast cancer; (d) establish interdependent partnerships among community health programs and between the tribe and outside organizations; and (e) adopt local policy initiatives to bolster tribal cancer control. These findings demonstrate the value of targeting a combination of individual, community, and environmental factors, which affect community breast cancer screening rates and incorporating cultural strengths and resources into all facets of a tribal health promotion intervention.

  20. Ultrasonic mammography

    International Nuclear Information System (INIS)

    Hueneke, B.

    1982-01-01

    608 women are examined by means of ultrasonic mammography during the period of 1 year. 432 patients were examined with the compound method with the U.I. Octoson, a water tank scanner, and 176 patients with the real time method with a directly connected linear-array-scanner. The following results were obtained at the end of the examination period: In the ultrasonic and also in the X-ray mammogram tumour diameters can be determined with an error rate of +- 30%. In the diagnosing of carcinomas, a significant dependence of the exactness on the sice of the tumour is found for the combination of the five methods tested (clinical examination, X-ray mammography, ultrasonic mammography, thermography, cytology). Classifying the individual methods with regard to their exactness, X-ray mammography ranks in front of ultrasonic mammography. Mastopathic changes in the breast can be screened by means of ultrasonic mammography. The structure of the changes can be determined more exactly than with an X-ray picture which is due to the possibility of differentiating solid and cystic structures. In diagnosing fibro-adenomas and establishing diagnoses on young women with dense gland bodies, ultrasonic mammography is superior to radiology both in the ability of screening a finding of a fibro-adenoma (US=88%, X-ray=75%) and in the possibility of classifying it as ''more benign than malignant''. (orig./MG) [de

  1. Quality control as a way to find out doses as low as reasonably practicable in mammography systems

    International Nuclear Information System (INIS)

    Hwang, S.F.; Nogueira, M.S.; Peixoto, J.E.; Paraguay, Y.V.

    2008-01-01

    The breast cancer is the most common neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to guarantee the effectiveness of the diagnosis taking into account the patient radiation safety, it is mandatory to perform the quality control tests of the mammographic equipment. The main objective of this work has been to evaluate the relationship between the image quality and the total performance of the medical equipment. Primary data were collected from several radiological facilities during the quality control inspections performed by the local regulatory authorities of the Brazilian health, the National Commission of Nuclear Energy and the Brazilian College of Radiology. The main important functioning parameters were evaluated as well as the image quality using the simulator 'phantom mama'. In spite of the fact that high quality images could suggest delivering large radiation doses to patients it has been demonstrated that it is possible to acquire images with a good quality for clinical diagnosis without delivering high doses if the system is working properly. It has been concluded that following an optimized quality control program could avoid the complex dosimetric studies to guarantee good images quality. (author)

  2. Comparison of TLD air kerma measurements in mammography

    International Nuclear Information System (INIS)

    Pernicka, F.

    2002-01-01

    The mammography examination is usually targeted at asymptomatic women so the narrow balance between benefit and undesirable effects is important. During the past few decades there have been significant advances in the equipment used for mammography. Even when the latest equipment and imaging systems are used, there is considerable variation from centre-to-centre in the choice of imaging parameters and techniques. There may be quite large differences in image quality and breast dose among the centres. A Co-ordinated Research Programme on 'Image quality and patient dose optimization in mammography in Eastern European Countries' was conducted by the IAEA, aiming at defining a methodology for the implementation of a quality assurance (QA) programme in mammography and at exercising the assessment of image quality and patient doses in a sample of hospitals in East European countries. Selected mammography clinics from Czech Republic, Hungary, Poland, Romania and Slovakia participate in the project. The teams consisted of experienced clinicians and physicists. They were supported by a group of experts (clinicians and medical physicists) from France, Italy and Spain. As an outcome of the project, improvements in these indicators (image quality and patient dose) after the implementation of the QA programme are expected. A comparison of dosimetry systems has been organized to assure that dosimetry measurements done in the frame of the project are comparable and traceable to the international measurement system. All five East European countries plus Spain took part in the exercise. The thermoluminescent (TL) method was selected for the comparison

  3. Mammography Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mammography Facility Database is updated periodically based on information received from the four FDA-approved accreditation bodies: the American College of...

  4. Influence of diagnostic quality scanning technique with CR mammography; Influencia de la tecnica de exploracion en la calidad diagnostica de la mamografia ocn CR

    Energy Technology Data Exchange (ETDEWEB)

    Rivas Ballarin, M. A.; Ruiz Manzano, P.; Ortega Pardina, P.; Laliena Bielsa, V.; Calvo Carrillo, S.; Garcia Romero, A.; Millan Cebrian, E.

    2013-07-01

    Image quality criteria laid down in the Spanish Protocol of Control of quality in Radiology (PECCR) to a team of mammography with CR imaging system are applied in this work and evaluated the dosimetry impact implied by the modification of the technique of exposure required for the fulfilment of those criteria. Is also analyzes the impact on the image quality of the new radiographic technique, evaluated by three radiologists. (Author)

  5. Use of Iodine-based contrast media in digital full-field mammography - initial experience

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Taupitz, M.; Bick, U.; Winzer, K.-J.; Huettner, C.; Muller, S.; Jeunehomme, F.; Hamm, B.

    2003-01-01

    Aim: To investigate the use of iodine-based contrast media in digital full-field mammography. Methods: After performing initial phantom studies, seven patients underwent digital mammography (Senographe 2000D, GE Medical Systems, Milwaukee, USA) using a specially filtered beam before as well as 60, 120, and 180 seconds after injection of 80 ml of iodine contrast medium (Ultravist 370, Schering AG, Germany). The precontrast mammograms were then subtracted from the postcontrast mammograms and the resulting images compared with a contrast-enhanced dynamic MRI study, performed on all women. Results: Contrast medium accumulation within the tumors was visualized with a good quality in all cases. The conditions under which successful contrast-enhanced digital mammography can be performed were determined in phantom studies. Conclusions: Contrast-enhanced digital mammography has a potential for improving the visualization of breast tumors in mammography using special beam filtering, adjusted X-ray parameters, proper timing, and suitable subtraction software. (orig.) [de

  6. Magnification mammography

    International Nuclear Information System (INIS)

    Sickles, E.A.

    1987-01-01

    Lack of detail, a situation commonly encountered, renders unreliable the diagnostic criteria described above, leading to equivocal radiographic interpretations. Standard practice calls for biopsy of such equivocal lesions in order to rule out malignancy; indeed, this is necessary to detect as many small cancers as possible. An unfortunate consequence of this approach, however, is that several benign lesions have to be removed for each cancer discovered. In some circumstances, especially when malignancy is thought to be unlikely, biopsy is deferred in favor of a series of follow-up mammographic examinations. It is even more unfortunate, if this latter course of action is chosen, when the underlying lesion proves to be cancerous and appropriate treatment is thereby delayed. One potential solution to this double-edged problem of equivocal interpretations is to substantially improve the sharpness and detail of the radiographic image, thus permitting one to utilize more fully the standard mammographic interpretive criteria that otherwise might be ignored. If this approach proves successful, some equivocal interpretations will be converted into more definitive diagnoses, either benign or malignant. The technique of direct radiographic magnification has been shown to be very helpful in this regard. Not only are magnification images known to display improved sharpness and detail, but magnification techniques have already been applied successfully to mammography, angiography, and skeletal radiography, resulting in increased diagnostic accuracy for these examinations

  7. Evaluation of quality in Service of Mammography of the State of Pernambuco; Levantamento da qualidade dos servicos de mamografia do Estado de Pernambuco

    Energy Technology Data Exchange (ETDEWEB)

    Menezes, Claudio J.M.; Hwang, Suy F. [Centro Regional de Ciencias Nucleares (CRCN), Recife, PE (Brazil)]. E-mail: cjmm@elogica.com.br; Peixoto, Joao Emilio [Agencia Nacional de Vigilancia Sanitaria (ANVISA), Brasilia, DF (Brazil)]. E-mail: joao.emilio@anvisa.gov.br

    2001-07-01

    The cancer of breast is what more contributes to mortality among women in the world. In 2000, it is considered that happened about 28.300 new cases and 8.200 death in Brazil. Thus, programs of precocious detection have been transmitted and driven the professionals of health and the population, where the used method and indicated for the diagnosis it is the mammography. However, to be capable to detect small lesions, still without clinical expression, the Service of Mammography should have mechanisms that guarantee the quality and effectiveness of the exam, assuring the great levels of sensibility and of specific. That work has as objective to evaluate the quality of the Services of Mammography of the State of Pernambuco, seeking to adapt them to the effective norms, guaranteeing like this the success of programs of precocious detection. Results show that 55% of the Services present problems in the envisage of the bunch of ray-X, 57% of the apparels do not present system of automatic control of the exhibition (CAE) regulated or it does not exist, by force of compression of 37% of the apparels they were out of the interval of tolerance (11 to 18 kg) and 36% of the processor were just in conformity with the operation patterns for mammography. Of the one of the 31 Services evaluated 3 they were just totally approved, while 10 did not present minimum quality for the diagnosis. (author)

  8. Automated Area Beam Equalization Mammography for Improved Imaging of Dense Breast

    National Research Council Canada - National Science Library

    Molloi, Sabee

    2004-01-01

    ...) because of degraded contrast from large scatter intensities and relatively high noise. Area x-ray beam equalization can improve image quality by increasing the x-ray exposure to under-penetrated regions without increasing the exposure to other breast regions...

  9. Practical digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Beverly E. [Washington Univ., Seattle, WA (United States)]|[Virginia Mason Medical Center, VA (United States)

    2008-07-01

    This book is meant for the radiologist who is facing the challenge of organizing a digital mammographic imaging center. This text is meant to be a practical book that provides information about digital mammographic physics and equipment which will allow one to intelligently compare technologies and systems. Some of the major challenges include: large expense; rapidly changing technology, and inconsistent connectivity; and finally, need for strong information technology support. The initial conversion cost to digital mammographic imaging is relatively expensive due to the cost of digital mammography hardware, software, and storage. Virtually all other imaging modalities are being converted to purely digital storage and transfer, and the digital trend in mammography is inevitable. Technical advantages of digital mammography are described. However, the improved flexibility in image display and transfer are some of its strongest features. In conclusion, although there are increasing imaging modalities that may be used to evaluate breast disease, mammography will continue to play a key role in detecting breast cancer. To be an effective imager, the radiologist should become familiar with digital mammography and understand its role within the increasing complex structure of breast imaging techniques.

  10. Practical digital mammography

    International Nuclear Information System (INIS)

    Hashimoto, Beverly E.

    2008-01-01

    This book is meant for the radiologist who is facing the challenge of organizing a digital mammographic imaging center. This text is meant to be a practical book that provides information about digital mammographic physics and equipment which will allow one to intelligently compare technologies and systems. Some of the major challenges include: large expense; rapidly changing technology, and inconsistent connectivity; and finally, need for strong information technology support. The initial conversion cost to digital mammographic imaging is relatively expensive due to the cost of digital mammography hardware, software, and storage. Virtually all other imaging modalities are being converted to purely digital storage and transfer, and the digital trend in mammography is inevitable. Technical advantages of digital mammography are described. However, the improved flexibility in image display and transfer are some of its strongest features. In conclusion, although there are increasing imaging modalities that may be used to evaluate breast disease, mammography will continue to play a key role in detecting breast cancer. To be an effective imager, the radiologist should become familiar with digital mammography and understand its role within the increasing complex structure of breast imaging techniques

  11. Improved scintimammography using a high-resolution camera mounted on an upright mammography gantry

    International Nuclear Information System (INIS)

    Itti, Emmanuel; Patt, Bradley E.; Diggles, Linda E.; MacDonald, Lawrence; Iwanczyk, Jan S.; Mishkin, Fred S.; Khalkhali, Iraj

    2003-01-01

    99m Tc-sestamibi scintimammography (SMM) is a useful adjunct to conventional X-ray mammography (XMM) for the assessment of breast cancer. An increasing number of studies has emphasized fair sensitivity values for the detection of tumors >1 cm, compared to XMM, particularly in situations where high glandular breast densities make mammographic interpretation difficult. In addition, SMM has demonstrated high specificity for cancer, compared to various functional and anatomic imaging modalities. However, large field-of-view (FOV) gamma cameras are difficult to position close to the breasts, which decreases spatial resolution and subsequently, the sensitivity of detection for tumors 2 FOV and an array of 2x2x6 mm 3 discrete crystals coupled to a photon-sensitive photomultiplier tube readout. This camera is mounted on a mammography gantry allowing upright imaging, medial positioning and use of breast compression. Preliminary data indicates significant enhancement of spatial resolution by comparison with standard imaging in the first 10 patients. Larger series will be needed to conclude on sensitivity/specificity issues

  12. MDSplus quality improvement project

    Energy Technology Data Exchange (ETDEWEB)

    Fredian, Thomas W., E-mail: twf@psfc.mit.edu [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Stillerman, Joshua [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Manduchi, Gabriele; Rigoni, Andrea [Consorzio RFX, Euratom-ENEA Association, Corso Stati Uniti 4, Padova 35127 (Italy); Erickson, Keith [Princeton Plasma Physics Laboratory, Princeton, NJ 08543 (United States)

    2016-11-15

    Highlights: • Project to improve the quality of the MDSplus software package. • Use of modern software technology, compiler options, automake. • Refactoring of older code. • Use of testing tools. - Abstract: MDSplus is a data acquisition and analysis system used worldwide predominantly in the fusion research community. Development began 29 years ago on the OpenVMS operating system. Since that time there have been many new features added and the code has been ported to many different operating systems. There have been contributions to the MDSplus development from the fusion community in the way of feature suggestions, feature implementations, documentation and porting to different operating systems. The bulk of the development and support of MDSplus, however, has been provided by a relatively small core developer group of three or four members. Given the size of the development team and the large number of users much more effort was focused on providing new features for the community than on keeping the underlying code and documentation up to date with the evolving software development standards. To ensure that MDSplus will continue to provide the needs of the community in the future, the MDSplus development team along with other members of the MDSplus user community has commenced on a major quality improvement project. The planned improvements include changes to software build scripts to better use GNU Autoconf and Automake tools, refactoring many of the source code modules using new language features available in modern compilers, using GNU MinGW-w64 to create MS Windows distributions, migrating to a more modern source code management system, improvement of source documentation as well as improvements to the (www.mdsplus.org) web site documentation and layout, and the addition of more comprehensive test suites to apply to MDSplus code builds prior to releasing installation kits to the community. This work should lead to a much more robust product and

  13. MDSplus quality improvement project

    International Nuclear Information System (INIS)

    Fredian, Thomas W.; Stillerman, Joshua; Manduchi, Gabriele; Rigoni, Andrea; Erickson, Keith

    2016-01-01

    Highlights: • Project to improve the quality of the MDSplus software package. • Use of modern software technology, compiler options, automake. • Refactoring of older code. • Use of testing tools. - Abstract: MDSplus is a data acquisition and analysis system used worldwide predominantly in the fusion research community. Development began 29 years ago on the OpenVMS operating system. Since that time there have been many new features added and the code has been ported to many different operating systems. There have been contributions to the MDSplus development from the fusion community in the way of feature suggestions, feature implementations, documentation and porting to different operating systems. The bulk of the development and support of MDSplus, however, has been provided by a relatively small core developer group of three or four members. Given the size of the development team and the large number of users much more effort was focused on providing new features for the community than on keeping the underlying code and documentation up to date with the evolving software development standards. To ensure that MDSplus will continue to provide the needs of the community in the future, the MDSplus development team along with other members of the MDSplus user community has commenced on a major quality improvement project. The planned improvements include changes to software build scripts to better use GNU Autoconf and Automake tools, refactoring many of the source code modules using new language features available in modern compilers, using GNU MinGW-w64 to create MS Windows distributions, migrating to a more modern source code management system, improvement of source documentation as well as improvements to the (www.mdsplus.org) web site documentation and layout, and the addition of more comprehensive test suites to apply to MDSplus code builds prior to releasing installation kits to the community. This work should lead to a much more robust product and

  14. Image quality control of mammography equipment -Mammography System MX-300- of the Teachers Hospital of UNSA and dose measurement in breasts with radiographic films; Control de calidad de imagen del equipo de mamografia -Mammography System MX-300- del Hospital de Docentes de la UNSA y medicion de dosis en mamas con peliculas radiograficas

    Energy Technology Data Exchange (ETDEWEB)

    Quispe F, L. K.; Vega R, J., E-mail: karinaqflores839@gmail.com [Universidad Nacional de San Agustin, Escuela Profesional de Fisica, Arequipa (Peru)

    2015-10-15

    This work is part of medical imaging for the evaluation of quality. Will have an accredited breast phantom Rmi-156 that allows evaluating the image quality of mammography equipment and through a series of techniques and processes that will submit to mammography films we obtain characteristic curves, which allows to evaluate different parameters that will serve for our study. Images were acquired with different k Vp and m As of the equipment, also with different thicknesses of the breast phantom. Also we want to use the lowest possible dose for obtaining our images. In this paper we develop a simple protocol that aims to unify the conditions under which are acquired the images for later evaluation. By obtaining these characteristic curves demonstrate that the Kodak film is the most suitable for our study because it requires lower dose for obtaining our images. (Author)

  15. Evaluation of the weekly quality control of a digital mammography machine; Evaluacion del control de calidad semanal de un mamografo digital

    Energy Technology Data Exchange (ETDEWEB)

    Angulo Pain, E.; Ramos Caballero, L. J.; Urena Llinares, A.; Iborra Oquendo, M. A.; Quinones Rodriguez, L. A.; Castro Ramirez, I.; Gonzalez Aquino, P.; Aguirre Huelga, M. J.

    2013-07-01

    In the new edition of the PCCRD (2011) has been established as weekly quality control testing for digital mammography equipment the analysis of artifacts from the team and defective items in the DR, the constancy of the functioning of the CAE, the accuracy of the thickness determined by the compression system, constancy in the uniformity and quality of the image. The objective of the study is to evaluate data collected during the first year of operation of the equipment. (Author)

  16. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment

    Science.gov (United States)

    Nikitovic-Jokic, Milica; Tu, Hong Anh; Palimaka, Stefan; Higgins, Caroline; Holubowich, Corinne

    2016-01-01

    mammography among average-risk women aged 50 years and over. In women at high risk of developing breast cancer, there is low-quality evidence that screening with mammography and adjunct ultrasound detects additional cases of disease, with improved sensitivity compared to mammography alone. Screening with adjunct ultrasound also increases the number of false-positive findings and subsequent biopsy recommendations. It is unclear if the use of screening breast ultrasound as an adjunct to mammography will reduce breast cancer–related mortality among high-risk women. The annual cost burden of using adjunct ultrasound to screen high-risk women who cannot receive MRI in Ontario would be small. PMID:27468326

  17. Slit aperture technique for mammography

    International Nuclear Information System (INIS)

    Friedrich, M.

    1984-01-01

    Following a discussion of various principles used in the elimination of scatter, the prototype of a simple slit aperture mammography apparatus is described (modified Mammomat, Siemens). The main advantage of this technique compared with grid mammography is a halving of the radiation dose for identical image quality, using an identical film system. The technical requirements (heavy duty tube, new generator) are, however, considerable. If the film-screen systems currently in use are to remain the common systems for the future, then the development of a multi-lamellar slit diaphragm technique carries much promise for mammography. (orig.) [de

  18. Tests with films and film-screens using grid-mammography

    International Nuclear Information System (INIS)

    Wolf, G.; Kallinger, G.

    1982-01-01

    A comparison was made between mammography using grid-technique with a film-screen-system and mammography without grid, and with film-screens and also using industrial films. The image-quality of grid mammography looks like the same than using conventional techniques and industrial films. The problem of soft tissue grid techniques lies in the dose requirements, which was more than using film-screen-techniques without grid. New and improved recording systems, which reduce radiation dose when using the grid technique were analyzed. (orig.) [de

  19. Optimization of the radiological protection of patients: Image quality and dose in mammography (co-ordinated research in Europe). Results of the coordinated research project on optimization of protection mammography in some eastern European States

    International Nuclear Information System (INIS)

    2005-05-01

    Mammography is an extremely useful non-invasive imaging technique with unparalleled advantages for the detection of breast cancer. It has played an immense role in the screening of women above a certain age or with a family history of breast cancer. The IAEA has a statutory responsibility to establish standards for the protection of people against exposure to ionizing radiation and to provide for the worldwide application of those standards. A fundamental requirement of the International Basic Safety Standards for Protection Against Ionizing Radiation (BSS) and for the Safety of Radiation Sources, issued by the IAEA and co-sponsored by FAO, ILO, WHO, PAHO and NEA, is the optimization of radiological protection of patients undergoing medical exposure. In keeping with its responsibility on the application of standards, the IAEA programme on Radiological Protection of Patients attempts to reduce radiation doses to patients while balancing quality assurance considerations. IAEA-TECDOC-796, Radiation Doses in Diagnostic Radiology and Methods for Dose Reduction (1995), addresses this aspect. The related IAEA-TECDOC-1423 on Optimization of the Radiological Protection of Patients undergoing Radiography, Fluoroscopy and Computed Tomography, (2004) constitutes the final report of the coordinated research in Africa, Asia and eastern Europe. The preceding publications do not explicitly consider mammography. Mindful of the importance of this imaging technique, the IAEA launched a Coordinated Research Project on Optimization of Protection in Mammography in some eastern European States. The present publication is the outcome of this project: it is aimed at evaluating the situation in a number of countries, identifying variations in the technique, examining the status of the equipment and comparing performance in the light of the norms established by the European Commission. A number of important aspects are covered, including: - quality control of mammography equipment; - imaging

  20. Optimization in mammography - monthly monitoring of image quality at the state of Minas Gerais, Brazil; Otimizacao em mamografia - monitoramento mensal da qualidade da imagem no estado de Minas Gerais, Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Joana, Georgia S.; Andrade, Mauricio C. de; Silva, Sabrina D. da; Silva, Rafael R. da; Cesar, Adriana C.Z.; Oliveira, Mauricio de, E-mail: georgia.santos@saude.mg.gov.b, E-mail: mauricio.cavalcanti@saude.mg.gov.b, E-mail: adrianac@saude.mg.gov.b, E-mail: mauricio.oliveira@saude.mg.gov.b [Secretaria de Estado da Saude de Minas Gerais (SVS/SES-MG), Belo Horizonte, MG (Brazil). Superintendencia de Vigilancia Sanitaria; Oliveira, Marcio A.; Nogueira, Maria do S., E-mail: marcio.alves@saude.mg.gov.b, E-mail: mnogue@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Peixoto, Joao E. [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    The State Program of Quality Control in Mammography (PECQMamo) of the state of Minas Gerais was established in 2004 and consists of tests for evaluation of image quality and performance of equipment used in the diagnosis of breast cancer, and evaluation the infrastructure of mammography centers. The monthly monitoring of image quality in mammography is part of this program that has been executed since May 2009 with a character essentially educational. In the assessment of individual services that participate in the monthly monitoring, there was an increased percentage of average annual compliance from 2009 to 2010 in all 85 services with the exception of one service. Therefore, evolution of the performance of the services evaluated, since the program began, shows a positive impact on the numbers, confirming the relevance of this type of operation of Sanitary Surveillance in the area of quality in mammography. (author)

  1. Evaluation of the quality of CR mammography images in Chugoku Rosai Hospital. Visual evaluation and digital evaluation

    International Nuclear Information System (INIS)

    Makihata, Hiroshi; Fukuda, Tomoya; Aomori, Masaji; Hara, Shinji

    2005-01-01

    New mammography system (50-micrometer system) composed of Fuji computed tomography (FCR) both sides IP, 5000MA and dry imager was introduced in the Department of Physical Checkup of Chugoku Rosai Hospital in 2003. We performed visual evaluation and digital evaluation using 50-micrometer system in accordance with (the quality control guidance of) Non-Profit Organization the Central Committee on Quality Control of Mammographic Screening. In visual evaluation using RMI156 phantom the system cleared the quality control guidance about a fiber, calcification, and masses. On step phantom, it passed about 10 steps, masses, and calcifications. Since a success standard was not announced officially, the performance in digital evaluation cannot be judged and only the result is presented. In digital evaluation, signal-to-noise ratio (SNR) is 14.9, root of mean squares (RMS) is 32.9, SNRC is 16.4, SNRT is 3.65. This system image has high sharpness and is considered from the result in visual evaluation to have the ability of offering images with a high degree of information. (author)

  2. Glandular dose and image quality control in mammography facilities with computerized radiography systems; Dose glandular e controle de qualidade da imagem em servicos de mamografia com sistema de radiografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Dantas, Marcelino Vicente de Almeida

    2010-07-01

    Breast cancer is the most common cancer among women, and early detection is critical to its diagnosis and treatment. To date, the most effective method for early detection of breast cancer has been x-ray mammography for which the screen/film (SF) technique has been the gold standard. However, even though SF combinations have been improved and optimized over the years for breast imaging, there are some critical limitations, including a narrow exposure range, image artifacts, film processing problems, and inflexibility in image processing and film management. In recent years, digital mammography has been introduced in cancer screening programmes with the screen/film techniques gradually being phased out. Computed radiography (CR), also commonly known as photostimulable phosphor (PSP) imaging or storage phosphor, employs reusable imaging plates and associated hardware and software to acquire and to display digital projection radiographs. In this work, a protocol model was tested for performing image quality control and average glandular dose (AGD) evaluation in 19 institutions with computed radiography systems for mammography. The protocol was validated through tests at the Laboratorio de Radioprotecao Aplicada a Mamografia (LARAM) from the Centro de Desenvolvimento da Tecnologia Nuclear (CDTN). The image quality visual evaluation of CDMAM phantom showed that 53% of the facilities were able to produce images of excellent quality. Furthermore, the automated evaluation of image quality, using the analyze software cdcom.exe, showed that 57% of the images were considered to be of good quality. The detector linearity test showed that the CR response is very linear, where 95% of facilities evaluated were considered to be compliant. For the image noise was found that only 20% of facilities are in agreement with the parameters established for this test. The average glandular doses, which patients may be getting to perform an examination, were below the action levels

  3. Validation of image quality in full-field digital mammography: Is the replacement of wet by dry laser printers justified?

    International Nuclear Information System (INIS)

    Schueller, Gerd; Kaindl, Elisabeth; Langenberger, Herbert; Stadler, Alfred; Schueller-Weidekamm, Claudia; Semturs, Friedrich; Helbich, Thomas H.

    2007-01-01

    Objective: Dry laser printers have replaced wet laser printers to produce hard copies of high-resolution digital images, primarily because of environmental concerns. However, no scientific research data have been published that compare the image quality of dry and wet laser printers in full-field digital mammography (FFDM). This study questions the image quality of these printers. Materials and methods: Objective image quality parameters of both printers were evaluated using a standardized printer test image, i.e., optical density and detectability of specific image elements (lines, curves, and shapes). Furthermore, mammograms of 129 patients with different breast tissue composition patterns were imaged with both printers. A total of 1806 subjective image quality parameters (brightness, contrast, and detail detection of anatomic structures), the detectability of breast lesions, as well as diagnostic performance according to the BI-RADS classification were evaluated. In addition, the presence of film artifacts was investigated. Results: Optical density values were equal for the dry and the wet laser printer. Detection of specific image elements on the printer test image was not different. Ratings of subjective image quality parameters were equal, as were the detectability of breast lesions and the diagnostic performance. Dry laser printer images showed more artifacts (164 versus 27). However, these artifacts did not influence image quality. Conclusion: Based on the evidence of objective and subjective parameters, a dry laser printer equals the image quality of a wet laser printer in FFDM. Therefore, not only for reasons of environmental preference, the replacement of wet laser printers by dry laser printers in FFDM is justified

  4. Organization and standards of screening and diagnostic mammography

    International Nuclear Information System (INIS)

    Linderbraten, L.D.; Chikirdin, Eh.G.; Rozhkova, N.I.

    1999-01-01

    Problem of organizing and standards of the reference and diagnostic mammography in our country is discussed. Attention is paid to the terminology, accreditation of mammographic establishments and specialists, specifications of equipment, image quality, mammography results processing, radiation doses [ru

  5. Workers' Objectives in Quality Improvement.

    Science.gov (United States)

    Brossard, Michel

    1990-01-01

    A case study of quality circles in an appliance factory found that circle members and nonmembers obtained better working conditions by improving quality through the direct impact of their work on the company's market position. The study of the quality improvement process shows that workers seek more than psychological rewards for their…

  6. Image processing techniques to evaluate mammography screening quality; Tecnicas de processamento de imagem para avaliar a qualidade de exames de mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Quintana, Clara; Tirao, German [Consejo Nacional de Investigaciones Cientificas y Tecnicas, Buenos Aires (Argentina); Valente, Mauro [Universidad Nacional de Cordoba (Argentina). Facultad de Matematica, Astronomia y Fisica

    2011-07-01

    Mammography imaging has proved to be the best noninvasive method for breast cancer diagnosis, but it requires that irradiation parameters are set within Protocols recommendations (minimal dose delivering). This work presents an investigation on mammography image formation by means of validated Monte Carlo simulations along with further image analysis and mathematical processing. Several image processing methods have been suitably introduced and investigated according to their capability for micro-calcification detection and quality evaluation. The obtained results suggest the feasibility of all the proposed methods. Furthermore, it was possible to characterize the reliability of each and to infer the corresponding advantages or disadvantages, obtaining an image quality evaluation as a function of several parameters configurations. (author)

  7. Interobserver agreement and performance score comparison in quality control using a breast phantom: screen-film mammography vs computed radiography

    International Nuclear Information System (INIS)

    Shimamoto, Kazuhiro; Ikeda, Mitsuru; Satake, Hiroko; Ishigaki, Satoko; Sawaki, Akiko; Ishigaki, Takeo

    2002-01-01

    Our objective was to evaluate interobserver agreement and to compare the performance score in quality control of screen-film mammography and computed radiography (CR) using a breast phantom. Eleven radiologists interpreted a breast phantom image (CIRS model X) by four viewing methods: (a) original screen-film; (b) soft-copy reading of the digitized film image; (c) hard-copy reading of CR using an imaging plate; and (d) soft-copy reading of CR. For the soft-copy reading, a 17-in. CRT monitor (1024 x 1536 x 8 bits) was used. The phantom image was evaluated using a scoring system outlined in the instruction manual, and observers judged each object using a three-point rating scale: (a) clearly seen; (b) barely seen; and (c) not seen. For statistical analysis, the kappa statistic was employed. For ''mass'' depiction, interobserver agreement using CR was significantly lower than when using screen-film (p<0.05). There was no significant difference in the kappa value for detecting ''microcalcification''; however, the performance score of ''microcalcification'' on CR hard-copy was significantly lower than on the other three viewing methods (p<0.05). Viewing methods (film or CR, soft-copy or hard-copy) could affect how the phantom image is judged. Paying special attention to viewing conditions is recommended for quality control of CR mammograms. (orig.)

  8. Statistical methods for quality improvement

    National Research Council Canada - National Science Library

    Ryan, Thomas P

    2011-01-01

    ...."-TechnometricsThis new edition continues to provide the most current, proven statistical methods for quality control and quality improvementThe use of quantitative methods offers numerous benefits...

  9. Review of the first 50 cases completed by the RACR mammography QA programme; Phantom image quality, processor control and dose considerations

    International Nuclear Information System (INIS)

    McLean, D.; Chan, W.; Eckert, M.; Heard, R.

    1997-01-01

    The Mammography Quality Assurance Programme, recently established by the Royal Australasian College of Radiologists, has processed the first 50 applications. This programme, which closely follows the programme of the American College of Radiology (ACR), utilizes phantom film images, thermoluminescent dosimetry measurement of mean glandular dose, processor control charts, clinical images, equipment reports and required survey information to establish that a centre conforms to a minimum standard in mammography. The present paper describes the initial results of the first phantom images, dose measurements, processor control and survey information. Fifty films have been evaluated up to the present time with a failure rate of 26%. The major causes of failure were unacceptable film artefacts and poor contrast (as indicated by reduced fibre and mass visibility). A surprising result was the high failure in processing, where 23% of units reviewed had significant problems, including failure to keep the processor within required control limits. Only one centre recorded a mean glandular dose above 2 mGy with no centre over the 3 mGy limit. A review of the frequency of the quality control testing shows that the acceptance of quality assurance in mammography, while greater than in the initial stages of the ACR programme, is less than current US practice. These initial results for the accreditation process probably reflect an initial period of adjustment, as seen by the high pass rate achieved by centres that have re submitted material to gain accreditation. (authors)

  10. Quality controls in two mammography of the Institute of Oncology Angel H. Roffo - C.A.B.A - Buenos Aires

    International Nuclear Information System (INIS)

    Pirchio, R.; Sánchez, H.; Lerman, Y.; Ángel H. Roffo, Av. San Martín 5481 - C1417DTO, C.A.B.A, Buenos Aires (Argentina))" data-affiliation=" (Universidad de Buenos Aires, Instituto de Oncología Ángel H. Roffo, Av. San Martín 5481 - C1417DTO, C.A.B.A, Buenos Aires (Argentina))" >Casal, M.

    2013-01-01

    National Atomic Energy Commission of Argentina (CNEA) under the Technical Cooperation Project with the International Atomic Energy Agency (IAEA) “ARG/6/013 Implementing a Dosimetric System in Diagnostic Radiology to Minimize Doses Received by Patients” for the biennium 2012-2013, is carrying on courses for physicians, technicians and physicist working on radiodiagnost and studies about quality control in mammography equipment. The goal of this project is minimizing the dose received by patients who undergo diagnostic studies X-rays. The first controls were performed at the Institute of Oncology Angel H. Roffo of C.A.B.A – Buenos Aires. The mammographs used were: the digital FujiFilm Amulet and ther hybrid General Electric (GE) Senographe DMR, out of order. The latter was used to adjust protocols and equipment. Quality controls of mamography equipments were done according to the following IAEA documents: Technical Reports Series (TRS) N° 457, Technical Document (TECDOC) -1517 and IAEA Human Health Series N° 17. Among the checks performed are mentioned: mechanical (visual inspection), compression, compression thickness, mean glandular dose for Mo-Mo 28 kV and Mo-Rh 28 kV, repeatability and linearity, half-value layer, accuracy and repeatability voltage, leakage radiation and focus- tray distance. The Radcal calibrated equipment, used for the measurements was provided by the IAEA as part of the project. They are: reader, chamber for mammography, chamber for leakage, voltage meter and other elements such as aluminum plates. In addition, dosimeters TLDs rods 700 and 200 of the Personal Dosimetry Laboratory - CNEA, and dosimetry films of the Medical University - Personal Dosimetry Laboratory and Radiological Protection - were calibrated in the GE mammograph in Mo-Mo for the incident air kerma values of 2.28, 4.58, 6.38, 9.15, 10.96, 14.71 and 18.34 mGy. For both TLDs dosemeters, the effective energy response has been studied for: 14.4, 15, 15.4, 15.7 y 16.1 kev

  11. Hardware for mammography

    International Nuclear Information System (INIS)

    Rozhkova, N.I.; Chikirdin, Eh.G.; Ryudiger, Yu.G.; Kochetova, G.P.; Lisachenko, I.V.; Yakobs, O.Eh.

    2000-01-01

    The comparative studies on various visualization means, in particular, the intensifying screens and films with application of quantitative methods for determining small details on photographs, including measurements of corresponding exposures, absorbed doses and verification of conclusions through the analysis of clinical observations are carried out. It is shown, that technical equipment of the modern mammography room should include the X-ray mammographic apparatus, providing for the image high-quality by low dose loads with special film holders, meeting the mammography requirements, the corresponding X-ray film and the automatic photolaboratory process, provided by one and the same company. The quality of photographs under such conditions is guarantied, the defects and errors by the image interpretation are excluded. The modern computerized information technologies for work with medical images on the basic of creating new generations of diagnostic instrumentation with digital video channels and computerized working places dispose of many medical, technological, organizational and financial problems [ru

  12. Quantitative research versus quality assurance, quality improvement, total quality management, and continuous quality improvement.

    Science.gov (United States)

    Vogelsang, J

    1999-04-01

    The purpose of this report is to provide a review of the scientific method used in the quantitative research studies for consumers, evaluators, and applied nurse researchers. The fundamental characteristics of the problem-solving/ performance-improvement processes of quality assurance, quality improvement, total quality management, and continuous quality improvement are described. Research is compared with these processes, and is followed by a discussion about the publication of quantitative research findings.

  13. Establishing daily quality control (QC) in screen-film mammography using leeds tor (max) phantom at the breast imaging unit of USTH-Benavides Cancer Institute

    Science.gov (United States)

    Acaba, K. J. C.; Cinco, L. D.; Melchor, J. N.

    2016-03-01

    Daily QC tests performed on screen film mammography (SFM) equipment are essential to ensure that both SFM unit and film processor are working in a consistent manner. The Breast Imaging Unit of USTH-Benavides Cancer Institute has been conducting QC following the test protocols in the IAEA Human Health Series No.2 manual. However, the availability of Leeds breast phantom (CRP E13039) in the facility made the task easier. Instead of carrying out separate tests on AEC constancy and light sensitometry, only one exposure of the phantom is done to accomplish the two tests. It was observed that measurements made on mAs output and optical densities (ODs) using the Leeds TOR (MAX) phantom are comparable with that obtained from the usual conduct of tests, taking into account the attenuation characteristic of the phantom. Image quality parameters such as low contrast and high contrast details were also evaluated from the phantom image. The authors recognize the usefulness of the phantom in determining technical factors that will help improve detection of smallest pathological details on breast images. The phantom is also convenient for daily QC monitoring and economical since less number of films is expended.

  14. Medical and physical problems of mammography. 2. Studies on optimum quality of radiation and on radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Barke, R; Geissler, S; Rosenkranz, G [Medizinische Akademie, Dresden (German Democratic Republic). Radiologische Klinik

    1980-02-01

    Problems concerning the implications of the radiation energy in relation to the image contrast and the radiation exposure are discussed, and measurements of the energy distribution are described. The effects of the voltage and of the filter on the energy distribution were determined, with and without a molybdenum filter, in the voltage range of 25 - 50 kV. The form of the spectral energy distribution depends but slightly on the output voltage. On the other side, the radiation exposure can be expressed as a function of the radiographic kilovoltage. The effects of the quantum energy and of the scattered radiation on the contrast and the optimal energy were studied on a model. With regard to the importance of the detection of microcalcifications, the effects of the scattered radiation on the contrast behaviour of details of varying size were investigated. The direct proportionality of the contrast to the detail size is lost under the influence of the scattered radiation. For this reason, minimal kV values are required for imaging very small details. Studies on the imaging geometry of the DG 40 mammographical device permit to conclude that the necessary resolving power (..gamma.. = 5 mm/sup -1/) is reached with the TF 13 and XR 10 films. On the basis of the relevant literature, the present views on radiation exposure and especially on cancer induction by mammography are discussed. To estimate the risk, the radiation exposure must be determined in the own system. By means of thermoluminescent dosimetry in patients, using LiF and CaSO/sub 4/, the surface dose, the exit dose and the sternal exposure, adding the XR 10 and the TF 13 to the DG 40 (the mean values at 30 kV were 49 and 34 ..mu..Gy, respectively) were determined. An increase in voltage leads to a reduction of the dose, but impairs the quality of the image. The values obtained are compared with data from the literature. Conclusions are drawn as to the use of mammography in practice.

  15. Digital mammography: what do we and what don't we know?

    International Nuclear Information System (INIS)

    Bick, Ulrich; Diekmann, Felix

    2007-01-01

    High-quality full-field digital mammography has been available now for several years and is increasingly used for both diagnostic and screening mammography. A number of different detector technologies exist, which all have their specific advantages and disadvantages. Diagnostic accuracy of digital mammography has been shown to be at least equivalent to film-screen mammography in a general screening population. Digital mammography is superior to screen-film mammography in younger women with dense breasts due to its ability to selectively optimize contrast in areas of dense parenchyma. This advantage is especially important in women with a genetic predisposition for breast cancer, where intensified early detection programs may have to start from 25 to 30 years of age. Tailored image processing and computer-aided diagnosis hold the potential to further improve the early detection of breast cancer. However, at present no consensus exists among radiologists on which processing is optimal for digital mammograms. Image processing may also vary significantly among vendors with so far limited interoperability. This review aims to summarize the available information regarding the impact of digital mammography on workflow and breast cancer diagnosis. (orig.)

  16. Preanalytical quality improvement : in quality we trust

    OpenAIRE

    Lippi, Giuseppe; Becan-McBride, Kathleen; Behulova, Darina; Bowen, Raffick A.; Church, Stephen; Delanghe, Joris; Grankvist, Kjell; Kitchen, Steve; Nybo, Mads; Nauck, Matthias; Nikolac, Nora; Palicka, Vladimir; Plebani, Mario; Sandberg, Sverre; Simundic, Ana-Maria

    2013-01-01

    Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and qu...

  17. Current status of mammography

    International Nuclear Information System (INIS)

    Crymes, J.E.

    1979-01-01

    Great progress has been made in recent years in the diagnosis and treatment of breast cancer; however, breast cancer continues to be the most common and lethal cancer in women today. Early diagnosis is essential in order for treatmet to be given before the tumor spreads beyond the breast. The radiation risks of mammography have been greatly reduced with the use of newer low-dose techniques, and the benefits of mammography have increased because of a better understanding of the natural history of breast cancer, as well as improved methods of treatment. Radiologists must continue to take an active role in the early diagnosis of breast cancer. Continued research is needed in order to improve screening methods and to develop newer, noninvasive techniques

  18. Application of phase contrast imaging to mammography

    International Nuclear Information System (INIS)

    Tohyama, Keiko; Yamada, Katsuhiko; Katafuchi, Tetsuro; Matsuo, Satoru; Morishita, Junji

    2005-01-01

    Phase contrast images were obtained experimentally by using a customized mammography unit with a nominal focal spot size of 100 μm and variable source-to-image distances of up to 1.5 m. The purpose of this study was to examine the applicability and potential usefulness of phase contrast imaging for mammography. A mammography phantom (ACR156 RMI phantom) was imaged, and its visibility was examined. The optical density of the phantom images was adjusted to approximately 1.3 for both the contact and phase contrast images. Forty-one observers (18 medical doctors and 23 radiological technologists) participated in visual evaluation of the images. Results showed that, in comparison with the images of contact mammography, the phantom images of phase contrast imaging demonstrated statistically significantly superior visibility for fibers, clustered micro-calcifications, and masses. Therefore, phase contrast imaging obtained by using the customized mammography unit would be useful for improving diagnostic accuracy in mammography. (author)

  19. Implementation of quantitative methods of analysis of the image quality in mammography

    International Nuclear Information System (INIS)

    Ruiz Rodriguez, Ana Mariela

    2012-01-01

    A proper diagnosis of a mammogram requires optimal contrast and maximum resolution, this allows to visualize different structures with low contrast and diameter of the order of millimeters. The evaluation of image quality allows to characterize the physical properties of the system of image acquisition, such assessment is one of the cornerstones in a quality control program. The image quality of the ACR phantom was evaluated with the IAEA TECDOC 1517 protocol. Analytical methods have determined quality parameters of the dummy image TOR MAS. A method is developed to analyze the image quality of both mammographic phantoms by use of computational techniques with the ImageJ program, in doing this, more information was able to objectively characterize the image quality of the dummies. Furthermore, these parameters will serve to compare the images obtained at different mammographic centers of the Caja Costarricense de Seguro Social (CCSS) and eventually the time evolution in a particular installation. (author) [es

  20. Quality improvement: the nurse's role.

    Science.gov (United States)

    Moran, M J; Johnson, J E

    1992-06-01

    Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers

  1. Comparison of image quality between mammography dedicated monitor and UHD 4K monitor, using standard mammographic phantom: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Young; Cha, Soon Joo; Hong, Sung Hwan; Kim, Su Young; Kim, Yong Hoon; Kim, You Sung; Kim, Jeong A [Dept. of Radiology, Inje Unveristy Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2017-03-15

    Using standard mammographic phantom images, we compared the image quality obtained between a mammography dedicated 5 megapixel monitor (5M) and a UHD 4K (4K) monitor with digital imaging and communications in medicine display, to investigate the possibility of clinical application of 4K monitors. Three different exposures (autoexposure, overexposure and underexposure) images of mammographic phantom were obtained, and six radiologists independently evaluated the images in 5M and 4K without image modulation, by scoring of fibers, groups of specks and masses within the phantom image. The mean score of each object on both monitors was independently analyzed, using t-test and interobserver reliability by intraclass correlation coefficient (ICC) of SPSS. The overall mean scores of fiber, group of specks, and mass in 5M were 4.25, 3.92, and 3.28 respectively, and scores obtained in 4K monitor were 3.81, 3.58, and 3.14, respectively. No statistical difference was seen in scores of fiber and mass between the two monitors at all exposure conditions, but the score of group of specks in 4K was statistically lower in the overall (p = 0.0492) and in underexposure conditions (p = 0.012). The ICC for interobserver reliability was excellent (0.874). Our study suggests that since the mammographic phantom images are appropriate with no significant difference in image quality observed between the two monitors, the 4K monitor could be used for clinical studies. Since this is a small preliminary study using phantom images, the result may differ in actual mammographic images, and subsequent investigation with clinical mammographic images is required.

  2. Update on new technologies in digital mammography

    Directory of Open Access Journals (Sweden)

    Patterson SK

    2014-08-01

    Full Text Available Stephanie K Patterson, Marilyn A Roubidoux Division of Breast Imaging, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA Abstract: Despite controversy regarding mammography's efficacy, it continues to be the most commonly used breast cancer-screening modality. With the development of digital mammography, some improved benefit has been shown in women with dense breast tissue. However, the density of breast tissue continues to limit the sensitivity of conventional mammography. We discuss the development of some derivative digital technologies, primarily digital breast tomosynthesis, and their strengths, weaknesses, and potential patient impact. Keywords: screening mammography, breast cancer, contrast media, digital breast tomosynthesis

  3. Stability of two measuring systems used in quality control of mammography; Estabilidade de dois sistemas de medicao utilizados no controle de qualidade de mamografos

    Energy Technology Data Exchange (ETDEWEB)

    Barreira, Jacqueline Sales; Vivolo, Vitor, E-mail: jacsales@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2014-07-01

    The use of X-Rays for diagnosis is very important for medicine, including mammographic exam. A quality control program is necessary to control the radiation systems performance. The objective of this paper is evaluation of stability of measurement working system and measurement standard system, collecting meters of charge and dose using one source of Strontium 90 (Sr-90). The results of this test are very important to determine if the instruments are calibrated for use in quality control program for a mammography equipment. (author)

  4. NETWORKS AND QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag Hadžistević

    2009-12-01

    Full Text Available Tools used in the past to analyze business value creation, such as value chain and process models, are simply too slow, inadequate, or inappropriate to address this new level of business complexity. In stead of that, company has to find way to create quality management system in a multi-layered supply chain. The problem can be solved by networking in the cluster. Cluster can be known as a competitive cooperation in the purpose to gain higher level of competitiveness and success. Bat there is another problem: Organization of the production process in a company is extremely complex process itself, and when we transfer it to the cluster level, we get a complex task which is difficult to solve. For that purpose, this paper analyses the conditions and possibilities that would enable those structures to adapt to changes in the surroundings - flexibility and management adequacy of production and organizational structures - by creating network value system.

  5. Experimental investigations of image quality in X-ray mammography with conventional screen film system (SFS), digital phosphor storage plate in/without magnification technique (CR) and digital CCD-technique (CCD)

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Aichinger, U.; Boehner, C.; Dobritz, M.; Wenkel, E.; Bautz, W.; Saebel, M.

    2001-01-01

    Comparison of image quality in X-ray mammography between conventional film screen film system (SFS), digital phosphor storage plate in and without magnification technique (CR) and digital CCD-technique (CCD). Radiograms of an RMI-mammography phantom were acquired using a conventional screen film system, three digital storage plate systems and two digital systems in CCD-technique. Additionally the radiograms of one digital phosphor storage plate system were post-processed regarding contrast and included in the comparison. The detectability of details was best with the digital mammography in CCD-technique. After confirming these promising results in clinical studies, digital mammography should be able to replace conventional screen film technique. (orig.)

  6. Mammography in public hospitals at Rio de Janeiro: a quality assurance program

    International Nuclear Information System (INIS)

    Briquet, C.; Coutinho, C.M.C.; Mota, H.C.; Tavares, E.

    1998-01-01

    This paper presents the preliminary results and the methodology followed by the implementation of a Quality Assurance Program in public hospitals at Rio de Janeiro. We observed that the main problems of image are due to the processing. None facility has a dedicated processor and the processor daily quality control is a concern not yet adopted. (Author)

  7. Evaluation of image quality versus doses in service of mammography of Belo Horizonte, MG, BR; Avaliacao da qualidade da imagem versus doses em servicos de mamografia de Belo Horizonte

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, M.; Nogueira, M.S.; Guedes, E. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Seguranca Nuclear; Andrade, M.C. [Superintendencia Estadual de Vigilancia Sanitaria, Belo Horizonte, MG (Brazil); Peixoto, J.E. [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Radiologia; Silva, V.L.S.; Borges, J.C. [Vigilancia Sanitaria da Secretaria Municipal de Saude de Belo horizonte (VISA/PBH), MG (Brazil)

    2004-07-01

    Cancer is the second cause of death for Brazilian women and breast cancer is the most common neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to be effective, the mammography must be of good quality. This study sought to evaluate the radiation protection and quality of 37 services out a total of 82 mammography facilities existing in the city of Belo Horizonte, Brazil. Two instruments were used: a proposed evaluation protocol of the Health Surveillance -VISA and a protocol for evaluation of image quality. Of the 37 services who completed the study, none was achieved 100% conformity in image quality. The results of radiation protection requirements according to the VISA protocol bore close relation to final image quality, a central issue for early cancer detection (p>0.05)

  8. [Controversial attitude to mammography screening in asymptomatic women between 40 and 50 years of age].

    Science.gov (United States)

    Frischbier, H J

    1994-01-01

    The results of screening studies conducted in the United States and in Europe in females between the ages of 40 and 50 are analysed. It is shown, that the results of this study on mortality reduction are less favourable, the poorer the technique of mammography (foregoing of general two-view mammography) and the longer the time interval between two mammography screenings. Arguments are presented, that are brought forward when declining to perform general mammography screening in this age group. The author's own results, obtained in the Hamburg mammography screening study, which included from 1971 to 1986 also premenopausal women, show, that the survival rates of patients below 50 years of age with mammographically detected carcinomas of the breast do not differ from those in patients older than 50 years, according to a relevant age group classification. The advances in the technique of mammography in recent years are analysed on the basis of the author's own patient material. It is evident, that the positive predictive value has been doubled, especially in the age group between 40 and 50. An analysis of the distribution of diagnosed noninvasive carcinomas compared with the invasive carcinomas reveals, that particularly this age group has the highest percentage of identification of prognostically favourable carcinoma stages. Further analyses show, why the randomised European mammography studies could not yield a significant mortality rate improvement. A prerequisite for the inclusion of mammography screening in the legally prescribed early detection of carcinoma examinations, however, are the quality controls, whose realisation, in our health system, will have to be confirmed by the German mammography study.

  9. Mammography screening in Denmark

    DEFF Research Database (Denmark)

    Vejborg, Ilse; Mikkelsen, Ellen Margrethe; Garne, Jens Peter

    2011-01-01

    Mammography screening is offered healthy women, and a high standard on professional and organizational level is mandatory not only in the screening programme but even in the diagnostic work-up and treatment. The main goal is to achieve a substantial reduction in disease specific mortality......, but it is not possible to evaluate the effect on mortality until several years later, and continuously monitoring of the quality of all aspects of a screening programme is necessary. Based on other European guidelines, 11 quality indicators have been defined, and guidelines concerning organizational requirements...... for a Danish screening programme as well as recommendations for the radiographic and radiological work have been drawn up....

  10. Preanalytical quality improvement: in quality we trust.

    Science.gov (United States)

    Lippi, Giuseppe; Becan-McBride, Kathleen; Behúlová, Darina; Bowen, Raffick A; Church, Stephen; Delanghe, Joris; Grankvist, Kjell; Kitchen, Steve; Nybo, Mads; Nauck, Matthias; Nikolac, Nora; Palicka, Vladimir; Plebani, Mario; Sandberg, Sverre; Simundic, Ana-Maria

    2013-01-01

    Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled "Preanalytical quality improvement: in quality we trust" (Zagreb, Croatia, 1-2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed.

  11. Screening for breast cancer with mammography

    International Nuclear Information System (INIS)

    Sickles, E.A.

    1991-01-01

    Mammography is generally accepted as a useful problem-solving clinical tool in characterizing known breast lesions, so that appropriate and timely treatment can be given. However, it remains grossly underutilized at what it does best: screening. The major strengths of mammography are (a) its ability to detect breast cancer at a smaller, potentially more curable stage than any other examination, and (b) its proved efficacy in reducing breast cancer mortality in asymptomatic women aged 40-74. If, as has recently been estimated, screening with mammography and physical examination can be expected to lower breast cancer deaths by 40%-50% among those actually examined (13), then the lives of almost 20,000 U.S. women might be saved each year if screening were to become very widely used. The challenges of the next decade are clear, to mount much more effective campaigns to educate physicians and lay women about the life-saving benefits of breast cancer screening, to devise increasingly effective and lower cost screening strategies, to further improve the current high quality of mammographic imaging despite its increasing proliferation, and to train large numbers of breast imaging specialists to guarantee that the growing case load of screening and problem-solving mammograms is interpreted with a very high level of skill

  12. Evaluation of mammography equipment performance, dose and image quality in five Latin American countries

    Science.gov (United States)

    Brandan, M.-E.; Ruiz-Trejo, C.; Caspani, C. E. M.; Fleitas, I.; de-la-Mora, R.; Miranda, A. A.; Plazas, M.-C.; Betancourt, C.-M.; Borras, C.

    2001-10-01

    Under the auspices of PAHO/WHO, a multicentric investigation is carried out in five Latin American countries. Its aim is to correlate quality indicators of radiology services with the accuracy of the radiological interpretation as determined by a panel of radiology experts. We present preliminary results from mammographic imaging facilities. Evaluation of the equipment performance and dose measurements in 21 mammographic units show that, on the average, 75% of the units comply with recommendations issued by various organizations. An independent evaluation of the quality of the clinical images show strong variations among the different radiological services.

  13. Evaluation of mammography equipment performance, dose and image quality in five Latin American countries

    International Nuclear Information System (INIS)

    Brandan, M.-E.; Ruiz-Trejo, C.; Caspani, C. E. M.; Fleitas, I.; Mora, R. de la; Miranda, A. A.; Plazas, M.-C.; Betancourt, C.-M.; Borras, C.

    2001-01-01

    Under the auspices of PAHO/WHO, a multicentric investigation is carried out in five Latin American countries. Its aim is to correlate quality indicators of radiology services with the accuracy of the radiological interpretation as determined by a panel of radiology experts. We present preliminary results from mammographic imaging facilities. Evaluation of the equipment performance and dose measurements in 21 mammographic units show that, on the average, 75% of the units comply with recommendations issued by various organizations. An independent evaluation of the quality of the clinical images show strong variations among the different radiological services

  14. Quantitative Digital Tomosynthesis Mammography for Improved Breast Cancer Detection and Diagnosis

    National Research Council Canada - National Science Library

    Zhang, Yiheng

    2008-01-01

    .... When fully developed, the DTM can provide radiologists improved quantitative, three-dimensional volumetric information of the breast tissue, and assist in breast cancer detection and diagnosis...

  15. Initial Image Quality and Clinical Experience with New CR Digital Mammography System: A Phantom and Clinical Study

    International Nuclear Information System (INIS)

    Gaona, Enrique; Enriquez, Jesus Gabriel Franco; Alfonso, Beatriz Y. Alvarez; Castellanos, Gustavo Casian

    2008-01-01

    The goal of the study was to evaluate the first CR digital mammography system ( registered Konica-Minolta) in Mexico in clinical routine for cancer detection in a screening population and to determine if high resolution CR digital imaging is equivalent to state-of-the-art screen-film imaging. The mammograms were evaluated by two observers with cytological or histological confirmation for BIRADS 3, 4 and 5. Contrast, exposure and artifacts of the images were evaluated. Different details like skin, retromamillary space and parenchymal structures were judged. The detectability of microcalcifications and lesions were compared and correlated to histology. The difference in sensitivity of CR Mammography (CRM) and Screen Film Mammography (SFM) was not statistically significant. However, CRM had a significantly lower recall rate, and the lesion detection was equal or superior to conventional images. There is no significant difference in the number of microcalcifications and highly suspicious calcifications were equally detected on both film-screen and digital images. Different anatomical regions were better detectable in digital than in conventional mammography

  16. Quality assurance in X-ray mammography. Comparison of proposed EUREF guidelines with relevant German regulations

    International Nuclear Information System (INIS)

    Zaers, J.; Brix, G.; Woudenberg, S. van

    1997-01-01

    The Program 'Europe against Cancer' published the 2nd edition of quality assurance guidelines for breast cancer screening in June 1996. For the enforcement of these guidelines, a European network of reference centres (EUREF) is being established. Although the EUREF protocol contains guidelines for all disciplines involved in breast cancer screening, this article concentrates on the physical and technical aspect. The comparison with the German regulations (DIN Norms) demonstrates the high requirements requested by the EUREF guidelines with its tighter limits and more extensive and more frequent tests. (orig.) [de

  17. Mammography fixture

    International Nuclear Information System (INIS)

    Henkes, J.L. Jr.

    1979-01-01

    A device is described for compressing a pendant breast during tomographic mammography using X-rays. The device utilises a thin, elastic membrane pressurised by a fluid whose X-ray absorption properties are similar to those of soft human tissue. The membrane changes the normal conical shape of a pendant breast into a substantially cylindrical shape. The breast is surrounded by a second fluid medium whose X-ray absorption properties are also similar to that of soft human tissue and tomography transmission is carried out through the second fluid medium and the breast. This patent claims the advantages of eliminating high gradients in X-ray absorption density and the effective detection of breast tumours with minimum radiation dosage and processing time. (UK)

  18. Improving and monitoring air quality.

    Science.gov (United States)

    DuPont, André

    2018-05-01

    Since the authorization of the Clean Air Act Amendments of 1990, the air quality in the USA has significantly improved because of strong public support. The lessons learned over the last 25 years are being shared with the policy analysts, technical professionals, and scientist who endeavor to improve air quality in their communities. This paper will review how the USA has achieved the "high" standard of air quality that was envisioned in the early 1990s. This document will describe SO 2 gas emission reduction technology and highlight operation of emission monitoring technology. This paper describes the basic process operation of an air pollution control scrubber. A technical review of measures required to operate and maintain a large-scale pollution control system will be described. Also, the author explains how quality assurance procedures in performance of continuous emission monitoring plays a significant role in reducing air pollution.

  19. Radiographic techniques for digital mammography

    International Nuclear Information System (INIS)

    Horita, Katsuhei

    2007-01-01

    Since the differences in X-ray absorption between various breast tissues are small, a dedicated X-ray system for examination of the breast and a high-contrast, high-resolution screen/film system (SFM) (light-receiving system) are employed for X-ray diagnosis. Currently, however, there is a strong trend toward digital imaging in the field of general radiography, and this trend is also reflected in the field of mammographic examination. In fact, approximately 70% of facilities purchasing new mammography systems are now selecting a digital mammography system (DRM). Given this situation, this report reviews the differences between SFM and DRM and discusses the radiographic techniques and quality assurance procedures for digital mammography. (author)

  20. IMPROVING QUALITY MANAGEMENT IN PANIFICATION

    Directory of Open Access Journals (Sweden)

    Cornelia Petroman

    2010-12-01

    Full Text Available Consumers of panification products (as well as consumers of any other type of product or service are concerned about the quality of the products they purchase. Implementing the quality management system in the food industry is not compulsory, but it can bring about numerous, palpable benefits, particularly in reducing the amount of acryl amide. It is a modern system allowing the management analysis aiming at checking and reaching the goals to define new objectives, and the continuous improvement of the quality of processes and products.

  1. Significance of MPEG-7 textural features for improved mass detection in mammography.

    Science.gov (United States)

    Eltonsy, Nevine H; Tourassi, Georgia D; Fadeev, Aleksey; Elmaghraby, Adel S

    2006-01-01

    The purpose of the study is to investigate the significance of MPEG-7 textural features for improving the detection of masses in screening mammograms. The detection scheme was originally based on morphological directional neighborhood features extracted from mammographic regions of interest (ROIs). Receiver Operating Characteristics (ROC) was performed to evaluate the performance of each set of features independently and merged into a back-propagation artificial neural network (BPANN) using the leave-one-out sampling scheme (LOOSS). The study was based on a database of 668 mammographic ROIs (340 depicting cancer regions and 328 depicting normal parenchyma). Overall, the ROC area index of the BPANN using the directional morphological features was Az=0.85+/-0.01. The MPEG-7 edge histogram descriptor-based BPNN showed an ROC area index of Az=0.71+/-0.01 while homogeneous textural descriptors using 30 and 120 channels helped the BPNN achieve similar ROC area indexes of Az=0.882+/-0.02 and Az=0.877+/-0.01 respectively. After merging the MPEG-7 homogeneous textural features with the directional neighborhood features the performance of the BPANN increased providing an ROC area index of Az=0.91+/-0.01. MPEG-7 homogeneous textural descriptor significantly improved the morphology-based detection scheme.

  2. Computation of beam quality parameters for Mo/Mo, Mo/Rh, Rh/Rh, and W/Al target/filter combinations in mammography

    International Nuclear Information System (INIS)

    Kharrati, Hedi; Zarrad, Boubaker

    2003-01-01

    A computer program was implemented to predict mammography x-ray beam parameters in the range 20-40 kV for Mo/Mo, Mo/Rh, Rh/Rh, and W/Al target/filter combinations. The computation method used to simulate mammography x-ray spectra is based on the Boone et al. model. The beam quality parameters such as the half-value layer (HVL), the homogeneity coefficient (HC), and the average photon energy were computed by simulating the interaction of the spectrum photons with matter. The checking of this computation was done using a comparison of the results with published data and measured values obtained at the Netherlands Metrology Institute Van Swinden Laboratorium, National Institute of Standards and Technology, and International Atomic Energy Agency. The predicted values with a mean deviation of 3.3% of HVL, 3.7% of HC, and 1.5% of average photon energy show acceptable agreement with published data and measurements for all target/filter combinations in the 23-40 kV range. The accuracy of this computation can be considered clinically acceptable and can allow an appreciable estimation for the beam quality parameters

  3. Quality Improvement with Trustee Commitment.

    Science.gov (United States)

    Chaffee, Ellen Earle; Seymour, Daniel

    1991-01-01

    Total Quality Management is a comprehensive system for developing organizationwide participation in planning for and implementing continuous improvement in critical processes. In colleges, trustees can be central to the success of the method through their commitment and the development of supportive policy and procedures. (MSE)

  4. Quality Improvement Practices and Trends

    DEFF Research Database (Denmark)

    Dahlgaard, Jens J.; Hartz, Ove; Edgeman, Rick L.

    1998-01-01

    professor, as well as key individuals from various industries. In addition to the above activities, Rick will be working with the European Foundation for Quality Management on their "European Master's Programme in Total Quality Management." That program involves a consortium of European universities. Rick......The following article, "Quality Improvement Practices and Trends in Denmark," is the first in a series of papers arranged for and co-authored by Dr. Rick L. Edgeman. Rick is a member of QE's Editorial Board and is on sabbatical from Colorado State University. During the year, Rick and his family...... has begun the process of developing a comparable consortium of American universities for the same purpose-- an activity which is cosponsored by the Education Division of the American Society for Quality (ASQ)....

  5. Continuous improvement of software quality

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    1999-04-01

    The present report is the first Halden Work Report delivered from the OECD Halden Reactor Project's research activity on formal methods and software quality. Of particular concern in this activity is to reach a consensus between regulators, licensees and the nuclear industry on questions related to the effective, industrial use of formal methods. The report gives considerable attention to the importance of continuous improvement as a characteristic of a living software quality system, and to the need of providing a basis for software process/product quality integration. In particular, the report discusses these aspects from the perspectives of defect prevention, formal methods, Total Quality Management (TQM), and Bayesian Belief Nets. Another concern is to promote controlled experiments on the use of new methods, techniques, and tools. This is achieved partly by reviewing suggestions on the collection and experimental use of data, and by surveying a number of metrics believed to have some potential for comparison studies (author) (ml)

  6. Quality improvement tools and processes.

    Science.gov (United States)

    Lau, Catherine Y

    2015-04-01

    The Model for Improvement and the Plan-Do-Study-Act cycle is a popular quality improvement (QI) tool for health care providers to successfully lead QI projects and redesign care processes. This tool has several distinct components that must be addressed in sequence to organize and critically evaluate improvement activities. Unlike other health sciences clinical research, QI projects and research are based on dynamic hypotheses that develop into observable, serial tests of change with continuous collection and feedback of performance data to stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Quality control of mammographic systems

    International Nuclear Information System (INIS)

    Espana Lopez, M. L.

    2001-01-01

    High quality in mammography is a difficult objective to achieve, that is the reason for what efforts are made in order to improve equipment, to offer good combinations screen-film, and professional staff dedicated to this technique [es

  8. The radiation metrology network related to the field of mammography: implementation and uncertainty analysis of the calibration system

    Science.gov (United States)

    Peixoto, J. G. P.; de Almeida, C. E.

    2001-09-01

    It is recognized by the international guidelines that it is necessary to offer calibration services for mammography beams in order to improve the quality of clinical diagnosis. Major efforts have been made by several laboratories in order to establish an appropriate and traceable calibration infrastructure and to provide the basis for a quality control programme in mammography. The contribution of the radiation metrology network to the users of mammography is reviewed in this work. Also steps required for the implementation of a mammography calibration system using a constant potential x-ray and a clinical mammography x-ray machine are presented. The various qualities of mammography radiation discussed in this work are in accordance with the IEC 61674 and the AAPM recommendations. They are at present available at several primary standard dosimetry laboratories (PSDLs), namely the PTB, NIST and BEV and a few secondary standard dosimetry laboratories (SSDLs) such as at the University of Wisconsin and at the IAEA's SSDL. We discuss the uncertainties involved in all steps of the calibration chain in accord with the ISO recommendations.

  9. Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

    Science.gov (United States)

    Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

    2015-03-01

    To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

  10. Modalities of hemodialysis: Quality improvement

    Directory of Open Access Journals (Sweden)

    Ayman Karkar

    2012-01-01

    Full Text Available Hemodialysis (HD treatment had, over many years, improved the survival rate of patients with end-stage renal disease. However, standard or conventional HD prescription is far from being optimal in replacing the function of normal kidneys. Its unphysiologic clearance pattern and inability to remove all types and sizes of uremic toxins results in inter- and intra-dialysis complications and an unacceptably high rate of cardiovascular morbidity and mortality. Efficiency of HD can be improved by increasing blood and dialysate flow rates, dialyzer size and surface area and duration and frequency of dialysis sessions. Home HD, where short daily or long slow nocturnal HD sessions can conveniently be performed, provides an excellent option for quality of life improvement and reduction in morbidity and mortality. Recent innovations in the specifications of HD machines and improvement in dialysis membranes characteristics and water treatment technology paved the way for achieving quality HD. These advancements have resulted in efficient implementation of adsorption, diffusion and/or convection principles using adsorption HD, hemofiltration, hemodiafiltration (HDF and online HDF modalities in order to achieve optimum HD. Implementation of these innovations resulted in better quality care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients.

  11. Radiogenic breast cancer risk and mammography

    International Nuclear Information System (INIS)

    Jayaprakash, Shobha; Nair, C.P.R.; Rao, B.S.; Sawant, S.G.

    2001-01-01

    There is a general concern that the risks from mammography screening in inducting radiogenic breast cancer may outweigh the possible benefits to be derived from it. A review of epidemiological, case-control and cohort studies of radiogenic breast cancer, age-specific incidence and dose and dose-rate relationship reveals that such a fear is unfounded. The dose to the breast tissues in a quality assured mammography screening programme falls far below the levels that were observed to produce increased relative risk. The age-specific incidence rates also indicate that the need for mammography is for the women of age at which the relative risk is minimum

  12. Using Lean to Advance Quality Improvement Research.

    Science.gov (United States)

    Blackmore, Christopher Craig; Williams, Barbara L; Ching, Joan M; Chafetz, Lynne A; Kaplan, Gary S

    2016-01-01

    Quality improvement research skills are not commonplace among quality improvement practitioners, and research on the effectiveness of quality improvement has not always kept pace with improvement innovation. However, the Lean tools applied to quality improvement should be equally relevant to the advancement of quality improvement research. We applied the Lean methods to develop a simplified quality improvement publication pathway enabling a small research methodology group to increase quality improvement research throughout the institution. The key innovations of the pathway are horizontal integration of the quality improvement research methods group across the institution, implementation of a Lean quality improvement research pathway, and application of a just-in-time quality improvement research toolkit. This work provides a road map and tools for the acceleration of quality improvement research. At our institution, the Lean quality improvement research approach was associated with statistically significant increases in the number (annual mean increase from 3.0 to 8.5, p = .03) and breadth of published quality improvement research articles, and in the number of quality improvement research projects currently in process. Application of Lean methods to the quality improvement research process can aid in increasing publication of quality improvement articles from across the institution.

  13. Improving coal quality and service

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-06-01

    Russia's new coal export industry has quickly produced a generation of extremely experienced operators. While improvements are happening, can buyers also expect the service, flexibility and quality control that they get from other export sources? In the light of the first-ever Coaltrans Russia conference held in April the article reports on developments in Russia's coal industry, quoting from many of the papers presented. 5 photos.

  14. Control of image quality in mammography. Influence of assessing subjective image of a test object; Control de calidad de imagen en mamografia. Influencia de la valoracion subjetiva de la imagen de un objeto de prueba

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez Concepcion, E.; Garrido Breton, C.; Batista Arce, A.; Gonzalez Lopez, S.; Catalan Acosta, A.; Hernandez Armas, J.

    2013-07-01

    . The object of this work is to assess the influence of the observer in the control of image quality to the digital mammography machine of our hospital, establishing reference values and tolerances that take into account the variability between observers. (Author)

  15. Studies of breast masses in Korean woman using tungsten anode mammography

    International Nuclear Information System (INIS)

    Suh, C. O.; Oh, K. K.; Lee, K. S.

    1979-01-01

    Mammography is the oldest and most popular method in the diagnosis of breast disease and received the special attention as the powerful instrument in early detection of breast cancer. In Korea, the mammography has not been widely used, yet, but nowadays, increasing incidence of breast cancer and good prognosis after early detection and proper treatment need the clinical application of mammography for management of patient with breast disease and for the detection of occult cancer. The technique obtaining the good quality film is essential for improving the diagnostic accuracy of mammography in breast disease and in general, excellent film radiographs of breast can be obtained with proper combination of Kvp, processing, selection of fine grained film, fine focus tube and compression. In present study, radiographic technique was used in which 36-40 Kvp and 200 mAs were derived from a small focus Tungsten Anode tube. Medio-lateral and Cranio-caudad view were taken using Acryl compression device, which was specially designed by authors in order to properly examine the small, dense breasts of Korean women. Non-screen fine grained mammographic films was used and processing was manual.The materials consisted of 150 cases of mammography performed at Yonsei University Medical College, Severance Hospital, since January, 1978. We analyzed the diagnostic accuracy of mammography and mammographic findings in pathologically confirmed 39 cases. The conclusions are as follows: 1. Because women are sensitive to her breast changes, mammography is very useful not only in diagnosis of breast disease and early detection of cancer, but also management of patients with breast symptom and sign. 2. We obtained the relatively good quality film and high diagnostic accuracy with our own method, using conventional Tungsten Anode tube, compression device and hand processing. 3. We also applied specimen radiography in diagnosis of breast disease, which was helpful in verification of the adequacy

  16. A comparison of the performance of modern screen-film and digital mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Monnin, P [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Gutierrez, D [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Bulling, S [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Lepori, D [Department of Radiology, University Hospital Center (CHUV), CH-1011 Lausanne (Switzerland); Valley, J-F [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Verdun, F R [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland)

    2005-06-07

    This work compares the detector performance and image quality of the new Kodak Min-R EV mammography screen-film system with the Fuji CR Profect detector and with other current mammography screen-film systems from Agfa, Fuji and Kodak. Basic image quality parameters (MTF, NPS, NEQ and DQE) were evaluated for a 28 kV Mo/Mo (HVL = 0.646 mm Al) beam using different mAs exposure settings. Compared with other screen-film systems, the new Kodak Min-R EV detector has the highest contrast and a low intrinsic noise level, giving better NEQ and DQE results, especially at high optical density. Thus, the properties of the new mammography film approach those of a fine mammography detector, especially at low frequency range. Screen-film systems provide the best resolution. The presampling MTF of the digital detector has a value of 15% at the Nyquist frequency and, due to the spread size of the laser beam, the use of a smaller pixel size would not permit a significant improvement of the detector resolution. The dual collection reading technology increases significantly the low frequency DQE of the Fuji CR system that can at present compete with the most efficient mammography screen-film systems.

  17. SQIMSO: Quality Improvement for Small Software Organizations

    OpenAIRE

    Rabih Zeineddine; Nashat Mansour

    2005-01-01

    Software quality improvement process remains incomplete if it is not initiated and conducted through a wide improvement program that considers process quality improvement, product quality improvement and evolution of human resources. But, small software organizations are not capable of bearing the cost of establishing software process improvement programs. In this work, we propose a new software quality improvement model for small organizations, SQIMSO, based on three ...

  18. Introduction of organised mammography screening in tyrol: results of a one-year pilot phase

    Directory of Open Access Journals (Sweden)

    Daniaux Martin

    2011-02-01

    Full Text Available Abstract Background Efficiency and efficacy of organised mammography screening programs have been proven in large randomised trials. But every local implementation of mammography screening has to check whether the well established quality standards are met. Therefore it was the aim of this study to analyse the most common quality indices after introducing organised mammography screening in Tyrol, Austria, in a smooth transition from the existing system of opportunistic screening. Methods In June 2007, the system of opportunistic mammography screening in Tyrol was changed to an organised system by introducing a personal invitation system, a training program, a quality assurance program and by setting up a screening database. All procedures are noted in a written protocol. Most EU recommendations for organised mammography screening were followed, except double reading. All women living in Tyrol and covered by social insurance are now invited for a mammography, in age group 40-59 annually and in age group 60-69 biannually. Screening mammography is offered mainly by radiologists in private practice. We report on the results of the first year of piloting organised mammography screening in two counties in Tyrol. Results 56,432 women were invited. Estimated participation rate was 34.5% at one year of follow-up (and 55.5% at the second year of follow-up; 3.4% of screened women were recalled for further assessment or intermediate screening within six months. Per 1000 mammograms nine biopsies were performed and four breast cancer cases detected (N = 68. Of invasive breast cancer cases 34.4% were ≤ 10 mm in size and 65.6% were node-negative. In total, six interval cancer cases were detected during one year of follow-up; this is 19% of the background incidence rate. Conclusions In the Tyrolean breast cancer screening program, a smooth transition from a spontaneous to an organised mammography screening system was achieved in a short time and with minimal

  19. Design and image-quality performance of high resolution CMOS-based X-ray imaging detectors for digital mammography

    Science.gov (United States)

    Cha, B. K.; Kim, J. Y.; Kim, Y. J.; Yun, S.; Cho, G.; Kim, H. K.; Seo, C.-W.; Jeon, S.; Huh, Y.

    2012-04-01

    In digital X-ray imaging systems, X-ray imaging detectors based on scintillating screens with electronic devices such as charge-coupled devices (CCDs), thin-film transistors (TFT), complementary metal oxide semiconductor (CMOS) flat panel imagers have been introduced for general radiography, dental, mammography and non-destructive testing (NDT) applications. Recently, a large-area CMOS active-pixel sensor (APS) in combination with scintillation films has been widely used in a variety of digital X-ray imaging applications. We employed a scintillator-based CMOS APS image sensor for high-resolution mammography. In this work, both powder-type Gd2O2S:Tb and a columnar structured CsI:Tl scintillation screens with various thicknesses were fabricated and used as materials to convert X-ray into visible light. These scintillating screens were directly coupled to a CMOS flat panel imager with a 25 × 50 mm2 active area and a 48 μm pixel pitch for high spatial resolution acquisition. We used a W/Al mammographic X-ray source with a 30 kVp energy condition. The imaging characterization of the X-ray detector was measured and analyzed in terms of linearity in incident X-ray dose, modulation transfer function (MTF), noise-power spectrum (NPS) and detective quantum efficiency (DQE).

  20. The mammography screening employee inreach program.

    Science.gov (United States)

    Robinson, Joanne; Seltzer, Vicki; Lawrence, Loretta; Autz, George; Kostroff, Karen; Weiselberg, Lora; Colagiacomo, Maria

    2007-02-01

    To determine whether our health care employees were undergoing mammography screening according to American Cancer Society guidelines and to determine whether aggressive outreach, education and streamlining of mammography scheduling could improve compliance. All female employees at North Shore University Hospital (NSUH) and several other health system facilities (SF) were sent mailings to their homes that included breast health education and mammography screening guidelines, a questionnaire regarding their own mammography screening history and the opportunity to have their mammography screening scheduled by the Mammography Screening Employee Inreach Program (MSEIP) coordinator. Of the approximately 2,700 female employees aged 40 and over at NSUH and SF, 2,235 (82.7%) responded to the questionnaire, and 1,455 had a mammogram done via the MSEIP. Of the 1,455, 43% either were overdue for a mammogram or had never had one. During a second year of the MSEIP at NSUH and SF, an additional 1,706 mammograms were done. People employed in health care jobs do not necessarily avail themselves of appropriate health care screening. An aggressive program that utilized education, outreach and assistance with scheduling was effective in increasing compliance with mammography screening.

  1. Achieving Improvement Through Nursing Home Quality Measurement

    OpenAIRE

    Harris, Yael; Clauser, Steven B.

    2002-01-01

    CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a...

  2. Quality Improvement and Learning in Productive Systems

    OpenAIRE

    Charles H. Fine

    1986-01-01

    Recent interest in product quality suggests that effort devoted to improving the quality of manufactured products may reduce unit costs. This conjecture---that improving quality can lower costs---challenges the traditional assumption that unit costs increase with increased quality assurance activities and has significant implications for quality management. By introducing the idea of a quality-based learning curve, this paper links the previously disjoint literatures of quality control and le...

  3. Trading emissions improve air quality

    International Nuclear Information System (INIS)

    Lents, J.M.

    1993-01-01

    While admitting sharply contrasting views exist, James M. Lents of the South Coast Air Quality Management District in southern California sees emissions trading open-quotes as a lifesaver for our troubled planet.close quotes He explains: open-quotes If political support for the environment is to be maintained, we must seek the most economical and flexible means of pursuing cleanup. At present, market incentives and emissions trading represent our best hope.close quotes Lents is putting his money where his pen is. The air quality management district he heads plans to use market incentives, including emissions trading, to reduce air pollution in the notoriously dirty southern California area. When the system goes into operation in 1994, he estimates it will save southern California businesses more than $400 million a year in compliance costs, while also making major improvements in the region's air quality. If the idea works there, why won't it work elsewhere, even on a global scale, Lents asks? He believes it will. But open-quotes the ultimate success of emissions-trading programs, whether regional, national, or international in scope, lies in the proof that they're actually achieving reductions in harmful emissions,close quotes he emphasizes. open-quotes These reductions must be real and verifiable to satisfy the Clean Air Act and a skeptical public.close quotes

  4. Study on patient exposure from mammography, 3

    International Nuclear Information System (INIS)

    Sato, Miyao

    1983-01-01

    Risks and benefits of the patient from mammography performed in Japan were estimated, and the indication of mammography were discussed. 1) Breast cancers induced by mammography were estimated based on the average breast dose, the average life span, risks of radiation-induced breast cancer and the breast cancer significant factor. 2) The breast cancer significant factor was calculated, similar to those of leukemia significant factor by Hashizume, from latent periods of radiation-induced breast cancer and the excess breast cancer induction rate in female A-bomb survivors. 3) Numbers of the deaths and Lost-years were calculated from risks of radiation-induced breast cancer, incidence of breast cancer by mammography, cure rate of breast cancer, average life span and latent period of radiation-induced breast cancer. 4) Numbers of the increased life and years saved were calculated from the improved rate of the ability of diagnosis, frequency of mammography, the average life span and cure rate of breast cancer. 5) Induction of leukemia, lung cancer and thyroid cancer by mammography also were investigated. Its contribution was not significant, compared to the induction of breast cancer. 6) Comparing risk and benefit, the latter was much higher than the former by factors of 71-76. This was suggested the efficacy of mammography. 7) From a pointview of risk and benefit, routine mammography is contraindicative for 10-19 years old women because of large risk, the indication must be scrutinized for 20-29 years old ones, and the benefit increases with age for over 30 years old ones so that mammography was positively admitted for the symptomatic women. (author)

  5. The role of a local mammography workshop, considered from the results of reading examinations and associated questionnaires

    International Nuclear Information System (INIS)

    Matsunami, Nobuki; Tatsuta, Masayuki; Nishi, Toshio

    2011-01-01

    The mammography workshop group for the southern Osaka prefectural area (Hannan Mammography Workshop Group) started in April, 2001, and reading examinations have been carried out periodically since the 9th workshop held in April, 2004, in order to promote mammography breast cancer screening and improve quality control. Questionnaire studies were performed in association with the 3rd (December, 2006) and 4th (March, 2008) reading examinations in order to analyze the role of the local workshop. The questionnaires included items inquiring about the examinee's sex, age, institution location, type of occupation, attendance at mammography training courses provided by the Central Committee for Quality Control, the number of attendances at the local workshop, performance of breast cancer screening, experience of recall examinations, and the number of readings performed. In addition, the questions that yielded varied interpretations at reading examinations were carefully checked in order to better manage subsequent workshops. Examinees who had attended the workshops more than 6 times tended to have a high category sensitivity (62.2% at the 3rd reading examination, and 58.9% at the 4th). Test cases that showed a low conformity rate of category judgment were as follows: judgment of typically benign calcifications, distinction between amorphous or indistinct calcifications and pleomorphic or heterogeneous calcifications, judgment of focal asymmetric density (FAD) and architectural distortion. We intend to use these results to improve the quality control of breast cancer screening through our local mammography workshop activity. (author)

  6. Solutions to Improve Educational Management Quality

    OpenAIRE

    Ramezan Jahanian; Masoomeh Motahari

    2013-01-01

    Nowadays, enhancing the quality in educational systems of different countries has gained especial importance and stand. Improving utilizing and increasing the quality in our country’s educational system is felt too. One of the utilizing factors in education system is to improve the educational management quality.In this article, effective factors in educational management quality and one of its improving solutions, thorough management quality, is analyzed.

  7. Improving Tanzanian childbirth service quality.

    Science.gov (United States)

    Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

    2018-04-16

    Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

  8. Improving the quality of life.

    Science.gov (United States)

    Suyono, H

    1993-12-01

    It is encouraging that most developing countries now have population policies, but it is discouraging that some countries have been unable to implement their policies. Therefore, Indonesia believes technical cooperation should be strengthened among developing countries. International cooperation is working in 108 developing countries, but the desired impact has yet to be reached, and the quality of life in many countries is still unacceptable. For example, life expectancy at birth in developing countries is 14-17 years shorter for females and 10-13 years shorter for males as compared to developed countries which have superior health and welfare systems. The speed of population growth is also hindering efforts to help improve living conditions, and the biggest increase in growth will occur in Asia and Africa. This will increase the numbers of poor, hungry, and illiterate in developing countries and will lead to a lack of arable land, deterioration in education, and increase in unsafe sanitation. In order to slow population growth, quality family planning (FP) services must be provided to those who want them. By the year 2000, developed countries and donors should be ready to provide half of the required US$10.5 billion to FP services in developing countries. In Indonesia, population programs and policies have been governed by the National FP Coordinating Board as well as by the State Ministry for Population and the Environment, which was divided into two ministries in 1993 in order to deal with the enormity and seriousness of the two issues.

  9. Why did the breast cancer lymph node status distribution improve in Denmark in the pre-mammography screening period of 1978-1994?

    DEFF Research Database (Denmark)

    Rostgaard, K.; Vaeth, M.; Rootzen, Helle

    2010-01-01

    Background. Danish breast cancer patients diagnosed in 1978-1994 experienced a trend over time towards a more favourable distribution of lymph node status at time of diagnosis, which was not due to mammography screening. We investigated how this trend could be explained by patient characteristics...... at diagnosis: age (biological processes), calendar period (e.g. environmental changes), birth cohort (living conditions over a life time), post-menopausal status (a predictor of less favourable nodal status), and tumour diameter (a marker of detection time). Material and methods. The data set consisted of 22...... using an EM algorithm in order to reduce misclassification. Results and discussion. We found that the improved lymph node status distribution was most likely a period effect due to a combination of earlier detection of clinical tumours, explaining most of the trend in node-positive breast cancer...

  10. Heavy-ion mammography and breast cancer

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Tobias, C.A.; Capp, M.P.; Holley, W.R.; Woodruff, K.H.; Sickles, E.A.

    1980-01-01

    Heavy-ion radiography is a new diagnostic imaging technique developed in our laboratory that produces superior density resolution at low radiation doses. Heavy-ion mammography has now emerged as a low-dose, safe, reliable, noninvasive diagnostic radiological procedure that can quantitate and image very small differences in soft tissue densities in the breast tissues of patients with clinical breast disease. The improved density resolution of heavy-ion mammography over conventional X-ray mammography and breast xerography provides the potential of detecting small breast cancers of less than 1 cm diameter. The radiation dose to the breast from carbon-ion mammorgraphy is about 50 mrad or less, and can potentially be only a fraction of this level. The results of the present clinical trial in progress of heavy-ion mammography in 37 patients, thus far studied, are extremely encouraging, and warrant continued study for application to the early diagnosis of breast cancer in women

  11. Dual-frequency electrical impedance mammography for the diagnosis of non-malignant breast disease

    International Nuclear Information System (INIS)

    Trokhanova, O V; Okhapkin, M B; Korjenevsky, A V

    2008-01-01

    Electrical impedance tomography (EIT) enables one to determine and visualize non-invasively the spatial distribution of the electrical properties of the tissues inside the body, thus providing valuable diagnostic information. The electrical impedance mammography (EIM) system is a specialized EIT system for diagnostics and imaging of the breast. While breast cancer is the main target for any investigation conducted in this area, the diagnosis of non-cancerous diseases is also very important because it opens the way to improve the quality of life for many women and it may also reduce the incidence of breast cancer through effective treatment of mastopathy. This paper presents the main results of a comprehensive examination of 166 women using four methods: multifrequency electrical impedance mammography, ultrasonic investigation, x-ray mammography and puncture biopsy. The objective of the investigation is to estimate the usefulness of multifrequency electrical impedance mammography for diagnosing dyshormonal mammary gland diseases. The results demonstrate the advantages of the multifrequency EIM method. In particular, dual-frequency electrical impedance mammography in contrast with the single-frequency variant enables one not only to diagnose mastopathy, but also allows accurate detection of its cystless form based on observation of the absence of any difference between average conductivity in both phases of the menstrual cycle. Because the cystless form of mastopathy is associated with a higher risk of cancer development, this method allows identification of a higher risk group of patients for more frequent investigations

  12. Mammography image assessment; validity and reliability of current scheme

    International Nuclear Information System (INIS)

    Hill, C.; Robinson, L.

    2015-01-01

    Mammographers currently score their own images according to criteria set out by Regional Quality Assurance. The criteria used are based on the ‘Perfect, Good, Moderate, Inadequate’ (PGMI) marking criteria established by the National Health Service Breast Screening Programme (NHSBSP) in their Quality Assurance Guidelines of 2006 1 . This document discusses the validity and reliability of the current mammography image assessment scheme. Commencing with a critical review of the literature this document sets out to highlight problems with the national approach to the use of marking schemes. The findings suggest that ‘PGMI’ scheme is flawed in terms of reliability and validity and is not universally applied across the UK. There also appear to be differences in schemes used by trainees and qualified mammographers. Initial recommendations are to be made in collaboration with colleagues within the National Health Service Breast Screening Programme (NHSBSP), Higher Education Centres, College of Radiographers and the Royal College of Radiologists in order to identify a mammography image appraisal scheme that is fit for purpose. - Highlights: • Currently no robust evidence based marking tools in use for the assessment of images in mammography. • Is current system valid, reliable and robust? • How can the current image assessment tool be improved? • Should students and qualified mammographers use the same tool? • What marking criteria are available for image assessment?

  13. CAD in breast imaging. Application in mammography and MR mammography

    International Nuclear Information System (INIS)

    Obenauer, S.; Hermann, K.P.

    2012-01-01

    Computer aided diagnosis systems (CAD-systems) are evaluated in different parts of diagnostic imaging. In breast imaging double reading which is time- and cost spending is necessary. Therefore a lot of studies evaluated the use of CAD-systems in mammography. However the rate of false-positives is too high to implement CAD-systems as double reader in routine work. In the future, improvements in this technique could perhaps change the performance of CAD-systems. (orig.)

  14. Computer assisted visualization of digital mammography images

    International Nuclear Information System (INIS)

    Funke, M.; Breiter, N.; Grabbe, E.; Netsch, T.; Biehl, M.; Peitgen, H.O.

    1999-01-01

    Purpose: In a clinical study, the feasibility of using a mammography workstation for the display and interpretation of digital mammography images was evaluated and the results were compared with the corresponding laser film hard copies. Materials and Methods: Digital phosphorous plate radiographs of the entire breast were obtained in 30 patients using a direct magnification mammography system. The images were displayed for interpretation on the computer monitor of a dedicated mammography workstation and also presented as laser film hard copies on a film view box for comparison. The images were evaluted with respect to the image handling, the image quality and the visualization of relevant structures by 3 readers. Results: Handling and contrast of the monitor displayed images were found to be superior compared with the film hard copies. Image noise was found in some cases but did not compromise the interpretation of the monitor images. The visualization of relevant structures was equal with both modalities. Altogether, image interpretation with the mammography workstation was considered to be easy, quick and confident. Conclusions: Computer-assisted visualization and interpretation of digital mammography images using a dedicated workstation can be performed with sufficiently high diagnostic accuracy. (orig.) [de

  15. Mammography and breast sonography in transsexual women

    Energy Technology Data Exchange (ETDEWEB)

    Weyers, S., E-mail: steven.weyers@ugent.b [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Villeirs, G.; Vanherreweghe, E. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Verstraelen, H. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Monstrey, S. [Department of Plastic Surgery, Ghent University Hospital, Ghent (Belgium); Van den Broecke, R.; Gerris, J. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2010-06-15

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  16. Mammography and breast sonography in transsexual women

    International Nuclear Information System (INIS)

    Weyers, S.; Villeirs, G.; Vanherreweghe, E.; Verstraelen, H.; Monstrey, S.; Van den Broecke, R.; Gerris, J.

    2010-01-01

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  17. Quality improvement and emerging global health priorities

    Science.gov (United States)

    Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward

    2018-01-01

    Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793

  18. Digital Mammography Tomosynthesis

    International Nuclear Information System (INIS)

    Gergov, I.; Alexov, G.; Rusonov, K.

    2017-01-01

    Siemens MAMMOMAT Inspiration with Tomosynthesis enhances the diagnostic precision in mammographic screening. The apparatus has a wide-angle tomosynthesis up to 50 degrees. The Siemens breast augmentation algorithm reconstructs multiple two-dimensional breast images into three-dimensional images at the lowest doses to help detect tumors hidden from the overlapping chest tissue, allowing for a more accurate diagnosis than standard 2-dimensional digital mammography, and reducing the number of false positive results. 3D digital tomosynthesis improves the precision of detecting and diagnosing a larger number of expansive lesions, ensures better morphological mass analysis and architectural distortion, and detecting calcifications by adding digital breast tomosynthesis to the traditional two-dimensional digital mammogram of the patient. In this way, it solves the problem of overlapping parenchyma, reduces the number of unnecessary biopsies from questionable sonomammographic findings, and the need for stressful repeating procedures, which usually contributes to both better patient outcomes and cost saving. [bg

  19. Development of test objects for image quality evaluation of digital mammography; Desenvolvimento de objetos de teste para avaliacao da qualidade da imagem em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Vitor Nascimento de Carvalho

    2013-07-01

    Mammography is the image exam called 'gold standard' for early detection of breast cancer. 111 Brazil, more than eight million mammograms are carried out per year. With the advancement of technology, the digital systems CR and DR for this diagnostic modality have been increasingly implemented, replacing the conventional screen-film system, which brought environmental problems, like the disposal of chemical waste, and is also responsible for the rejection of radiographic films with processing artifacts. Digital systems, besides not experiencing the problem of environmental pollution, are still capable of image processing, allowing a much lower rejection rate when compared to the conventional system. Moreover, the determination of an accurate diagnosis is highly dependent on the image quality of the examination. To ensure the reliability of the images produced by these systems, it is necessary to evaluate them on a regular basis. Unfortunately, there is no regulation in Brazil about the Quality Assurance of these systems. The aim of this study was to develop a set of test objects that allow the evaluation of some parameters of image quality of these systems, such as field image uniformity, the linearity between the air Kerma incident on detector and the mean pixel value (MPV) of the image, the spatial resolution of the system through the modulation transfer function (MTF) and also to suggest an object to be applied in the evaluation of contrast-to-noise ratio (CNR) and signal-difference-to-noise ratio (SDNR). In order to test the objects. 10 mammography centers were evaluated, seven with CR systems and three with the DR systems. To evaluate the linearity, besides the test objects high sensitivity dosimeters were necessary to be used, namely LiF:Mg,Cu,P TL dosimeters. The use of these dosimeters was recommended in order to minimize the time required to perform the tests and to decrease the number of exposures needed. For evaluation of digital images in DICOM

  20. Guideline for determining the mean glandular dose according to DIN 6868-162 and threshold contrast visibility according to the quality assurance guideline for digital mammography systems.

    Science.gov (United States)

    Sommer, A; Schopphoven, S; Land, I; Blaser, D; Sobczak, T

    2014-05-01

    As part of the physico-technical quality assurance of the German breast cancer screening program, the threshold contrast visibility and the average glandular dose of every digital mammography system have to fulfill the requirements of the "European guidelines for quality assurance in breast cancer screening and diagnosis" (4th Edition). To accomplish uniform measurements in all federal states of Germany, the physical board of the reference centers developed a special guideline in 2009. Due to recent changes in the guidelines and standards, a second version of the guideline was developed by the reference centers. This guideline describes the determination of the average glandular dose as well as the CDMAM image acquisition and the CDMAM image evaluation. The determination of the threshold contrast visibility can be performed visually or automatically. The determination of the average glandular dose is based on DIN 6868 - 162 and the threshold contrast visibility test is based on the German "Quality Assurance Guideline". © Georg Thieme Verlag KG Stuttgart · New York.

  1. Towards improvement in quality assurance

    International Nuclear Information System (INIS)

    1987-03-01

    This first document in the series of the International Nuclear Safety Advisory Group (INSAG) Technical Notes is a general guideline for the establishment of effective quality assurance procedures at nuclear facilities. It sets out primary requirements such as quality objectives, methods for measuring the effectiveness of the quality assurance programme, priority of activities in relation to importance of safety of items, motivation of personnel

  2. Early experience in the use of quantitative image quality measurements for the quality assurance of full field digital mammography x-ray systems

    International Nuclear Information System (INIS)

    Marshall, N W

    2007-01-01

    Quantitative image quality results in the form of the modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE) are presented for nine full field digital mammography (FFDM) systems. These parameters are routinely measured as part of the quality assurance (QA) programme for the seven FFDM units covered by our centre. Just one additional image is required compared to the standard FFDM protocol; this is the image of an edge, from which the MTF is calculated. A variance image is formed from one of the flood images used to measure the detector response and this provides useful information on the condition of the detector with respect to artefacts. Finally, the NNPS is calculated from the flood image acquired at a target detector air kerma (DAK) of 100 μGy. DQE is then estimated from these data; however, no correction is currently made for effects of detector cover transmission on DQE. The coefficient of variation (cov) of the 50% point of the MTF for five successive MTF results was 1%, while the cov for the 50% MTF point for an a-Se system over a period of 17 months was approximately 3%. For four a-Se based systems, the cov for the NNPS at 1 mm -1 for a target DAK of 100 μGy was approximately 4%; the same result was found for four CsI based FFDM units. With regard to the stability of NNPS over time, the cov for four NNPS results acquired over a period of 12 months was also approximately 4%. The effect of acquisition geometry on NNPS was also assessed for a CsI based system. NNPS data acquired with the antiscatter grid in place showed increased noise at low spatial frequency; this effect was more severe as DAK increased. DQE results for the three detector types (a-Se, CsI and CR) are presented as a function of DAK. Some reduction in DQE was found for both the a-Se and CsI based systems at a target DAK of 12.5 μGy when compared to DQE data acquired at 100 μGy. For the CsI based systems, DQE at 1 mm -1 fell from 0

  3. Evaluation of patient dose in some mammography centres in Iran

    International Nuclear Information System (INIS)

    Paknyat, A.; Samarin, E. R. P.; Jeshvaghane, N. A.; Paydar, R.; Fasaei, B.; Karamloo, A.; Khosravi, H. R.; Deevband, M. R.

    2011-01-01

    High diagnostic sensitivity and specificity while maintaining the least dose to the patient is the ideal mammography. The objective of this work was to evaluate patient dose and image quality of mammograms to propose corrective actions. The image quality for 1242 patient in 7 mammography facilities in Tehran city was evaluated based on selected image quality criteria using a three-point scale. Clinical image quality, the entrance surface air kerma, the average glandular dose and optical density of films for standard PMMA phantom of 4.5 cm thickness were evaluated. The results showed that up to 72 % of mammograms were in good condition to be diagnosed, and only about 3.4 % of the images were unacceptable or with suboptimal quality. The entrance surface air kerma values were in the range of 3.8-10.5 mGy, average glandular dose 0.5-1.8 mGy and optical density of films 0.74-2.03. The image quality evaluation after correction actions, periodic image quality evaluation and using the correct equipment certainly will improve patient dose. (authors)

  4. Establishment of qualities mammography according to the standard IEC-61267 in the laboratory of metrology of ionizing radiation of the National Center of Dosimetry and enlargement of the accreditation by ENAC

    International Nuclear Information System (INIS)

    Roig Petit, F.; Mestre de Juan, V.; Alabau Albors, J.; Palma Copete, J.; Ruiz Rodriguez, J. C.; Pons Mocholi, S.

    2013-01-01

    The extension of the accreditation of the laboratory of the National Center Dosimetry (No. 58/LC10.036) by the national accreditation entity (ENAC), according to the ISO 17025 standard [2], for the standard qualities of mammography by the IEC 61267 comes to meet part of the needs that demand our health care environment in terms of radiation measuring instruments calibration. This work intends to publicize this enlargement commenting on the different phases of the process to get the accreditation. (Author)

  5. A Standard Mammography Unit - Standard 3D Ultrasound Probe Fusion Prototype: First Results.

    Science.gov (United States)

    Schulz-Wendtland, Rüdiger; Jud, Sebastian M; Fasching, Peter A; Hartmann, Arndt; Radicke, Marcus; Rauh, Claudia; Uder, Michael; Wunderle, Marius; Gass, Paul; Langemann, Hanna; Beckmann, Matthias W; Emons, Julius

    2017-06-01

    The combination of different imaging modalities through the use of fusion devices promises significant diagnostic improvement for breast pathology. The aim of this study was to evaluate image quality and clinical feasibility of a prototype fusion device (fusion prototype) constructed from a standard tomosynthesis mammography unit and a standard 3D ultrasound probe using a new method of breast compression. Imaging was performed on 5 mastectomy specimens from patients with confirmed DCIS or invasive carcinoma (BI-RADS ™ 6). For the preclinical fusion prototype an ABVS system ultrasound probe from an Acuson S2000 was integrated into a MAMMOMAT Inspiration (both Siemens Healthcare Ltd) and, with the aid of a newly developed compression plate, digital mammogram and automated 3D ultrasound images were obtained. The quality of digital mammogram images produced by the fusion prototype was comparable to those produced using conventional compression. The newly developed compression plate did not influence the applied x-ray dose. The method was not more labour intensive or time-consuming than conventional mammography. From the technical perspective, fusion of the two modalities was achievable. In this study, using only a few mastectomy specimens, the fusion of an automated 3D ultrasound machine with a standard mammography unit delivered images of comparable quality to conventional mammography. The device allows simultaneous ultrasound - the second important imaging modality in complementary breast diagnostics - without increasing examination time or requiring additional staff.

  6. Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

    Science.gov (United States)

    Helge Østerås, Bjørn; Skaane, Per; Gullien, Randi; Catrine Trægde Martinsen, Anne

    2018-02-01

    The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra™). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra™. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

  7. Voltage Quality Improvement Using Solar Photovoltaic Systems

    Directory of Open Access Journals (Sweden)

    Denisa Galzina

    2015-06-01

    This paper briefly shows the methods of power quality improvement, and then the results of on-site power quality measurements in the grid before and after the connection of the solar photovoltaic system.

  8. San Francisco Bay Water Quality Improvement Fund

    Science.gov (United States)

    EPAs grant program to protect and restore San Francisco Bay. The San Francisco Bay Water Quality Improvement Fund (SFBWQIF) has invested in 58 projects along with 70 partners contributing to restore wetlands, water quality, and reduce polluted runoff.,

  9. Does quality improvement work in neonatology improve clinical outcomes?

    Science.gov (United States)

    Ellsbury, Dan L; Clark, Reese H

    2017-04-01

    Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants. Declines in morbidities, resource use, and length of stay have been associated with reductions in healthcare costs. Recent quality improvement work has shown evidence of improvement in clinical outcomes in neonatal intensive care patients. These improvements have important implications for the reduction of healthcare costs in this population.

  10. Mammography image quality and evidence based practice: Analysis of the demonstration of the inframammary angle in the digital setting.

    Science.gov (United States)

    Spuur, Kelly; Webb, Jodi; Poulos, Ann; Nielsen, Sharon; Robinson, Wayne

    2018-03-01

    The aim of this study is to determine the clinical rates of the demonstration of the inframammary angle (IMA) on the mediolateral oblique (MLO) view of the breast on digital mammograms and to compare the outcomes with current accreditation standards for compliance. Relationships between the IMA, age, the posterior nipple line (PNL) and compressed breast thickness will be identified and the study outcomes validated using appropriate analyses of inter-reader and inter-rater reliability and variability. Differences in left versus right data were also investigated. A quantitative retrospective study of 2270 randomly selected paired digital mammograms performed by BreastScreen NSW was undertaken. Data was collected by direct measurement and visual analysis. Intra-class correlation analyses were used to evaluate inter- and intra-rater reliability. The IMA was demonstrated on 52.4% of individual and 42.6% of paired mammograms. A linear relationship was found between the posterior nipple line (PNL) and age (p-value PNL was predicted to increase by 0.48 mm for every one year increment in age. The odds of demonstrating the IMA reduced by 2% for every one year increase in age (p-value = 0.001); are 0.4% higher for every 1 mm increase in PNL (p-value = 0.001) and 1.6% lower for every 1 mm increase in compressed breast thickness, (p-valuePNL while there was 100% agreement for the demonstration of the IMA. Analysis of the demonstration of the IMA indicates clinically achievable rates (42.6%) well below that required for compliance (50%-75%) to known worldwide accreditation standards for screening mammography. These standards should be aligned to the reported evidence base. Visualisation of the IMA is impacted negatively by increasing age and compressed breast thickness but positively by breast size (PNL). Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Patterns and determinants of mammography screening in Lebanese women

    Directory of Open Access Journals (Sweden)

    Nadia Elias

    2017-03-01

    Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.

  12. A comparison of the accuracy of film-screen mammography, full-field digital mammography, and digital breast tomosynthesis

    International Nuclear Information System (INIS)

    Michell, M.J.; Iqbal, A.; Wasan, R.K.; Evans, D.R.; Peacock, C.; Lawinski, C.P.; Douiri, A.; Wilson, R.; Whelehan, P.

    2012-01-01

    Aim: To measure the change in diagnostic accuracy of conventional film-screen mammography and full-field digital mammography (FFDM) with the addition of digital breast tomosynthesis (DBT) in women recalled for assessment following routine screening. Materials and methods: Ethics approval for the study was granted. Women recalled for assessment following routine screening with screen-film mammography were invited to participate. Participants underwent bilateral, two-view FFDM and two-view DBT. Readers scored each lesion separately for probability of malignancy on screen-film mammography, FFDM, and then DBT. The scores were compared with the presence or absence of malignancy based on the final histopathology outcome. Results: Seven hundred and thirty-eight women participated (93.2% recruitment rate). Following assessment 204 (26.8%) were diagnosed as malignant (147 invasive and 57 in-situ tumours), 286 (37.68%) as benign, and 269 (35.4%) as normal. The diagnostic accuracy was evaluated by using receiving operating characteristic (ROC) and measurement of area under the curve (AUC). The AUC values demonstrated a significant (p = 0.0001) improvement in the diagnostic accuracy with the addition of DBT combined with FFDM and film-screen mammography (AUC = 0.9671) when compared to FFDM plus film-screen mammography (AUC = 0.8949) and film-screen mammography alone (AUC = 0.7882). The effect was significantly greater for soft-tissue lesions [AUC was 0.9905 with the addition of DBT and AUC was 0.9201 for FFDM with film-screen mammography combined (p = 0.0001)] compared to microcalcification [with the addition of DBT (AUC = 0.7920) and for FFDM with film-screen mammography combined (AUC = 0.7843; p = 0.3182)]. Conclusion: The addition of DBT increases the accuracy of mammography compared to FFDM and film-screen mammography combined and film-screen mammography alone in the assessment of screen-detected soft-tissue mammographic abnormalities.

  13. How to Begin a Quality Improvement Project.

    Science.gov (United States)

    Silver, Samuel A; Harel, Ziv; McQuillan, Rory; Weizman, Adam V; Thomas, Alison; Chertow, Glenn M; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T

    2016-05-06

    Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Copyright © 2016 by the American

  14. Digital mammography; Mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Chevalier, M.; Torres, R.

    2010-07-01

    Mammography represents one of the most demanding radiographic applications, simultaneously requiring excellent contrast sensitivity, high spatial resolution, and wide dynamic range. Film/screen is the most widely extended image receptor in mammography due to both its high spatial resolution and contrast. The film/screen limitations are related with its narrow latitude, structural noise and that is at the same time the medium for the image acquisition, storage and presentation. Several digital detector made with different technologies can overcome these difficulties. Here, these technologies as well as their main advantages and disadvantages are analyzed. Also it is discussed its impact on the mammography examinations, mainly on the breast screening programs. (Author).

  15. Do Clinical Practice Guidelines Improve Quality?

    Science.gov (United States)

    Baldassari, Cristina M

    2017-07-01

    Controversy exists surrounding how to best define and assess quality in the health care setting. Clinical practice guidelines (CPGs) have been developed to improve the quality of medical care by highlighting key clinical recommendations based on recent evidence. However, data linking CPGs to improvements in outcomes in otolaryngology are lacking. Numerous barriers contribute to difficulties in translating CPGs to improvements in quality. Future initiatives are needed to improve CPG adherence and define the impact of CPG recommendations on the quality of otolaryngologic care provided to our patients.

  16. Implantation of radiation qualities for mammography in accordance with the IEC 61627 and TRS 457 criteria; Implantacao das qualidades de radiacao para mamografia, segundo os criterios da IEC 61627 e do TRS 457

    Energy Technology Data Exchange (ETDEWEB)

    Pires, Evandro J.; David, Mariano G.; Almeida, Carlos Eduardo de, E-mail: pires@lcr.uerj.b [Universidade do Estado do Rio de Janeiro (LCR/UERJ), RJ (Brazil). Lab de Ciencias Radiologicas; Peixoto, J. Guilherme, E-mail: guilhem@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    In this work it is discussed the technical conditions of the implantation of radiation qualities adequate for dosemeter applied to mammography at the Radiological Science Laboratory (RSL) of the University of State of Rio de Janeiro, Brazil. It performed tests for evaluation the homogeneity of the radiation field, the scattering, the half-layers and the system stability. The test results point for adequacy of the laboratory installed at the LCR for calibration of the mentioned dosemeters in seven qualities of radiation and the expanded uncertainty with better capacity of measurement at those qualities was of {+-}1.8% (k = 2)

  17. Mammography and radiation risk; Mammographie und Strahlenrisiko

    Energy Technology Data Exchange (ETDEWEB)

    Jung, H. [Hamburg Univ. (Germany). Inst. fuer Biophysik und Strahlenbiologie

    1998-10-01

    Breast cancer is the most frequent malignant neoplasia among women in Germany. The use of mammography as the most relevant diagnostic procedure has increased rapidly over the last decade. Radiation risks associated with mammography may be estimated from the results of numerous epidemiological studies providing risk coefficients for breast cancer in relation to age at exposure. Various calculations can be performed using the risk coefficients. For instance, a single mammography examination (bilateral, two views of each breast) of a women aged 45 may enhance the risk of developing breast cancer during her lifetime numerically from about 12% of 12.0036%. This increase in risk is lower by a factor of 3,300 as compared to the risk of developing breast cancer in the absence of radiation exposure. At the age of 40 or more, the benefit of mammography exceeds the radiation risk by a factor of about 100. At higher ages this factor increases further. Finally, the dualism of individual risk and collective risk is considered. It is shown that the individual risk of a patient, even after multiple mammography examinations, is vanishingly small. Nevertheless, the basic principle of minimising radiation exposure must be followed to keep the collective risk in the total population as low as reasonably achievable. (orig.) [Deutsch] Das Mammakarzinom ist in Deutschland die haeufigste Krebserkrankung der Frau, und entsprechend oft wird die Mammographie als das derzeit wichtigste Diagnoseverfahren eingesetzt. Zur Beurteilung des mit einer mammographischen Untersuchung verbundenen Strahlenrisikos liegen die Resultate einer groesseren Anzahl strahlenepidemiologischer Studien vor. Diese liefern den Risikokoeffizienten fuer Brustkrebs in Abhaengigkeit vom Lebensalter bei Strahlenexposition und ermoeglichen somit die Berechnung des altersabhaengigen Strahlenrisikos. Beispielsweise wird durch eine einmalige Mammographie-Untersuchung (bilateral, je zwei Aufnahmen in zwei Ebenen) bei einer 45

  18. Rayleigh imaging in spectral mammography

    Science.gov (United States)

    Berggren, Karl; Danielsson, Mats; Fredenberg, Erik

    2016-03-01

    Spectral imaging is the acquisition of multiple images of an object at different energy spectra. In mammography, dual-energy imaging (spectral imaging with two energy levels) has been investigated for several applications, in particular material decomposition, which allows for quantitative analysis of breast composition and quantitative contrast-enhanced imaging. Material decomposition with dual-energy imaging is based on the assumption that there are two dominant photon interaction effects that determine linear attenuation: the photoelectric effect and Compton scattering. This assumption limits the number of basis materials, i.e. the number of materials that are possible to differentiate between, to two. However, Rayleigh scattering may account for more than 10% of the linear attenuation in the mammography energy range. In this work, we show that a modified version of a scanning multi-slit spectral photon-counting mammography system is able to acquire three images at different spectra and can be used for triple-energy imaging. We further show that triple-energy imaging in combination with the efficient scatter rejection of the system enables measurement of Rayleigh scattering, which adds an additional energy dependency to the linear attenuation and enables material decomposition with three basis materials. Three available basis materials have the potential to improve virtually all applications of spectral imaging.

  19. Software process improvement, quality assurance and measurement

    NARCIS (Netherlands)

    Trienekens, J.J.M.; Kusters, R.J.; Balla, K.; Kontogiannis, K.; Zou, Y.; Di Penta, M.

    2006-01-01

    The aim of this workshop was to present and discuss emergent software quality improvement approaches, with an emphasis on practical applications. Different views on the improvement of software processes, software products, and their interrelations, have been addressed during the workshop.

  20. Physical Activity Improves Quality of Life

    Science.gov (United States)

    ... It Works Healthy Workplace Food and Beverage Toolkit Physical activity improves quality of life Updated:Mar 2,2015 ... proven to improve both mental and physical health. Physical activity boosts mental wellness. Regular physical activity can relieve ...

  1. Clinical experience of photon counting breast tomosynthesis: comparison with traditional mammography

    International Nuclear Information System (INIS)

    Svane, Gunilla; Azavedo, Edward; Lindman, Karin; Urech, Mattias; Nilsson, Jonas; Weber, Niclas; Lindqvist, Lars; Ullberg, Christer

    2011-01-01

    Background: In two-dimensional mammography, a well-known problem is over- and underlying tissue which can either obstruct a lesion or create a false-positive result. Tomosynthesis, with an ability to layer the tissue in the image, has the potential to resolve these issues. Purpose: To compare the diagnostic quality, sensitivity and specificity of a single tomosynthesis mammography image and a traditional two-view set of two-dimensional mammograms and to assess the comfort of the two techniques. Material and Methods: One hundred and forty-four women, mainly chosen because of suspicious features on standard mammograms (76 malignant), had a single tomosynthesis image taken of one breast using a novel photon counting system. On average, the dose of the tomosynthesis images was 0.63 times that of the two-view images and the compression force during the procedure was halved. The resulting images were viewed by two radiologists and assessed both individually and comparing the two techniques. Results: In 56% of the cases the radiologists rated the diagnostic quality of the lesion details higher in the tomosynthesis images than in the conventional images (and in 91% equal or higher), which means there is a statistically significant preference for the tomosynthesis technique. This included the calcifications which were rated as having better quality in 41% of the cases. While sensitivity was slightly higher for traditional mammography the specificity was higher for tomosynthesis. However, neither of these two differences was large enough to be statistically significant. Conclusion: The overall accuracy of the two techniques was virtually equal despite the radiologist's very limited experience with tomosynthesis images and vast experience with two-dimensional mammography. As the diagnostic quality of the lesion details in the tomosynthesis images was valued considerably higher this factor should improve with experience. The patients also favored the tomosynthesis examination

  2. Mammography manual for the daily routine. A technical, practical and quality guide for radiologists, gynaecologists and radiographers

    International Nuclear Information System (INIS)

    Roth-Ganter, G.; Fischer, U.

    2002-01-01

    Gudrun Roth-Ganther presents in this book a wealth of professional experience that she has been accumulating over many years as a radiographer tutor at home and abroad. Step by step the reader will learn how to make high-quality mammographs. Important aspects: the normal radiographic anatomy of the mamma, factors influencing the image quality, technical parameters, exposure techniques, approaches for quality assessment and quality assurance, detecting and avoiding mistakes. (orig./CB) [de

  3. [Quality assurance and quality improvement. Personal experiences and intentions].

    Science.gov (United States)

    Roche, B G; Sommer, C

    1995-01-01

    In may 1994 we were selected by the surgical Swiss association to make a study about quality in USA. During our travel we visited 3 types of institutions: Hospitals, National Institute of standard and Technology, Industry, Johnson & Johnson. We appreciate to compare 2 types of quality programs: Quality Assurance (QA) and Continuous Quality Improvement (CQI). In traditional healthcare circles, QA is the process established to meet external regulatory requirements and to assure that patient care is consistent with established standards. In a modern quality terms, QA outside of healthcare means designing a product or service, as well as controlling its production, so well that quality is inevitable. The ideas of W. Edward Deming is that there is never improvement just by inspection. He developed a theory based on 14 principles. A productive work is accomplished through processes. Understanding the variability of processes is a key to improve quality. Quality management sees each person in an organisation as part of one or more processes. The job of every worker is to receive the work of others, add value to that work, and supply it to the next person in the process. This is called the triple role the workers as customer, processor, and supplier. The main source of quality defects is problems in the process. The old assumption is that quality fails when people do the right thing wrong; the new assumption is that, more often, quality failures arise when people do the wrong think right. Exhortation, incentives and discipline of workers are unlikely to improve quality. If quality is failing when people do their jobs as designed, then exhorting them to do better is managerial nonsense. Modern quality theory is customer focused. Customers are identified internally and externally. The modern approach to quality is thoroughly grounded in scientific and statistical thinking. Like in medicine, the symptom is a defect in quality. The therapist of process must perform diagnostic

  4. Studies on the calibration of mammography automatic exposure mode with computed radiology

    International Nuclear Information System (INIS)

    Zhu Hongzhou; Shao Guoliang; Shi Lei; Liu Qing

    2010-01-01

    Objective: To realize the optimization of image quality and radiation dose by correcting mammography automatic exposure, according to automatic exposure controlled mode of mammography film-screen system. Methods: The film-screen system (28 kV) was applied to perform automatic exposure of plexiglass (40 mm) and get the standard dose of exposure, the exposure mode of CR base on LgM=2.0 was rectified, which was divided into 10 steps. Mammary glands pattern (Fluke NA18-220) were examined with CR (26, 28, and 30 kV) by the automatic exposure mode corrected. The exposure values (mAs) were recorded. CR image was diagnosed and evaluated in double blind way by 4 radiologists according to American Collage of Radiology (ACR) standard. Results: Based on the standard of CR automatic exposure with the dose higher than the traditional exposure of film-screen system, the calibration of mammography automatic exposure was accomplished. The test results of the calibrated mode was better than the scoring system of ACR. Conclusions: Comparative study showed improvement in acquiring high-quality image and reduction of radiation dose. The corrected mammography automatic exposure mode might be a better method for clinical use. (authors)

  5. "Rheum to Improve": Quality Improvement in Outpatient Rheumatology.

    Science.gov (United States)

    Chow, Shirley L; Shojania, Kaveh G

    2017-09-01

    The commitment to improve care processes and patient outcomes is a professional mandate for clinicians and is also seen as an operational priority for institutions. Quality improvement now figures in the accreditation of training programs, specialty examinations, and hospital scorecards. Rheumatologists have traditionally focused primarily on quality problems such as guideline adherence; however, improvement goals should also include other aspects of care that are helpful to patients and are professionally rewarding for practitioners. This review makes use of improvement projects in outlining tangible tools rheumatologists can use to resolve quality concerns in their practices.

  6. Nationwide quality improvement in lung cancer care

    DEFF Research Database (Denmark)

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell

    2013-01-01

    To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry...... was opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators....

  7. Practical Approaches to Quality Improvement for Radiologists.

    Science.gov (United States)

    Kelly, Aine Marie; Cronin, Paul

    2015-10-01

    Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

  8. Mammography practices for radiation protection in Kenya

    International Nuclear Information System (INIS)

    Shadrack, Anthony K.

    2008-01-01

    All mammography units in the country, totaling fourteen in number at the time, were evaluated on the basis of performance and practice to come up with useful data for summing up the mammography practice in Kenya. The study was carried out by performing hands-on quality control tests on the units using internationally established protocols. Image quality and dose measurement data were generated in all the centers and clearly indicated that the practice of mammography, more so on optimization viewpoint is so much varied. A standard method was used to obtain these data by use of mammography accreditation phantom. Data from actual patients was also collected in three major centers in Nairobi. On the criteria used for evaluating phantom image quality, ten out of fourteen units did satisfy the set criterion. The average glandular dose was 2.79 mGy per cranio caudal (cc) view of the phantom and 3.27 mGy per cc view for the sampled patients. The internationally recommended dose level for such a view is 3.0 mGy. One worrying observation made was that most units failed on one of the easiest test of mammographic unit assembly. Of most concern was the lack of technique charts for the practice detailing the imaging parameters being employed for the procedure. Most centers do not take the servicing of equipment seriously and others merely ignore even the crucial issues of equipment performance like the automatic exposure control and viewing conditions of the reporting areas.The results of this study calls for the setting up of a programme of optimization of radiological protection in mammography using the experience of other countries that have put in place quality assurance programs, setting and adoption of Dose Reference Levels (DRLs) as part of Quality Assurance (QA). This practice needs an effective quality control program which should start with the selection of appropriate equipment for mammography and the use of qualified personnel including the radiologist, radiographer

  9. Structured data quality reports to improve EHR data quality.

    Science.gov (United States)

    Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

    2015-12-01

    To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (pImprovement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Improving Quality in Colorectal Surgery

    NARCIS (Netherlands)

    J.C. Slieker (Juliette)

    2014-01-01

    markdownabstract__Abstract__ Colorectal surgery is an important aspect of our current health system, due to the high incidence of colorectal cancer combined with an ageing population, improved long-term outcomes after colorectal surgery, and the perfectioning of the operative and postoperative

  11. Technological measures to improve automotive product quality

    OpenAIRE

    Gladkov, V.; Kruglov, S.

    2010-01-01

    The paper examines the basic technological measures aimed at improving product quality in automotive industry. While paying due attention to solving organizational and technological problems, including the development of certification systems for production processes, it is also necessary to improve the technical standards of specific technologies, equipment and materials as they largely determine product quality. Special emphasis is given to the importance of improving the production of auto...

  12. Does competition improve health care quality?

    Science.gov (United States)

    Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton; Chernew, Michael

    2008-12-01

    To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey(R) (CAHPS) data (calendar years 1998-2002). All plans submitting data to the National Committee for Quality Assurance (NCQA) were included regardless of their decision to allow NCQA to disclose their results publicly. NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Fixed-effects models were estimated that relate HMO competition to HMO quality controlling for an unmeasured, time-invariant plan, and market traits. Results are compared with estimates from models reliant on cross-sectional variation. Estimates suggest that plan quality does not improve with increased levels of HMO competition (as measured by either the Herfindahl index or the number of HMOs). Similarly, increased HMO penetration is generally not associated with improved quality. Cross-sectional models tend to suggest an inverse relationship between competition and quality. The strategies that promote competition among HMOs in the current market setting may not lead to improved HMO quality. It is possible that price competition dominates, with purchasers and consumers preferring lower premiums at the expense of improved quality, as measured by HEDIS and CAHPS. It is also possible that the fragmentation associated with competition hinders quality improvement.

  13. Quality improvement through multiple response optimization

    International Nuclear Information System (INIS)

    Noorossana, R.; Alemzad, H.

    2003-01-01

    The performance of a product is often evaluated by several quality characteristics. Optimizing the manufacturing process with respect to only one quality characteristic will not always lead to the optimum values for other characteristics. Hence, it would be desirable to improve the overall quality of a product by improving quality characteristics, which are considered to be important. The problem consists of optimizing several responses using multiple objective decision making approach and design of experiments. A case study will be discussed to show the application of the proposal method

  14. Mammography - recent technical developments and their clinical potential

    Energy Technology Data Exchange (ETDEWEB)

    Hemdal, Bengt; Mattsson, Soeren [Malmoe Univ. Hospital (Sweden). Dept. of Radiation Physics; Andersson, Ingvar [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Thilander Klang, Anne [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Medical Physics and Biomedical Engineering; Bengtsson, Gert; Jarlman, O. [Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Leitz, Wolfram [Swedish Radiation Protection Authority, Stockholm (Sweden); Bjurstam, Nils [Univ. of North Norway, Troms (Norway). Dept. of Radiology

    2002-05-01

    The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

  15. Mammography - recent technical developments and their clinical potential

    International Nuclear Information System (INIS)

    Hemdal, Bengt; Mattsson, Soeren; Bjurstam, Nils

    2002-05-01

    The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

  16. The impact of leadership qualities on quality management improvement

    Directory of Open Access Journals (Sweden)

    Ph. D. Radoslaw Wolniak

    2011-05-01

    Full Text Available Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the following publication presents the analysis of the dependence between leadership qualities of managers and the improvement of quality management. There has been an attempt to define the qualities, which a manager being responsible for quality management, should have.

  17. The impact of leadership qualities on quality management improvement

    Directory of Open Access Journals (Sweden)

    Radoslaw Wolniak

    2011-12-01

    Full Text Available Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the following publication presents the analysis of the dependence between leadership qualities of managers and the improvement of quality management. There has been an attempt to define the qualities, which a manager being responsible for quality management, should have.

  18. Eighteen cases of small breast cancer: a comparative study of mammography, CT scan and pathology

    International Nuclear Information System (INIS)

    Wu Yaopan; Lin Haogao; Cai Peiqiang; Ouyang Yi; Zhang Weizhang; Lu Bingui

    2003-01-01

    Objective: To improve the early diagnosis of breast cancer through a study of the mammography and CT findings of small breast cancer. Methods: The mammography and CT findings of 18 cases of small breast cancer (φ≤2.0 cm in diameter) were studied and compared with pathological results. Results: The diagnostic accuracy of CT and mammography was 83% and 61%, respectively. There was a statistical difference between both modalities (P<0.05), CT scan was superior to mammography. However, there was no difference between them when assessing the lesion arising in F-type breast. In detecting breast fine cluster of calcification, the sensitivity of mammography was better than CT scan. Conclusion: The patient suspected of small breast cancer should take mammography as the first evaluation. CT scan is reserved for the further investigation. The mammography combined with CT scan can improve the early diagnostic rate of breast cancer

  19. Power theories for improved power quality

    CERN Document Server

    Pasko, Marian

    2012-01-01

    Power quality describes a set of parameters of electric power and the load’s ability to function properly under specific conditions. It is estimated that problems relating to power quality costs the European industry hundreds of billions of Euros annually. In contrast, financing for the prevention of these problems amount to fragments of these costs. Power Theories for Improved Power Quality addresses this imbalance by presenting and assessing a range of methods and problems related to improving the quality of electric power supply. Focusing particularly on active compensators and the DSP based control algorithms, Power Theories for Improved Power Quality introduces the fundamental problems of electrical power. This introduction is followed by chapters which discuss: •‘Power theories’ including their historical development and application to practical problems, •operational principles of active compensator’s DSP control based algorithms using examples and results from laboratory research, and •t...

  20. Quality Improvement Initiatives in Inflammatory Bowel Disease.

    Science.gov (United States)

    Berry, Sameer K; Siegel, Corey A; Melmed, Gil Y

    2017-08-01

    This article serves as an overview of several quality improvement initiatives in inflammatory bowel disease (IBD). IBD is associated with significant variation in care, suggesting poor quality of care. There have been several efforts to improve the quality of care for patients with IBD. Quality improvement (QI) initiatives in IBD are intended to be patient-centric, improve outcomes for individuals and populations, and reduce costs-all consistent with "the triple aim" put forth by the Institute for Healthcare Improvement (IHI). Current QI initiatives include the development of quality measure sets to standardize processes and outcomes, learning health systems to foster collaborative improvement, and patient-centered medical homes specific to patients with IBD in shared risk models of care. Some of these programs have demonstrated early success in improving patient outcomes, reducing costs, improving patient satisfaction, and facilitating patient engagement. However, further studies are needed to evaluate and compare the effects of these programs over time on clinical outcomes in order to demonstrate long-term value and sustainability.

  1. Formalising medical quality indicators to improve guidelines

    NARCIS (Netherlands)

    Van Gendt, Marjolein; Ten Teije, Annette; Serban, Radu; Van Harmelen, Frank

    2005-01-01

    Medical guidelines can significantly improve quality of medical care and reduce costs. But how do we get sound and well-structured guidelines? This paper investigates the use of quality indicators that are formulated by medical institutions to evaluate medical care. The main research questions are

  2. Teaching atlas of mammography

    International Nuclear Information System (INIS)

    Tabar, L.; Dean, P.B.

    1985-01-01

    The illustrated case reports in this teaching atlas cover practically the entire range of possible pathological changes and are based on in-patient case material and 80,000 screening documents. The two basic approaches, - detection and analysis of changes -, are taught comprehensively and in great detail. A systematic procedure for analysing the mammographies, in order to detect even the very least changes, and its practical application is explained using mammographies showing unclear findings at first sight. A system of coordinates is presented which allows precise localisation of the changes. Exercises for practising the technique of identifying the pathological changes round up the methodolical chapters. Additional imaging technical enhancements and detail enlargements are of great help in interpreting the findings. The specific approach adopted for this teaching atlas is a 'reverse procedure', which leaves the beaten track and starts with analysing the mammographies and evaluating the radiographic findings, in order to finally derive the diagnosis. (orig./CB) [de

  3. Contrast to Noise Ratio and Contrast Detail Analysis in Mammography:A Monte Carlo Study

    International Nuclear Information System (INIS)

    Metaxas, V; Delis, H; Panayiotakis, G; Kalogeropoulou, C; Zampakis, P

    2015-01-01

    The mammographic spectrum is one of the major factors affecting image quality in mammography. In this study, a Monte Carlo (MC) simulation model was used to evaluate image quality characteristics of various mammographic spectra. The anode/filter combinations evaluated, were those traditionally used in mammography, for tube voltages between 26 and 30 kVp. The imaging performance was investigated in terms of Contrast to Noise Ratio (CNR) and Contrast Detail (CD) analysis, by involving human observers, utilizing a mathematical CD phantom. Soft spectra provided the best characteristics in terms of both CNR and CD scores, while tube voltage had a limited effect. W-anode spectra filtered with k-edge filters demonstrated an improved performance, that sometimes was better compared to softer x-ray spectra, produced by Mo or Rh anode. Regarding the filter material, k-edge filters showed superior performance compared to Al filters. (paper)

  4. Improving embryo quality in assisted reproduction

    NARCIS (Netherlands)

    Mantikou, E.

    2013-01-01

    The goal of this thesis was to improve embryo quality in assisted reproductive technologies by gaining more insight into human preimplantation embryo development and by improving in vitro culture conditions. To do so, we investigated an intriguing feature of the human preimplantation embryo, i.e.

  5. Quality measurement and improvement in liver transplantation.

    Science.gov (United States)

    Mathur, Amit K; Talwalkar, Jayant

    2018-06-01

    There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  6. Why did the breast cancer lymph node status distribution improve in Denmark in the pre-mammography screening period of 1978-1994?

    International Nuclear Information System (INIS)

    Rostgaard, Klaus; Lynge, Elsebeth; Vaeth, Michael; Rootzen, Helle

    2010-01-01

    Background. Danish breast cancer patients diagnosed in 1978-1994 experienced a trend over time towards a more favourable distribution of lymph node status at time of diagnosis, which was not due to mammography screening. We investigated how this trend could be explained by patient characteristics at diagnosis: age (biological processes), calendar period (e.g. environmental changes), birth cohort (living conditions over a life time), post-menopausal status (a predictor of less favourable nodal status), and tumour diameter (a marker of detection time). Material and methods. The data set consisted of 22 955 patients aged 30-69 years at time of diagnosis with known lymph node status, known tumour diameter, known menopausal status, and clinically detected tumours, available from the Danish Breast Cancer Cooperative Group (DBCG). Age, period, cohort, menopausal status, and tumour diameter were used as predictors in generalised linear models with either node-positive status (at least one of the excised lymph nodes being tumour-positive) or severely node-positive status (at least half of the excised lymph nodes being tumour-positive) as outcomes. Lymph node status was assessed both empirically and estimated using an EM algorithm in order to reduce misclassification. Results and discussion. We found that the improved lymph node status distribution was most likely a period effect due to a combination of earlier detection of clinical tumours, explaining most of the trend in node-positive breast cancer and half of the trend in severely node-positive breast cancer, and some unknown factor affecting lymph node status but not necessarily other tumour characteristics

  7. Potential Cost Savings of Contrast-Enhanced Digital Mammography.

    Science.gov (United States)

    Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

    2017-06-01

    The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

  8. Improving patient safety through quality assurance.

    Science.gov (United States)

    Raab, Stephen S

    2006-05-01

    Anatomic pathology laboratories use several quality assurance tools to detect errors and to improve patient safety. To review some of the anatomic pathology laboratory patient safety quality assurance practices. Different standards and measures in anatomic pathology quality assurance and patient safety were reviewed. Frequency of anatomic pathology laboratory error, variability in the use of specific quality assurance practices, and use of data for error reduction initiatives. Anatomic pathology error frequencies vary according to the detection method used. Based on secondary review, a College of American Pathologists Q-Probes study showed that the mean laboratory error frequency was 6.7%. A College of American Pathologists Q-Tracks study measuring frozen section discrepancy found that laboratories improved the longer they monitored and shared data. There is a lack of standardization across laboratories even for governmentally mandated quality assurance practices, such as cytologic-histologic correlation. The National Institutes of Health funded a consortium of laboratories to benchmark laboratory error frequencies, perform root cause analysis, and design error reduction initiatives, using quality assurance data. Based on the cytologic-histologic correlation process, these laboratories found an aggregate nongynecologic error frequency of 10.8%. Based on gynecologic error data, the laboratory at my institution used Toyota production system processes to lower gynecologic error frequencies and to improve Papanicolaou test metrics. Laboratory quality assurance practices have been used to track error rates, and laboratories are starting to use these data for error reduction initiatives.

  9. Improving PSA quality of KSNP PSA model

    International Nuclear Information System (INIS)

    Yang, Joon Eon; Ha, Jae Joo

    2004-01-01

    In the RIR (Risk-informed Regulation), PSA (Probabilistic Safety Assessment) plays a major role because it provides overall risk insights for the regulatory body and utility. Therefore, the scope, the level of details and the technical adequacy of PSA, i.e. the quality of PSA is to be ensured for the successful RIR. To improve the quality of Korean PSA, we evaluate the quality of the KSNP (Korean Standard Nuclear Power Plant) internal full-power PSA model based on the 'ASME PRA Standard' and the 'NEI PRA Peer Review Process Guidance.' As a working group, PSA experts of the regulatory body and industry also participated in the evaluation process. It is finally judged that the overall quality of the KSNP PSA is between the ASME Standard Capability Category I and II. We also derive some items to be improved for upgrading the quality of the PSA up to the ASME Standard Capability Category II. In this paper, we show the result of quality evaluation, and the activities to improve the quality of the KSNP PSA model

  10. [QUIPS: quality improvement in postoperative pain management].

    Science.gov (United States)

    Meissner, Winfried

    2011-01-01

    Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. Outcome improved in four of the six hospitals. Process indicators, such as routine pain documentation, were only poorly correlated with outcomes. To date, more than 130 German hospitals use QUIPS as a routine quality management tool. An EC-funded parallel project disseminates the concept internationally. QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine. Copyright © 2011. Published by Elsevier GmbH.

  11. Laboratory quality improvement in Thailand's northernmost provinces.

    Science.gov (United States)

    Kanitvittaya, S; Suksai, U; Suksripanich, O; Pobkeeree, V

    2010-01-01

    In Thailand nearly 1000 public health laboratories serve 65 million people. A qualified indicator of a good quality laboratory is Thailand Medical Technology Council certification. Consequently, Chiang Rai Regional Medical Sciences Center established a development program for laboratory certification for 29 laboratories in the province. This paper seeks to examine this issue. The goal was to improve laboratory service quality by voluntary participation, peer review, training and compliance with standards. The program consisted of specific activities. Training and workshops to update laboratory staffs' quality management knowledge were organized. Staff in each laboratory performed a self-assessment using a standard check-list to evaluate ten laboratory management areas. Chiang Rai Regional Medical Sciences Center staff supported the distribution of quality materials and documents. They provided calibration services for laboratory equipment. Peer groups performed an internal audit and successful laboratories received Thailand Medical Technology Council certification. By December 2007, eight of the 29 laboratories had improved quality sufficiently to be certified. Factors that influenced laboratories' readiness for quality improvement included the number of staff, their knowledge, budget and staff commitment to the process. Moreover, the support of each hospital's laboratory working group or network was essential for success. There was no clear policy for supporting the program. Laboratories voluntarily conducted quality management using existing resources. A bottom-up approach to this kind of project can be difficult to accomplish. Laboratory professionals can work together to illustrate and highlight outcomes for top-level health officials. A top-down, practical approach would be much less difficult to implement. Quality certification is a critical step for laboratory staff, which also encourages them to aspire to international quality standards like ISO. The

  12. Electronic health records improve clinical note quality.

    Science.gov (United States)

    Burke, Harry B; Sessums, Laura L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A; Hodge, Joshua A; Kane, Shawn; Magee, Charles; Makary, Zizette R; Mallory, Renee M; Miller, Thomas; Saperstein, Adam; Servey, Jessica; Gimbel, Ronald W

    2015-01-01

    The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes. A five and a half year longitudinal retrospective multicenter quantitative study comparing the quality of handwritten and electronic outpatient clinical visit notes for 100 patients with type 2 diabetes at three time points: 6 months prior to the introduction of the EHR (before-EHR), 6 months after the introduction of the EHR (after-EHR), and 5 years after the introduction of the EHR (5-year-EHR). QNOTE, a validated quantitative instrument, was used to assess the quality of outpatient clinical notes. Its scores can range from a low of 0 to a high of 100. Sixteen primary care physicians with active practices used QNOTE to determine the quality of the 300 patient notes. The before-EHR, after-EHR, and 5-year-EHR grand mean scores (SD) were 52.0 (18.4), 61.2 (16.3), and 80.4 (8.9), respectively, and the change in scores for before-EHR to after-EHR and before-EHR to 5-year-EHR were 18% (pquality scores significantly improved over the 5-year time interval. The EHR significantly improved the overall quality of the outpatient clinical note and the quality of all its elements, including the core and non-core elements. To our knowledge, this is the first study to demonstrate that the EHR significantly improves the quality of clinical notes. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  13. Mammography: Technique and diagnostic accuracy

    International Nuclear Information System (INIS)

    Kim, Chung Ja; Bahk, Yong Whee; Lee, Don Young

    1974-01-01

    Mammography is now in world wide use, But this has received rather scanty attention in Korea. The purposes of the present communication are twofold: (1) Detailing of technical and photographic aspects of mam in ography and (2) an assessment of its diagnostic accuracy as experienced by us. The clinical materials consisted of 88 cases of mammography performed at the Department of Radiology, St. Mary's Hospital, Catholic Medical College during the 2 years-period from April 1972. We used nonscreen type mammographic or industrial fine- grain films, and a special mammographic device that can be attached to any of the ordinary radiographic machine. Technical factors are shown in Table II. Of 88 cases 19 were operated on or biopsied. There were 7 cases of carcinoma. 8 cases of inflammatory diseases, and 4 cases of benign tumor. Mammographic diagnosis was correct in 85.7% of carcinoma and 87.5% of inflammatory diseases. One misdiagnosis of 7 cases of carcinoma was turned out to be cystosarcoma phylloides. Of 4 cases of benign tumors 2 were correctly diagnosed, and the other 2 mistaken for either inflammatory disease or simple lactating breast. However, none of the benign conditions were diagnosed as malignant process. We found that nonscreen type mammographic or industrial fine-grain films, and hand-processing were necessary in obtaining the mammograms of desirable quality

  14. Wavelet processing techniques for digital mammography

    Science.gov (United States)

    Laine, Andrew F.; Song, Shuwu

    1992-09-01

    This paper introduces a novel approach for accomplishing mammographic feature analysis through multiresolution representations. We show that efficient (nonredundant) representations may be identified from digital mammography and used to enhance specific mammographic features within a continuum of scale space. The multiresolution decomposition of wavelet transforms provides a natural hierarchy in which to embed an interactive paradigm for accomplishing scale space feature analysis. Similar to traditional coarse to fine matching strategies, the radiologist may first choose to look for coarse features (e.g., dominant mass) within low frequency levels of a wavelet transform and later examine finer features (e.g., microcalcifications) at higher frequency levels. In addition, features may be extracted by applying geometric constraints within each level of the transform. Choosing wavelets (or analyzing functions) that are simultaneously localized in both space and frequency, results in a powerful methodology for image analysis. Multiresolution and orientation selectivity, known biological mechanisms in primate vision, are ingrained in wavelet representations and inspire the techniques presented in this paper. Our approach includes local analysis of complete multiscale representations. Mammograms are reconstructed from wavelet representations, enhanced by linear, exponential and constant weight functions through scale space. By improving the visualization of breast pathology we can improve the chances of early detection of breast cancers (improve quality) while requiring less time to evaluate mammograms for most patients (lower costs).

  15. Improving care at cystic fibrosis centers through quality improvement.

    Science.gov (United States)

    Kraynack, Nathan C; McBride, John T

    2009-10-01

    Quality improvement (QI) using a clinical microsystems approach provides cystic fibrosis (CF) centers the opportunity to make a significant positive impact on the health of their patients. The availability of center-specific outcomes data and the support of the Cystic Fibrosis Foundation are important advantages for these quality improvement efforts. This article illustrates how the clinical microsystems methodology can improve care delivery and outcomes by describing the gradual application of quality improvement principles over the past 5 years by the CF team at the Lewis Walker Cystic Fibrosis Center at Akron Children's Hospital in Akron, Ohio. Using the example of a project to improve the pulmonary function of the pediatric patients at our center as a framework, we describe the QI process from the initial team-building phase, through the assessment of care processes, standardization of care, and developing a culture of continuous improvement. We outline how enthusiastic commitment from physician leadership, clinical managers and central administration, the availability of coaches, and an appreciation of the importance of measurement, patient involvement, communication, and standardization are critical components for successful process improvement. Copyright Thieme Medical Publishers.

  16. ISO certification pays off in quality improvement

    International Nuclear Information System (INIS)

    Vermeer, F.J.G.

    1992-01-01

    This paper reports that by obtaining and maintaining International Standards Organization (ISO) 9001 certification, a company can improve its quality control system, cut waste, and motivate its employees. In so doing it improves its competitive position in both international and domestic markets. The success of a number of countries (notably Japan) in the world markets has focused the attention of the industrialized countries on improving quality levels and striving for a unified, worldwide quality standard. This has been particularly true in Europe; with several countries competing in a single market, a common quality standard has been a highly desirable goal for decades. One of the first multinational quality standards evolved in the European Community, which is estimated to become a single market with a gross national product of $4.5 trillion by 1992. As a consequence, in 1987 the International Standards Organization created ISO 9000, a single standard to ensure uniform quality in products and services offered with this growing market. U.S. petroleum and natural gas companies must recognize and implement the ISO 9000 standards or possibly lose international markets. If the present worldwide trend towards ISO 9000 continues (and there is no reason to believe that it will not), the standards will be just as important in the domestic market

  17. Improvements in geomagnetic observatory data quality

    DEFF Research Database (Denmark)

    Reda, Jan; Fouassier, Danielle; Isac, Anca

    2011-01-01

    between observatories and the establishment of observatory networks has harmonized standards and practices across the world; improving the quality of the data product available to the user. Nonetheless, operating a highquality geomagnetic observatory is non-trivial. This article gives a record...... of the current state of observatory instrumentation and methods, citing some of the general problems in the complex operation of geomagnetic observatories. It further gives an overview of recent improvements of observatory data quality based on presentation during 11th IAGA Assembly at Sopron and INTERMAGNET...

  18. Strategies to improve quality of childbirth care

    Directory of Open Access Journals (Sweden)

    farahnaz Changaee

    2015-01-01

    Full Text Available Background: Access to affordable and quality health care is one of the most important ways for reducing maternal and child mortality. The purpose of this study was to provide strategies to promote the quality of care during childbirth in Lorestan province in 2011. Materials and Methods: This research was a mixed method (quantitative, qualitative, study in which quality of 200 care during childbirth in hospitals of Lorestan Province were evaluated. Data gathered through self-made tools (Checklists prepared according to the guidelines of the ministry of health. Descriptive statistics and SPSS software were used to data analysis.In the second part of the study which was qualitative, interview with service providers, hospital officials and high-ranking officials of Lorestan university of medical sciences (decision makers was used to discuss strategies to improve the quality of care. Results: The results showed that the care of the first stage delivery in %54.5, second stage %57 and third stage 66% were in accordance with the desired status and care in this three stages was of moderate quality. Based on the interviews, the officials who are in charge of Lorestan university of medical sciences, proposed strategies such as financial incentives and in-service training of midwives as suitable strategies to improve quality of services. Conclusion: According to the results, strategies such as financial incentives, increased use of private sector services to reduce the workload of the public sector and increase of quality and use of more in-service training, to improve the quality of services, are recommended.

  19. Studies Comparing Screen-Film Mammography and Full-Field Digital Mammography in Breast Cancer Screening: Updated Review

    International Nuclear Information System (INIS)

    Skaane, P.

    2009-01-01

    Full-field digital mammography (FFDM) has several potential benefits as compared with screen-film mammography (SFM) in mammography screening. Digital technology also opens for implementation of advanced applications, including computer-aided detection (CAD) and tomosynthesis. Phantom studies and experimental clinical studies have shown that FFDM is equal or slightly superior to SFM for detection and characterization of mammographic abnormalities. Despite obvious advantages, the conversion to digital mammography has been slower than anticipated, and not only due to higher costs. Until very recently, some countries did not even permit the use of digital mammography in breast cancer screening. The reason for this reluctant attitude was concern about lower spatial resolution and about using soft-copy reading. Furthermore, there was a lack of data supporting improved diagnostic accuracy using FFDM in a screening setting, since two pioneer trials both showed nonsignificantly lower cancer detection rate at FFDM. The 10 studies comparing FFDM and SFM in mammography screening published so far have shown divergent and rather conflicting results. Nevertheless, there is a rapid conversion to digital mammography in breast cancer screening in many western countries. The aim of this article is to give an updated review of these studies, discuss the conflicting findings, and draw some conclusions from the results

  20. Dual-energy mammography: simulation studies

    International Nuclear Information System (INIS)

    Bliznakova, K; Kolitsi, Z; Pallikarakis, N

    2006-01-01

    This paper presents a mammography simulator and demonstrates its applicability in feasibility studies in dual-energy (DE) subtraction mammography. This mammography simulator is an evolution of a previously presented x-ray imaging simulation system, which has been extended with new functionalities that are specific for DE simulations. The new features include incident exposure and dose calculations, the implementation of a DE subtraction algorithm as well as amendments to the detector and source modelling. The system was then verified by simulating experiments and comparing their results against published data. The simulator was used to carry out a feasibility study of the applicability of DE techniques in mammography, and more precisely to examine whether this modality could result in better visualization and detection of microcalcifications. Investigations were carried out using a 3D breast software phantom of average thickness, monoenergetic and polyenergetic beam spectra and various detector configurations. Dual-shot techniques were simulated. Results showed the advantage of using monoenergetic in comparison with polyenergetic beams. Optimization studies with monochromatic sources were carried out to obtain the optimal low and high incident energies, based on the assessment of the figure of merit of the simulated microcalcifications in the subtracted images. The results of the simulation study with the optimal energies demonstrated that the use of the DE technique can improve visualization and increase detectability, allowing identification of microcalcifications of sizes as small as 200 μm. The quantitative results are also verified by means of a visual inspection of the synthetic images

  1. Improving Power Quality in AC Supply Grids

    Directory of Open Access Journals (Sweden)

    Piotr Fabijański

    2015-12-01

    Full Text Available This paper describes a digital and actual model of the UPQC (Unified Power Quality Conditioner integrated system for power quality improvement. The UPQC’s design and its connection to an AC supply grid, 1-phase and 3-phase alike, provide effective compensation of unwanted interferences in the waveforms of load supply voltages and non-linear load currents. This article presents an overview of topologies and control strategies. The study of the UPQC confirmed its positive impact on the power quality. The electricity parameters were significantly improved. Total harmonic distortion in supply voltage THDu decreased six-fold to 1.89%, and total harmonic distortion in load current THDi decreased more than ten-fold to 2.38% for a non-linear load (uncontrolled bridge rectifier with load L. Additionally, symmetrisation of supply voltages and reactive power compensation Q of linear load was obtained. The UPQC integrated system for power quality improvement can be used wherever high-quality and PN-EN 50160 standard – compliant electricity is required.

  2. Calibration procedures for mammography dosemeters in Poland

    International Nuclear Information System (INIS)

    Gwiazdowska, B.; Ulkowski, P.; Tolwinski, J.; Bulski, W.

    2002-01-01

    Breast cancer is the most frequent tumour in women and the effectiveness of the treatment depends dramatically on the early detection of the disease. That is the reason why in Poland the mammography control examinations are strongly supported by the Centre of Oncology. In Poland there are over 400 mammography units which account for about 300,000 examinations per year. An investigation performed by the Medical Physics Department of the Centre of Oncology in Warsaw at about 100 mammography facilities proved that in most cases the doses absorbed by the patients could be reduced without decrease of image quality. This is one of the reasons why the Polish Secondary Standard Dosimetry Laboratory (SSDL) dealing mainly with calibration of radiotherapy dosemeters is extending its activities and therefore new facilities and equipment adapted for calibration of mammographic dosemeters have been installed. The mammography dosimetry calibration equipment is permanently installed in the same laboratory room where the radiotherapy dosemeters are calibrated. A base of a mammography unit no longer in clinical use, together with its movable system has been adapted to handle ionization chamber holders. An X-ray tube with a 50 kV high frequency generator was also installed. The tube, a Varian type OEG-50-2, (designed for laboratory applications) with molybdenum anode of an anode angle 23,7 deg. and with a large focus, effective size approximately 5 mm 2 , has an inherent filtration of 0,25 mm beryllium. It is installed in a housing with 2mm lead shielding; a cone shaped beam is formed by a system of three collimators

  3. Improving the Quality of Constructive Peer Feedback

    Science.gov (United States)

    Waggoner Denton, Ashley

    2018-01-01

    This article presents some simple strategies that instructors can use to improve the quality of the feedback students provide each other during a peer review activity. Briefly, I recommend that emphasis be placed solely on the provision of constructive comments, and that in order to qualify as constructive, a comment must: (1) identify a specific…

  4. Improving the Quality of Think-Alouds

    Science.gov (United States)

    Ness, Molly; Kenny, MaryBeth

    2016-01-01

    An essential element in teaching children to effectively comprehend text is the use of teacher-led think alouds. This article presents a three-step model to improve the quality and quantity of think alouds in K-6 classrooms. The article follows elementary teachers who planned, implemented, transcribed, and reflected upon think aloud lessons to…

  5. Teaching Quality Improvement Through a Book Club

    Directory of Open Access Journals (Sweden)

    Benjamin Doolittle

    2015-12-01

    Full Text Available Introduction: Quality Improvement projects are an important part of residency education in the United States and are required for accreditation by the Accreditation Council for Graduate Medical Education. Participation in standard chart-based quality improvement had failed to generate excitement among residents in our program. The objective of our innovation was to inspire interest in quality improvement among our residents. Methods: Our residency program instituted a book discussion group. Attendance and participation of attendees was recorded, and residents were sent a follow-up survey one month after the activity to gauge their impressions. Results: Out of 16 residents in the program, 12 attended the discussion group, and all attendees participated in the discussion. The follow-up survey revealed that 10/11 (91% of respondents had read at least part of the book and 11/11 (100% wanted to have another book discussion group in the upcoming year. Conclusion: We believe that the use of a book discussion group can be a novel, inspiring strategy to teach quality improvement in a residency program.

  6. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  7. National Quality Improvement Center on Early Childhood

    Science.gov (United States)

    Browne, Charlyn Harper

    2014-01-01

    The national Quality Improvement Center on early Childhood (QIC-eC) funded four research and demonstration projects that tested child maltreatment prevention approaches. The projects were guided by several key perspectives: the importance of increasing protective factors in addition to decreasing risk factors in child maltreatment prevention…

  8. Semen quality improves marginally during young adulthood

    DEFF Research Database (Denmark)

    Perheentupa, Antti; Sadov, Sergey; Rönkä, Riitta

    2016-01-01

    STUDY QUESTION: Does semen quality improve during early adulthood? SUMMARY ANSWER: Semen variables change little during the third decade of life, however some improvement in sperm morphology and motility may occur. WHAT IS KNOWN ALREADY: A suspicion of deteriorating semen quality has been raised...... in several studies. The longitudinal development of semen quality in early adulthood is insufficiently understood. STUDY DESIGN, SIZE, DURATION: A longitudinal follow-up of two cohorts of volunteer young adult Finnish men representing the general population was carried out. Cohorts A (discovery cohort, born...... 1979-1981, n = 336) and B (validation cohort, born 1983, n = 197) were followed up from the age of 19 years onward for 10 years. PARTICIPANTS/MATERIALS, SETTING, METHODS: Inclusion criteria included that both the men and their mothers were born in Finland. Semen analysis was performed in cohorts...

  9. Abnormality Detection in Mammography using Deep Convolutional Neural Networks

    OpenAIRE

    Xi, Pengcheng; Shu, Chang; Goubran, Rafik

    2018-01-01

    Breast cancer is the most common cancer in women worldwide. The most common screening technology is mammography. To reduce the cost and workload of radiologists, we propose a computer aided detection approach for classifying and localizing calcifications and masses in mammogram images. To improve on conventional approaches, we apply deep convolutional neural networks (CNN) for automatic feature learning and classifier building. In computer-aided mammography, deep CNN classifiers cannot be tra...

  10. Application of the ROC method to assessment of image quality issues in mammography. Part 2. Comparative evaluation of image quality and radiation dose to thick body sections

    International Nuclear Information System (INIS)

    Klein, R.; Saebel, M.

    2000-01-01

    For the experimental comparative assessment reported, the following radiation qualities were compared for radiation dose applied and image quality: molydenum anode, 30mum molybdenum filter, X-ray tube potential differences of 26-32 kV; molybdenum anode, 25 mum rhodium filter, X-ray tube potential differences of 26-32 kV; tungsten anode, 50 mum rhodium filter, X-ray tube potential differences of 26-32 kV. The results show that in the differentiated assessment according to the various radiation qualities, significant deviations in imaging quality of the different detail types are possible. (orig./CB) [de

  11. High-contrast mammography with a moving grid: assessment of clinical utility

    International Nuclear Information System (INIS)

    Sickles, E.A.; Weber, W.N.

    1986-01-01

    Mammography techniques using moving grids produce superior breast images in many patients but result in increased radiation dose. This prospective controlled study of 1000 unselected screen-film mammography patients identifies a subset of women who are most likely to benefit from higher-dose grid-assisted techniques. In approximately 60% of the patients, the increased contrast of grid films produced a noticeable improvement in overall image quality. In only 20% of cases did this translate into clinically useful information, however, usually resulting in an increased level of confidence in interpretation. In virtually all the cases in which grid images aided mammographic diagnosis, the patients were women having more than 50% dense fibroglandular tissue or compressed breast thickness greater than 6 cm (only 37% of the study population). We suggest that the use of grid techniques be restricted to patients with such dense or thick breasts, because only in these women can the increase in radiation dose be justified

  12. Prioritizing quality improvement in general surgery.

    Science.gov (United States)

    Schilling, Peter L; Dimick, Justin B; Birkmeyer, John D

    2008-11-01

    Despite growing interest in quality improvement, uncertainty remains about which procedures offer the most room for improvement in general surgery. In this context, we sought to describe the relative contribution of different procedures to overall morbidity, mortality, and excess length of stay in general surgery. Using data from the American College of Surgeons' National Surgery Quality Improvement Program (ACS-NSQIP), we identified all patients undergoing a general surgery procedure in 2005 and 2006 (n=129,233). Patients were placed in 36 distinct procedure groups based on Current Procedural Terminology codes. We first examined procedure groups according to their relative contribution to overall morbidity and mortality. We then assessed procedure groups according to their contribution to overall excess length of stay. Ten procedure groups alone accounted for 62% of complications and 54% of excess hospital days. Colectomy accounted for the greatest share of adverse events, followed by small intestine resection, inpatient cholecystectomy, and ventral hernia repair. In contrast, several common procedures contributed little to overall morbidity and mortality. For example, outpatient cholecystectomy, breast procedures, thyroidectomy, parathyroidectomy, and outpatient inguinal hernia repair together accounted for 34% of procedures, but only 6% of complications (and only 4% of major complications). These same procedures accounted for surgery. Focusing quality improvement efforts on these procedures may be an effective strategy for improving patient care and reducing cost.

  13. Engaging Clinical Nurses in Quality Improvement Projects.

    Science.gov (United States)

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. Copyright 2015, SLACK Incorporated.

  14. Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions.

    Science.gov (United States)

    Seitz, Holli H; Gibson, Laura; Skubisz, Christine; Forquer, Heather; Mello, Susan; Schapira, Marilyn M; Armstrong, Katrina; Cappella, Joseph N

    2016-10-01

    This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. 2918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Meta-analysis of breast cancer mortality benefit and overdiagnosis adjusted for adherence: improving information on the effects of attending screening mammography

    Science.gov (United States)

    Jacklyn, Gemma; Glasziou, Paul; Macaskill, Petra; Barratt, Alexandra

    2016-01-01

    Background: Women require information about the impact of regularly attending screening mammography on breast cancer mortality and overdiagnosis to make informed decisions. To provide this information we aimed to meta-analyse randomised controlled trials adjusted for adherence to the trial protocol. Methods: Nine screening mammography trials used in the Independent UK Breast Screening Report were selected. Extending an existing approach to adjust intention-to-treat (ITT) estimates for less than 100% adherence rates, we conducted a random-effects meta-analysis. This produced a combined deattenuated prevented fraction and a combined deattenuated percentage risk of overdiagnosis. Results: In women aged 39–75 years invited to screen, the prevented fraction of breast cancer mortality at 13-year follow-up was 0.22 (95% CI 0.15–0.28) and it increased to 0.30 (95% CI 0.18–0.42) with deattenuation. In women aged 40–69 years invited to screen, the ITT percentage risk of overdiagnosis during the screening period was 19.0% (95% CI 15.2–22.7%), deattenuation increased this to 29.7% (95% CI 17.8–41.5%). Conclusions: Adjustment for nonadherence increased the size of the mortality benefit and risk of overdiagnosis by up to 50%. These estimates are more appropriate when developing quantitative information to support individual decisions about attending screening mammography. PMID:27124337

  16. Comparative evaluation of average glandular dose and image of digital mammography and film mammography in Minas Gerais, Brazil

    International Nuclear Information System (INIS)

    Nogueira, M.; Leyton, F.; Rodrigue, L. L.C.; Oliveira, M.A.; Joana, G.S.; Silva, S.D.

    2015-01-01

    Breast cancer is the most common cancer among women, and early detection is critical to its diagnosis and treatment. Mammography is the best method for breast-cancer screening and is capable of reducing mortality rates To date, the most effective method for early detection of breast cancer has been x-ray mammography for which the screen/film (SF) technique has been the gold standard. Digital mammography has been proposed as a substitute for film mammography given the benefits inherent to digital technology. The purpose of our study was to compare the technical performance of digital mammographic and screen-film mammography. A PMMA phantom with objects to simulate breast structures. For the screen/film (SF) technique the results showed that 54% mammography units did not achieve the minimum acceptable performance as far the image quality. Besides, 67% services showed inadequate performance in their processing systems, which had significant influence on the image quality. At the mean glandular dose only 44% of digital systems evaluated were compliant in all thicknesses of PMMA. The average glandular dose AGD was 90 % higher than in screen/film systems. (authors)

  17. Dose measurements in mammography

    International Nuclear Information System (INIS)

    Kainberger, F.; Kallinger, W.

    1977-01-01

    Dose measurements at the mamma during mammography were carried out in the form of direct measurement with thermoluminescent dosimetry. Measurement was done for the in- and outcoming doses at the mamma, the dose exposure of the sternal region and the scattered rays above the symphysis, the latter as parameter for the genetic radiation exposure. As expected, the dose of the smooth radiation used for mammography showed a strong decrease at the outcome point in comparison with the income point. Surprisingly high was the scattered radiation in the sternal region. A corresponding protection by lead plates could be taken into consideration. Extremely low is the scattered radiation above the symphysis. Even measurements with the very sensitive calcium fluoride dosimeters did not reveal any practically important dose in the symphysis region. Most measurement values remained below the determinable dose of 0.3mR. Some maximal values varied in the range of 3-1 mR. (orig.) [de

  18. Soft copy digital mammography

    International Nuclear Information System (INIS)

    Kim, Hak Hee

    2005-01-01

    Screen-film mammography (SFM) has been the standard method used for breast cancer screening and making a clinical diagnosis. It is a valuable modality for the detection and differentiation of breast calcifications. The advantages are the high spatital resolution, the convenient display, and inexpensiveness. However, it has some inherent limitations such as its low detective quantum efficiency and difficulty of post-processing after obtaining after an image. Digital mammography (DM) has the potential to overcome the inherent limitations of SFM. DM systems directly qualify x-ray photons and decouple the process of x-ray photon detection from the image display. The digital images can be processed by a computer and displayed in multiple formats. Thus, DM is better than SFM for the detection of mass lesions due to its high contrast resolution

  19. Distributed power quality improvement in residential microgrids

    DEFF Research Database (Denmark)

    Naderi Zarnaghi, Yahya; Hosseini, Seyed Hossein; Ghassem Zadeh, Saeid

    2017-01-01

    The importance of power quality issue on micro grids and also the changing nature of power system distortions will lead the future power systems to use distributed power quality improvement (DPQI) devices. One possible choice of these DPQIs are multifunctional DGs that could compensate some...... harmonics in the location of generation and prevent the harmonics to enter main power grid. In this paper a control method based on virtual harmonic impedance is presented for these multifunctional DGs and the effect of the location of these DGs on compensation procedure is studied with simulating...

  20. Analysis of medical exposures in digital mammography

    International Nuclear Information System (INIS)

    Oliveira, Sergio R.; Mantuano, Natalia O.; Albrecht, Afonso S.

    2014-01-01

    Currently, the use of digital mammography in the early diagnosis of breast cancer is increasingly common due to the production of high definition image that allows to detect subtle changes in breast images profiles. However it is necessary to be an improvement of the technique used since some devices offer minimization parameters of entrance dose to the skin. Thus, this study seeks to examine how the qualification of technical professionals in radiology interferes with the use of the techniques applied in mammography. For this, survey was carried out in a hospital in the city of Rio de Janeiro, which evaluated the scans of 1190 patients undergoing routine mammography (It is considered routinely the 4 basic exhibitions: with 2 flow skull and 2 medium oblique side, excluding repeats and supplements) in 2013. The medical exposures analyzed obtained from a single full digital equipment, model Senographe DS were compared with three different procedures performed by professionals in mammography techniques. The images were classified according to exposure techniques available in the equipment: Standard (STD), contrast (CNT) and dose (dose), and to be selected as breast density of the patient. Comparing the variation of the radiographic technique in relation to the professional who made the exhibition, what is observed is that the professional B presented the best conduct in relation to radiological protection, because she considered breast density in the choice of technical equipment parameter. The professional A, which is newly formed, and C, which has more service time, almost did not perform variations in the pattern of exposure, even for different breast densities. Thus, we can conclude that there is a need to update the professionals so that the tools available of dose limitation and mamas variability to digital mammography are efficiently employed in the service routine and thus meet the requirements of current legislation

  1. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Molvin, Lior Z. [Stanford Hospital and Clinics, Stanford, CA (United States); Wang, Jia [Stanford University, Environmental Health and Safety, Stanford, CA (United States)

    2014-10-15

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  2. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik; Molvin, Lior Z.; Wang, Jia

    2014-01-01

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  3. Targeting Environmental Quality to Improve Population Health ...

    Science.gov (United States)

    Key goals of health care reform are to stimulate innovative approaches to improve healthcare quality and clinical outcomes while holding down costs. To achieve these goals value-based payment places the needs of the patient first and encourages multi-stakeholder cooperation. Yet, the stakeholders are typically all within the healthcare system, e.g. the Accountable Care Organization or Patient-Centered Medical Home, leaving important contributors to the health of the population such as the public health and environmental health systems absent. And rarely is the quality of the environment regarded as a modifiable factor capable of imparting a health benefit. Underscoring this point, a PubMed search of the search terms “environmental quality” with “value-based payment”, “value-based healthcare” or “value-based reimbursement” returned no relevant articles, providing further evidence that the healthcare industry largely disregards the quality of the environment as a significant determinant of wellbeing and an actionable risk factor for clinical disease management and population health intervention. Yet, the quality of the environment is unequivocally related to indicators of population health including all-cause mortality. The EPA’s Environmental Quality Index (EQI) composed of five different domains (air, land use, water, built environment and social) has provided new estimates of the associations between environmental quality and health stat

  4. [Hierarchy structuring for mammography technique by interpretive structural modeling method].

    Science.gov (United States)

    Kudo, Nozomi; Kurowarabi, Kunio; Terashita, Takayoshi; Nishimoto, Naoki; Ogasawara, Katsuhiko

    2009-10-20

    Participation in screening mammography is currently desired in Japan because of the increase in breast cancer morbidity. However, the pain and discomfort of mammography is recognized as a significant deterrent for women considering this examination. Thus quick procedures, sufficient experience, and advanced skills are required for radiologic technologists. The aim of this study was to make the point of imaging techniques explicit and to help understand the complicated procedure. We interviewed 3 technologists who were highly skilled in mammography, and 14 factors were retrieved by using brainstorming and the KJ method. We then applied Interpretive Structural Modeling (ISM) to the factors and developed a hierarchical concept structure. The result showed a six-layer hierarchy whose top node was explanation of the entire procedure on mammography. Male technologists were related to as a negative factor. Factors concerned with explanation were at the upper node. We gave attention to X-ray techniques and considerations. The findings will help beginners improve their skills.

  5. Creating quality improvement culture in public health agencies.

    Science.gov (United States)

    Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

  6. Creating Quality Improvement Culture in Public Health Agencies

    Science.gov (United States)

    Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

  7. A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators.

    Science.gov (United States)

    Williams, Linda; Daggett, Virginia; Slaven, James E; Yu, Zhangsheng; Sager, Danielle; Myers, Jennifer; Plue, Laurie; Woodward-Hagg, Heather; Damush, Teresa M

    2016-04-01

    Quality indicator collection and feedback improves stroke care. We sought to determine whether quality improvement training plus indicator feedback was more effective than indicator feedback alone in improving inpatient stroke indicators. We conducted a cluster-randomised quality improvement trial, randomising hospitals to quality improvement training plus indicator feedback versus indicator feedback alone to improve deep vein thrombosis (DVT) prophylaxis and dysphagia screening. Intervention sites received collaborative-based quality improvement training, external facilitation and indicator feedback. Control sites received only indicator feedback. We compared indicators pre-implementation (pre-I) to active implementation (active-I) and post-implementation (post-I) periods. We constructed mixed-effect logistic models of the two indicators with a random intercept for hospital effect, adjusting for patient, time, intervention and hospital variables. Patients at intervention sites (1147 admissions), had similar race, gender and National Institutes of Health Stroke Scale scores to control sites (1017 admissions). DVT prophylaxis improved more in intervention sites during active-I period (ratio of ORs 4.90, pimproved similarly in both groups during active-I, but control sites improved more in post-I period (ratio of ORs 0.67, p=0.04). In logistic models, the intervention was independently positively associated with DVT performance during active-I period, and negatively associated with dysphagia performance post-I period. Quality improvement training was associated with early DVT improvement, but the effect was not sustained over time and was not seen with dysphagia screening. External quality improvement programmes may quickly boost performance but their effect may vary by indicator and may not sustain over time. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Goal hierarchy: Improving asset data quality by improving motivation

    Energy Technology Data Exchange (ETDEWEB)

    Unsworth, Kerrie, E-mail: Kerrie.unsworth@uwa.edu.au [UWA Business School, University of Western Australia, Crawley, WA 6009 (Australia); Adriasola, Elisa; Johnston-Billings, Amber; Dmitrieva, Alina [UWA Business School, University of Western Australia, Crawley, WA 6009 (Australia); Hodkiewicz, Melinda [School of Mechanical Engineering, University of Western Australia, Crawley, WA 6009 (Australia)

    2011-11-15

    Many have recognized the need for high quality data on assets and the problems in obtaining them, particularly when there is a need for human observation and manual recording. Yet very few have looked at the role of the data collectors themselves in the data quality process. This paper argues that there are benefits to more fully understanding the psychological factors that lay behind data collection and we use goal hierarchy theory to understand these factors. Given the myriad of potential reasons for poor-quality data it has previously proven difficult to identify and successfully deploy employee-driven interventions; however, the goal hierarchy approach looks at all of the goals that an individual has in their life and the connections between them. For instance, does collecting data relate to whether or not they get a promotion? Stay safe? Get a new job? and so on. By eliciting these goals and their connections we can identify commonalities across different groups, sites or organizations that can influence the quality of data collection. Thus, rather than assuming what the data collectors want, a goal hierarchy approach determines that empirically. Practically, this supports the development of customized interventions that will be much more effective and sustainable than previous efforts. - Highlights: > We need to consider psychological aspects of data collectors to improve data quality. > We show how goal hierarchy theory furthers understanding. > Looks at the multiple goals of each individual to determine their behavior.

  9. Goal hierarchy: Improving asset data quality by improving motivation

    International Nuclear Information System (INIS)

    Unsworth, Kerrie; Adriasola, Elisa; Johnston-Billings, Amber; Dmitrieva, Alina; Hodkiewicz, Melinda

    2011-01-01

    Many have recognized the need for high quality data on assets and the problems in obtaining them, particularly when there is a need for human observation and manual recording. Yet very few have looked at the role of the data collectors themselves in the data quality process. This paper argues that there are benefits to more fully understanding the psychological factors that lay behind data collection and we use goal hierarchy theory to understand these factors. Given the myriad of potential reasons for poor-quality data it has previously proven difficult to identify and successfully deploy employee-driven interventions; however, the goal hierarchy approach looks at all of the goals that an individual has in their life and the connections between them. For instance, does collecting data relate to whether or not they get a promotion? Stay safe? Get a new job? and so on. By eliciting these goals and their connections we can identify commonalities across different groups, sites or organizations that can influence the quality of data collection. Thus, rather than assuming what the data collectors want, a goal hierarchy approach determines that empirically. Practically, this supports the development of customized interventions that will be much more effective and sustainable than previous efforts. - Highlights: → We need to consider psychological aspects of data collectors to improve data quality. → We show how goal hierarchy theory furthers understanding. → Looks at the multiple goals of each individual to determine their behavior.

  10. Improving the ignition quality of fuels

    KAUST Repository

    Sarathy, Mani

    2017-06-08

    Provided herein are compounds and methods of producing compounds for improving ignition quality and combustion efficiency of fuels, for example fossil fuels. In various aspects we generate highly oxygenated compounds from hydrocarbon feedstocks. The feedstock can be a branched alkane or n-alkane having a chain length greater than or equal to 6, a cycloalkane with a 5 or 6 membered ring structure, or a alkylated cycloalkane with 5 or more carbon atoms. The reactant can be fed in the gas- phase to a partial oxidation reactor (with or without a catalyst), and at a fixed temperature, mixture composition, and residence time. The reactant can be converted to a mixture of products including keto hydroperoxides, diketo hydroperoxides, keto dihydroperoxides, hydroperoxyl cyclic ethers, and alkenyl hydroperoxides. The compounds are inherently unstable and can quickly decompose to highly reactive radical species that can be used to improve the ignition quality of a fuel and advance ignition in an engine.

  11. A Model to Improve the Quality Products

    Directory of Open Access Journals (Sweden)

    Hasan GOKKAYA

    2010-08-01

    Full Text Available The topic of this paper is to present a solution who can improve product qualityfollowing the idea: “Unlike people who have verbal skills, machines use "sign language"to communicate what hurts or what has invaded their system’. Recognizing the "signs"or symptoms that the machine conveys is a required skill for those who work withmachines and are responsible for their care and feeding. The acoustic behavior of technical products is predominantly defined in the design stage, although the acoustic characteristics of machine structures can be analyze and give a solution for the actual products and create a new generation of products. The paper describes the steps intechnological process for a product and the solution who will reduce the costs with the non-quality of product and improve the management quality.

  12. Improving the ignition quality of fuels

    KAUST Repository

    Sarathy, Mani; Wang, Zhandong; Shankar, Vijai Shankar Bhavani

    2017-01-01

    Provided herein are compounds and methods of producing compounds for improving ignition quality and combustion efficiency of fuels, for example fossil fuels. In various aspects we generate highly oxygenated compounds from hydrocarbon feedstocks. The feedstock can be a branched alkane or n-alkane having a chain length greater than or equal to 6, a cycloalkane with a 5 or 6 membered ring structure, or a alkylated cycloalkane with 5 or more carbon atoms. The reactant can be fed in the gas- phase to a partial oxidation reactor (with or without a catalyst), and at a fixed temperature, mixture composition, and residence time. The reactant can be converted to a mixture of products including keto hydroperoxides, diketo hydroperoxides, keto dihydroperoxides, hydroperoxyl cyclic ethers, and alkenyl hydroperoxides. The compounds are inherently unstable and can quickly decompose to highly reactive radical species that can be used to improve the ignition quality of a fuel and advance ignition in an engine.

  13. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

    Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

    2017-11-01

    Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

  14. In Brief: Improving Mississippi River water quality

    Science.gov (United States)

    Showstack, Randy

    2007-10-01

    If water quality in the Mississippi River and the northern Gulf of Mexico is to improve, the U.S. Environmental Protection Agency (EPA) needs to take a stronger leadership role in implementing the federal Clean Water Act, according to a 16 October report from the U.S. National Research Council. The report notes that EPA has failed to use its authority to coordinate and oversee activities along the river. In addition, river states need to be more proactive and cooperative in efforts to monitor and improve water quality, and the river should be monitored and evaluated as a single system, the report indicates. Currently, the 10 states along the river conduct separate and widely varying water quality monitoring programs. ``The limited attention being given to monitoring and managing the Mississippi's water quality does not match the river's significant economic, ecological, and cultural importance,'' said committee chair David A. Dzombak, director of the Steinbrenner Institute for Environmental Education and Research at Carnegie Mellon University, Pittsburgh, Pa. The report notes that while measures taken under the Clean Water Act have successfully reduced much point source pollution, nutrient and sediment loads from nonpoint sources continue to be significant problems. For more information, visit the Web site: http://books.nap.edu/catalog.php?record_id=12051.

  15. Improving quality of service in the internet

    OpenAIRE

    Flückiger, François

    2000-01-01

    The Internet transport technology was designed to be robust, resilient to link or node outages, and with no single point of failure. The resulting connectionless system supports what is called a "best effort datagram delivery service", the perfo rmance of which is often greatly unpredictable. To improve the predictability of IP-based networks, several Quality of Service technologies have been designed over the past decade. The first one, RSVP, based on reservation of resources, is operational...

  16. Bioethanol Quality Improvement of Coffee Fruit Leather

    Directory of Open Access Journals (Sweden)

    Edahwati Luluk

    2016-01-01

    Full Text Available Recently, Indonesia’s dependence on petroleum is to be reduced and even eliminated. To overcome the problem of finding the needed alternative materials that can produce ethanol, in this case as a substitute material or a transport fuel mix, boosting the octane number, and gasoline ethanol (gasohol can be conducted. In the red coffee processing (cooking that will produce 65% and 35% of coffee beans, coffee leather waste is a source of organic material with fairly high cellulose content of 46.82%, 3.01% of pectin and 7.68% of lignin. In this case, its existence is abundant in Indonesia and optimally utilized. During the coffee fruit peeling, the peel waste is only used as a mixture of animal feed or simply left to rot. The purpose of this study was to produce and improve the quality of the fruit skin of bioethanol from coffee cellulose. However, to improve the quality of bioethanol, the production of the lignin content in the skin of the coffee fruit should be eliminated or reduced. Hydrolysis process using organosolve method is expected to improve the quality of bioethanol produced. In particular, the use of enzyme Saccharomyces and Zymmomonas will change the resulting sugar into bioethanol. On one hand, by using batch distillation process for 8 hours with Saccharomyces, bioethanol obtains high purity which is 39.79%; on the other hand, by using the same batch distillation process with Zymmomonas, the bioethanol obtains 38.78%.

  17. Compilation of historical dose to the breast received during mammography

    International Nuclear Information System (INIS)

    Thierry-Chef, Isabelle; Cardis, Elisabeth; Simon, Steven L.; Linet, Martha S.

    2008-01-01

    Full text: The effect of low to moderate diagnostic radiation exposures is a topic of interest currently in radiation protection and medicine. Most epidemiological studies, however, lack accurate information on doses received by individuals from medical diagnostic examinations. The need for a better assessment of doses from different types of radiographic examination, especially in the past is crucial for retrospective studies involving medical irradiation. The objective of the present study was to collect and review historic literature discussing radiation dose to the breast likely received from mammography as a function of year. Relevant publications related to mammography for time periods in the 20th century were collected and reviewed for data pertaining to doses to the breast. In many publications, dose to the breasts was not provided. However, it could be estimated in many cases from the dosimetric quantities reported, such as entrance surface dose, either by using provided technical parameters (kV, mAs, filtration) or by assuming typical values. The average value of dose to the breast was derived for each publication. Quality coefficients were derived to assign a greater weight to the most detailed and informative publications. From the dose data and the quality coefficients, a weighted average, minimum and maximum, by time period, were then estimated. Mammography has a long history, from its first use by Salomon in 1913 on 3000 mastectomy specimens to compare x-ray images with tumor lesions. Since then, mammography techniques have evolved in order to obtain better image quality with the objective of improving the diagnosis of breast cancer and other breast diseases. Major technology improvements were seen in the 1970's and 1980's resulting in modifications of medical protocols and consequential reductions of dose to the breast. Dose to the breast from a single view in mammography is presently about 10 times lower than it was in the 1960's when it was about

  18. Quality improvement in neurology: AAN Parkinson disease quality measures

    Science.gov (United States)

    Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

    2010-01-01

    Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

  19. How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

    Science.gov (United States)

    Cho, Yu Kyung

    2016-07-01

    In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.

  20. Trimodel Mammography with Perfect Coregistration

    Science.gov (United States)

    2017-02-01

    background, the major confounding factor in reading mammography; the imaging characteristics suggest that this contrast mechanism would be preferable...image with enhanced edges and reduced anatomical background, the major confounding factor in reading mammography; the imaging characteristics suggest...subjects, vertebrate animals , biohazards, and/or select agents Describe significant deviations, unexpected outcomes, or changes in approved protocols

  1. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    Energy Technology Data Exchange (ETDEWEB)

    Bogle, M.A.; Peterson, M.J.; Smith, J.G.; Southworth, G.R.

    1999-09-15

    Changes in physical and chemical characteristics of aquatic habitats made to reduce or eliminate ecological risks can sometimes have unforeseen consequences. Environmental management activities on the U.S. Dept. of Energy reservation in Oak Ridge, Tennessee,have succeeded in improving water quality in streams impacted by discharges fi-om industrial facilities and waste disposal sites. The diversity and abundance of pollution-sensitive components of the benthic macroinvertebrate communities of three streams improved after new waste treatment systems or remedial actions reduced inputs of various toxic chemicals. Two of the streams were known to be mercury-contaminated from historical spills and waste disposal practices. Waterborne mercury concentrations in the third were typical of uncontaminated systems. In each case, concentrations of mercury in fish, or the apparent biological availability of mercury increased over the period during which ecological metrics indicated improved water quality. In the system where waterborne mercury concentrations were at background levels, increased mercury bioaccumulation was probably a result of reduced aqueous selenium concentrations; however, the mechanisms for increased mercury accumulation in the other two streams remain under investigation. In each of the three systems, reduced inputs of metals and inorganic anions was followed by improvements in the health of aquatic invertebrate communities. However, this reduction in risk to aquatic invertebrates was accompanied by increased risk to humans and piscivorous wildlife related to increased mercury concentrations in fish.

  2. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    International Nuclear Information System (INIS)

    Bogle, M.A.; Peterson, M.J.; Smith, J.G.; Southworth, G.R.

    1999-01-01

    Changes in physical and chemical characteristics of aquatic habitats made to reduce or eliminate ecological risks can sometimes have unforeseen consequences. Environmental management activities on the U.S. Dept. of Energy reservation in Oak Ridge, Tennessee,have succeeded in improving water quality in streams impacted by discharges fi-om industrial facilities and waste disposal sites. The diversity and abundance of pollution-sensitive components of the benthic macroinvertebrate communities of three streams improved after new waste treatment systems or remedial actions reduced inputs of various toxic chemicals. Two of the streams were known to be mercury-contaminated from historical spills and waste disposal practices. Waterborne mercury concentrations in the third were typical of uncontaminated systems. In each case, concentrations of mercury in fish, or the apparent biological availability of mercury increased over the period during which ecological metrics indicated improved water quality. In the system where waterborne mercury concentrations were at background levels, increased mercury bioaccumulation was probably a result of reduced aqueous selenium concentrations; however, the mechanisms for increased mercury accumulation in the other two streams remain under investigation. In each of the three systems, reduced inputs of metals and inorganic anions was followed by improvements in the health of aquatic invertebrate communities. However, this reduction in risk to aquatic invertebrates was accompanied by increased risk to humans and piscivorous wildlife related to increased mercury concentrations in fish

  3. Average glandular dose in routine mammography screening using a Sectra Microdose Mammography unit

    International Nuclear Information System (INIS)

    Hemdal, B.; Herrnsdorf, L.; Andersson, I.; Bengtsson, G.; Heddson, B.; Olsson, M.

    2005-01-01

    The Sectra MicroDose Mammography system is based on direct photon counting (with a solid-state detector), and a substantially lower dose to the breast than when using conventional system can be expected. In this work absorbed dose measurements have been performed for the first unit used in routine mammography screening (at the Hospitals of Helsingborg (Sweden)). Two European protocols on dosimetry in mammography have been followed. Measurement of half value layer (HVL) cannot be performed as prescribed, but this study has demonstrated than non-invasive measurements of HVL can be performed accurately with a sensitive and well collimated solid-state detector with simultaneous correction for the energy dependence. The average glandular dose for a 50 mm standard breast with 50% glandularity, simulated by 45 mm polymethylmethacrylate, was found to be 0.21 and 0.28 mGy in March and December 2004, respectively. These values are much lower than for any other mammography system on the market today. It has to be stressed that the measurement were made using the current clinical settings and that no systematic optimisation of the relationship between absorbed dose and diagnostic image quality has been performed within the present study. In order to further increase the accuracy of absorbed dose measurements for this unit, the existing dose protocols should be revised to account also for the tungsten/aluminium anode/filter combination, the multi-slit pre-collimator device and the occurrence of a dose profile in the scanning direction. (authors)

  4. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    Richey, R.B.

    1991-01-01

    Total quality (TQ) at Carolina Power and Light (CP and L) is fulfilling a 1985 vision of Sherwood H. Smith, Jr., CP and L's chairman, president, and chief executive officer. The TQ concept has provided a way for employees to align their creative energies toward meeting the business needs of the company. Throughout CP and L, TQ has been recognized as the vehicle for reducing operating costs and improving customer satisfaction. Within the nuclear organization, application of the TQ process has helped to improve communications, resolve challenges, and provide more consistent work practices among CP and L's three nuclear plants. Total quality was introduced from the top down, with initial benefits coming from team interactions. Senior management at CP and L defined the corporate expectations and outlined the training requirements for implementing TQ. Management staffs at each organizational level became steering committees for TQ team activities within their departments. Teams of employees most knowledgeable about a given work area were empowered to solve problems or overcome obstacles related to that work area. Employees learned to become better team players and to appreciate the quality of decisions reached through group consensus. Now, formalized methods that started TQ are becoming part of the day-to-day work ethic

  5. 42 CFR 441.474 - Quality assurance and improvement plan.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474... improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State... pursue opportunities for system improvement. (b) The quality assurance and improvement plan shall also...

  6. Doses in mammography. Preliminary study

    International Nuclear Information System (INIS)

    Marquez P, F.; Acosta R, N.; Universidad Nacional Mayor de San Marcos, Lima; Benavente, T.; Universidad Nacional Mayor de San Marcos, Lima; Poma, M.

    2002-01-01

    Mammography is the most important method to detect lesions in the breast with this technique one can detect small tumours before clear clinical symptoms appear. Mammographic image of require high quality standards due that the extremely low contrast between the normal and pathological areas in the breast, eg.g., they have similar attenuation and absorption coefficient. The x-ray mammographic systems, used in this study are Senographe 500t and Senographe DMR, a detector with a RadCal ionization chambers calibrated to the qualities of mammographic x-ray beams, and a breast simulator that is a phantoms of polymethylmethacrylate (PMMA) of several thicknesses with the equivalence of 50% of the glandular tissue. The results obtained indicate that the values of doses at the entrance surface of a breast (DES) are greater the reference value 20 mGy to 5,0 cm of PMMA and the values of the mean glandular dose (MGD) exceed the reference value of 2,1 mGy for 5,1 cm of compressed thick breast. We consider that the values high of the EDS and MGD are due that the x-ray systems no meeting in good condition or for used of x-ray spectra no suitable, so is recommendable be carried out test of quality control to the x-ray systems and also realize studies, or characterize the of x-ray mammographic spectra

  7. Improving tomato seed quality- challenges and possibilities

    DEFF Research Database (Denmark)

    Shrestha, Santosh

    The thesis investigates the possibility of using single seed near-infrared (NIR) spectroscopy, multispectral imaging (MSI) and NIR hyperspectral imaging (NIR-HSI) in combination with chemometrics for rapid determination of the tomato seed quality. The results of the PhD study are compiled in four...... manuscripts (MS). These non-destructive methods show the potential of sorting tomato seeds as per their viability and varietal identity. The results are discussed in the context of possible contribution from these methods in the improvement of the seed quality in Nepal. In MS I, potential application of NIR...... spectroscopy in combination with chemometrics for prediction of tomato seed viability is demonstrated. The work in MS I also emphasises on identifying the important NIR spectral regions for the chemometric model that are relevant to the separation of viable and non-viable seeds. The NIR-HIS method was also...

  8. IMPROVEMENTS IN THE QUALITY OF COURIER DELIVERY

    Directory of Open Access Journals (Sweden)

    Jacek Karcz

    2016-06-01

    Full Text Available The functioning of courier companies is a vital component of modern trade. E-commerce services are changing the way of shopping. Along with them, also courier services change and become more advance. Customers of courier companies become more aware of quality, which they should expect from supplier of these services. The article presents the result of the research of the effectiveness and the timelines of deliveries realized by one of the terminals of a leading courier operator in Poland. The survey involved 55 courier routes over the course of 10 business days. The author analyses weak points of the supply chain and presents two solutions, which may improve quality of delivery processes.

  9. Improving wind power quality with energy storage

    DEFF Research Database (Denmark)

    Rasmussen, Claus Nygaard

    2009-01-01

    The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combination...... of wind and storage. The introduction of storage enables smoothening of wind power on a timescale proportional to the storage energy. Storage does not provide availability of wind power at all times, but allows for a certain fraction of average power in a given timeframe to be available with high...... probability. The amount of storage capacity necessary for significant wind power quality improvement in a given period is found to be 20 to 40% of the energy produced in that period. The necessary power is found to be 80 to 100% of the average power of the period....

  10. Improving the quality of care for patients with hypertension in Moshupa District, Botswana: Quality improvement cycle

    Directory of Open Access Journals (Sweden)

    Cathy Kande

    2014-01-01

    Full Text Available Background: Although there are no prevalence studies on hypertension in Botswana, this condition is thought to be common and the quality of care to be poor.Aim: The aim of this project was to assess and improve the quality of primary care forhypertension.Setting: Moshupa clinic and catchment area, Botswana.Methods: Quality improvement cycle.Results: Two hundred participants were included in the audit. Sixty-eight per cent were women with a mean age of 55 years. In the baseline audit none of the target standards were met. During the re-audit six months later, six out of nine structural target standards, five out of 11 process target standards and one out of two outcome target standards were achieved. Statistically-significant improvement in performance (p < 0.05 was shown in 10 criteria although the target standard was not always met. In the re-audit, the target of achieving blood pressure control (< 140/90 in 70% of patients was achieved.Conclusion: The quality of care for hypertension was suboptimal in our setting. Simple interventions were designed and implemented to improve the quality of care. These interventions led to significant improvement in structural and process criteria. A corresponding significant improvement in the control of blood pressure was also seen.

  11. MR mammography (MRM)

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, W.A.

    1993-01-01

    The book deals with MRI for the diagnostic evaluation of malignant breast lesions. A survey of methods available for breast examination, magnetic resonance mammography (MRM) is briefly explained in terms of development and technical problems encountered in the various examinations. The clinical aspects from a central part of the book, giving information relating to the various neoplasms and a comprehensive review of cases. The book concludes with a chapter discussing the interpretation of data and images, presenting examples of normal findings and of manifestations of carcinoma, fibroadenoma, cysts, mastopathies, scars due to plastic surgery, and the lactating breast. (UWA). 648 figs., 25 tabs.

  12. Synthesized Mammography: Clinical Evidence, Appearance, and Implementation

    Directory of Open Access Journals (Sweden)

    Melissa A. Durand

    2018-04-01

    Full Text Available Digital breast tomosynthesis (DBT has improved conventional mammography by increasing cancer detection while reducing recall rates. However, these benefits come at the cost of increased radiation dose. Synthesized mammography (s2D has been developed to provide the advantages of DBT with nearly half the radiation dose. Since its F.D.A. approval, multiple studies have evaluated the clinical performance of s2D. In clinical practice, s2D images are not identical to conventional 2D images and are designed for interpretation with DBT as a complement. This article reviews the present literature to assess whether s2D is a practical alternative to conventional 2D, addresses the differences in mammographic appearance of findings, and provides suggestions for implementation into clinical practice.

  13. Synthesized Mammography: Clinical Evidence, Appearance, and Implementation.

    Science.gov (United States)

    Durand, Melissa A

    2018-04-04

    Digital breast tomosynthesis (DBT) has improved conventional mammography by increasing cancer detection while reducing recall rates. However, these benefits come at the cost of increased radiation dose. Synthesized mammography (s2D) has been developed to provide the advantages of DBT with nearly half the radiation dose. Since its F.D.A. approval, multiple studies have evaluated the clinical performance of s2D. In clinical practice, s2D images are not identical to conventional 2D images and are designed for interpretation with DBT as a complement. This article reviews the present literature to assess whether s2D is a practical alternative to conventional 2D, addresses the differences in mammographic appearance of findings, and provides suggestions for implementation into clinical practice.

  14. Using genomics to improve fruit quality.

    Science.gov (United States)

    Meneses, Claudio; Orellana, Ariel

    2013-01-01

    New fruit varieties are needed to satisfy consumers, and the industry is facing new challenges in order to respond to these demands. The emergence of genomic tools is releasing information on polymorphisms that can be utilized to expedite breeding processes in species that are difficult to breed, given the long periods of time required to get new varieties. The present review describes the current stages of the ongoing efforts that are being taken to apply these technologies to obtain varieties with improved fruit quality in species of the family Rosaceae.

  15. Quality Rating and Improvement System State Evaluations and Research

    Science.gov (United States)

    Ferguson, Daniel

    2016-01-01

    A quality rating and improvement system (QRIS) is a method used by states and local jurisdictions to assess the level of quality of child care and early education programs, improve quality, and convey quality ratings to parents and other consumers. A typical QRIS incorporates the following components: quality standards for participating providers;…

  16. Estimation of patient dose in mammography screening examinations

    International Nuclear Information System (INIS)

    Suzuki, S.; Fujii, S.; Orito, T.; Asada, Y.; Koga, S.; Horita, K.; Kido, C.

    1996-01-01

    Mammography is one of the most effective examinations for detecting breast carcinoma. Although the dose is usually much higher than that in other types of X-ray examination, that is accepted by the patient because for fears of suffering cancer. Benefit of relatively high doses derived from mammographic examinations is considered to well exceed the risk of cancer induction by radiation exposure. The purpose of this study is to investigate patient dose of mammography in Japan by questionnaire sent to 531 institutions selected from whole Japan and direct measurements carried out in 28 hospitals in Aichi Prefecture. The user's guide in mammography published by NCRP and Quality Assurance Program of American College of Radiology were used to assess the exposure and image quality of mammogram. (author)

  17. Evaluation of the 1Shot Phantom dedicated to the mammography system using FCR

    International Nuclear Information System (INIS)

    Nagashima, Chieko; Uchiyama, Nachiko; Moriyama, Noriyuki; Nagata, Mio; Kobayashi, Hiroyuki; Sankoda, Katsuhiro; Saotome, Shigeru; Tagi, Masahiro; Kusunoki, Tetsurou

    2009-01-01

    Currently daily quality control (QC) tests for mammography systems are generally evaluated by using visual analysis phantoms, which of course means subjective measurement. In our study, however, we evaluated a novel digital phantom, the 1Shot Phantom M plus (1Shot Phantom), together with automatic analysis software dedicated for mammography systems using Fuji computed radiography (FCR). The digital phantom enables objective evaluation by providing for actual physical measurement rather than subjective visual assessment. We measured contrast to noise ratio (CNR), image receptor homogeneity, missed tissue at chest wall side, modulation transfer function (MTF), and geometric distortion utilizing the 1Shot Phantom. We then compared the values obtained using the 1Shot Phantom with values obtained from the European guidelines and International Electrotechnical Commission (IEC) standards. In addition, we evaluated the convenience of using the digital phantom. The values utilizing the 1Shot Phantom and those from the European guidelines and IEC standards were consistent, but the QC tests for the European guidelines and IEC standards methods took about six hours while the same QC tests using the 1Shot Phantom took 10 minutes or less including exposure of the phantom image, measurement, and analysis. In conclusion, the digital phantom and dedicated software proved very useful and produced improved analysis for mammography systems using FCR in clinical daily QC testing because of their objectivity and substantial time-saving convenience. (author)

  18. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  19. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  20. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  1. 45 CFR 1304.60 - Deficiencies and quality improvement plans.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Deficiencies and quality improvement plans. 1304... must correct the deficiency either immediately or pursuant to a Quality Improvement Plan. (c) An Early... Improvement Plan must submit to the responsible HHS official a Quality Improvement Plan specifying, for each...

  2. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    Ing. Andrea Zejdlova

    2013-01-01

    Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or “value-based purchasing,” this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

  3. Methodology of quality improvement projects for the Texas Medicare population.

    Science.gov (United States)

    Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

    1998-07-01

    The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

  4. Moving up the Ladder: How Do States Deliver Quality Improvement Supports within Their Quality Rating and Improvement Systems? Brief

    Science.gov (United States)

    Holod, Aleksandra; Faria, Ann-Marie; Weinberg, Emily; Howard, Eboni

    2015-01-01

    As national attention has increasingly focused on the potential for high-quality early childhood education (ECE) to improve children's school readiness, states have developed quality rating and improvement systems (QRISs) to document the quality of ECE programs, support systematic quality improvement, and provide clear information to families…

  5. Digital mammography and their developments

    International Nuclear Information System (INIS)

    Wienbeck, Susanne

    2015-01-01

    At the present time digital mammography is a satisfactory breast diagnostic imaging in clinical as well as screening mammography in defined age groups. Nevertheless it shows beside the application of ionizing radiation in women with dense breasts limitations in the detection of non calcification breast cancers. Tomosynthesis, digital contrast-enhanced mammography and breast-CT with or without contrast media lead to better results. Especially the application of contrast media for the visualisation of the tumor angiogenesis is invariably superior to all other non-contrast imaging modalities. However, the excellent results of breast MRI will be probably accessible with none of the new procedures.

  6. How can we recognize continuous quality improvement?

    Science.gov (United States)

    Rubenstein, Lisa; Khodyakov, Dmitry; Hempel, Susanne; Danz, Margie; Salem-Schatz, Susanne; Foy, Robbie; O'Neill, Sean; Dalal, Siddhartha; Shekelle, Paul

    2014-02-01

    Continuous quality improvement (CQI) methods are foundational approaches to improving healthcare delivery. Publications using the term CQI, however, are methodologically heterogeneous, and labels other than CQI are used to signify relevant approaches. Standards for identifying the use of CQI based on its key methodological features could enable more effective learning across quality improvement (QI) efforts. The objective was to identify essential methodological features for recognizing CQI. Previous work with a 12-member international expert panel identified reliably abstracted CQI methodological features. We tested which features met rigorous a priori standards as essential features of CQI using a three-phase online modified-Delphi process. Primarily United States and Canada. 119 QI experts randomly assigned into four on-line panels. Participants rated CQI features and discussed their answers using online, anonymous and asynchronous discussion boards. We analyzed ratings quantitatively and discussion threads qualitatively. Main outcome measure(s) Panel consensus on definitional CQI features. /st> Seventy-nine (66%) panelists completed the process. Thirty-three completers self-identified as QI researchers, 18 as QI practitioners and 28 as both equally. The features 'systematic data guided activities,' 'designing with local conditions in mind' and 'iterative development and testing' met a priori standards as essential CQI features. Qualitative analyses showed cross-cutting themes focused on differences between QI and CQI. We found consensus among a broad group of CQI researchers and practitioners on three features as essential for identifying QI work more specifically as 'CQI.' All three features are needed as a minimum standard for recognizing CQI methods.

  7. Quality improvement in neurology: dementia management quality measures.

    Science.gov (United States)

    Odenheimer, Germaine; Borson, Soo; Sanders, Amy E; Swain-Eng, Rebecca J; Kyomen, Helen H; Tierney, Samantha; Gitlin, Laura; Forciea, Mary Ann; Absher, John; Shega, Joseph; Johnson, Jerry

    2014-03-01

    Professional and advocacy organizations have long urged that dementia should be recognized and properly diagnosed. With the passage of the National Alzheimer's Project Act in 2011, an Advisory Council for Alzheimer's Research, Care, and Services was convened to advise the Department of Health and Human Services. In May 2012, the Council produced the first National Plan to address Alzheimer's disease, and prominent in its recommendations is a call for quality measures suitable for evaluating and tracking dementia care in clinical settings. Although other efforts have been made to set dementia care quality standards, such as those pioneered by RAND in its series Assessing Care of Vulnerable Elders (ACOVE), practitioners, healthcare systems, and insurers have not widely embraced implementation. This executive summary (full manuscript available at www.neurology.org) reports on a new measurement set for dementia management developed by an interdisciplinary Dementia Measures Work Group (DWG) representing the major national organizations and advocacy organizations concerned with the care of individuals with dementia. The American Academy of Neurology (AAN), the American Geriatrics Society, the American Medical Directors Association, the American Psychiatric Association, and the American Medical Association-convened Physician Consortium for Performance Improvement led this effort. The ACOVE measures and the measurement set described here apply to individuals whose dementia has already been identified and properly diagnosed. Although similar in concept to ACOVE, the DWG measurement set differs in several important ways; it includes all stages of dementia in a single measure set, calls for the use of functional staging in planning care, prompts the use of validated instruments in patient and caregiver assessment and intervention, highlights the relevance of using palliative care concepts to guide care before the advanced stages of illness, and provides evidence-based support

  8. Making quality improvement programs more effective.

    Science.gov (United States)

    Shaw-Taylor, Yoku

    2014-01-01

    In the past 25 years, and as recent as 2011, all external evaluations of the Quality Improvement Organization (QIO) Program have found its impact to be small or difficult to discern. The QIO program costs about $200 million on average to administer each year to improve quality of healthcare for people of 65 years or older. The program was created to address questionable quality of care. QIOs review how care is provided based on performance measures. The paper aims to discuss these issues. In 2012, the author supported the production of quarterly reports and reviewed internal monitoring and evaluation protocols of the program. The task also required reviewing all previous program evaluations. The task involved many conversations about the complexities of the program, why impact is difficult to discern and possible ways for eventual improvement. Process flow charts were created to simulate the data life cycle and discrete event models were created based on the sequence of data collection and reporting to identify gaps in data flow. The internal evaluation uncovered data gaps within the program. The need for a system of specification rules for data conceptualization, collection, distribution, discovery, analysis and repurposing is clear. There were data inconsistencies and difficulty of integrating data from one instance of measurement to the next. The lack of good and reliable data makes it difficult to discern true impact. The prescription is for a formal data policy or data governance structure to integrate and document all aspects of the data life cycle. The specification rules for governance are exemplified by the Data Documentation Initiative and the requirements published by the Data Governance Institute. The elements are all in place for a solid foundation of the data governance structure. These recommendations will increase the value of program data. The model specifies which agency units must be included in the governance authority and the data team. The

  9. Quality improvement education to improve performance on ulcerative colitis quality measures and care processes aligned with National Quality Strategy priorities.

    Science.gov (United States)

    Greene, Laurence; Moreo, Kathleen

    2015-01-01

    Studies on inflammatory bowel disease (IBD) have reported suboptimal approaches to patient care. In the United States, the findings have motivated leading gastroenterology organizations to call for initiatives that support clinicians in aligning their practices with quality measures for IBD and priorities of the National Quality Strategy (NQS). We designed and implemented a quality improvement (QI) education program on ulcerative colitis in which patient charts were audited for 30 gastroenterologists before (n = 300 charts) and after (n = 290 charts) they participated in QI-focused educational activities. Charts were audited for nine measures, selected for their alignment with four NQS priorities: making care safer, ensuring patient engagement, promoting communication, and promoting effective treatment practices. Four of the measures, including guideline-directed vaccinations and assessments of disease type and activity, were part of the CMS Physician Quality Reporting System (PQRS). The other five measures involved counseling patients on various topics in ulcerative colitis management, documentation of side effects, assessment of adherence status, and simplification of dosing. The gastroenterologists also completed baseline and post-education surveys designed to assess qualitative outcomes. One of the educational interventions was a private audit feedback session conducted for each gastroenterologist. The sessions were designed to support participants in identifying measures reflecting suboptimal care quality and developing action plans for improvement. In continuous improvement cycles, follow-up interventions included QI tools and educational monographs. Across the nine chart variables, post-education improvements ranged from 0% to 48%, with a mean improvement of 15.9%. Survey findings revealed improvements in self-reported understanding of quality measures and intentions to apply them to practice, and lower rates of perceived significant barriers to high-quality

  10. Involving vendors in continuous quality improvement efforts.

    Science.gov (United States)

    McDevitt, M C

    1995-03-01

    In the hospital environment, vendors supply a wide range of items, from surgical sutures to the latest in high-cost technological equipment. Also, many clinical and support services, such as respiratory therapy, transcription, and computer databanks are now outsourced to commercial vendors. Interaction with such vendors is often less than satisfactory, with prolonged timelines and disruption of an important process that is being computerized. Although hospitals deal with very few vendors in long-term relationships, such as those seen in manufacturing, this should not preclude the formation of a supplier-customer relationship that goes beyond management's interaction with the sales representative in response to a request for proposal. This is especially true when a process improvement team has studied an internal process and defined a key quality characteristic.

  11. A Report Card on Continuous Quality Improvement

    Science.gov (United States)

    Blumenthal, David; Kilo, Charles M.

    1998-01-01

    Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved. PMID:9879305

  12. Quality improvement in neurological surgery graduate medical education.

    Science.gov (United States)

    Parker, Scott L; McGirt, Matthew J; Asher, Anthony L; Selden, Nathan R

    2015-04-01

    There has been no formal, standardized curriculum for neurosurgical resident education in quality improvement. There are at least 2 reasons to integrate a formalized quality improvement curriculum into resident education: (1) increased emphasis on the relative quality and value (cost-effectiveness) of health care provided by individual physicians, and (2) quality improvement principles empower broader lifelong learning. An integrated quality improvement curriculum should comprise specific goals and milestones at each level of residency training. This article discusses the role and possible implementation of a national program for quality improvement in neurosurgical resident education. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. SF Bay Water Quality Improvement Fund: Projects and Accomplishments

    Science.gov (United States)

    San Francisco Bay Water Quality Improvement Fund (SFBWQIF) projects listed here are part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  14. Improving smoked herring quality by gamma irradiation

    International Nuclear Information System (INIS)

    Zahran, D.A.; Abd El-Wahab, S.A.; Hendy, B.A.

    2009-01-01

    Smoked herring which is a highly purchasable product in Egypt, was exposed to different gamma irradiation doses (1.5,3.0 and 5.0 kGy) and stored at environmental temperature (12± 2 deg C) until spoilage of the control. Microbiological, chemical and sensory analyses were performed throughout storage to monitor the quality attributes. It is worthy to mention that irradiation reduced the population of bacteria and the effect was more pronounced at the highest dose used (5.0 kGy). At the same time 1.5 kGy completely eliminated staphylococcus aureus (coagulase + ve) and coliforms. By chemical analysis, there was significant decrease in average moisture content by different gamma irradiation doses and storage. Although the average thiobarbituric acid reactive substances (TBARS) increased slightly by γ-irradiation, this increase was highly significant by storage . At the same time there was a significant (p< 0.05)decrease in the average trimethylamine (TMA) value of all irradiated samples compared with unirradiated control, this value increased significantly by storage. interestingly, the average histamine value decreased significantly in all irradiated samples. The sensory analysis revealed a highly significant difference in the average acceptability scores between different irradiation doses used and also by storage. Therefore it could be concluded that the quality of smoked herring during storage at environmental temperature (12 ± 2 deg C) could be improved by using 5.0 kGy γ -irradiation

  15. Toyota production system quality improvement initiative improves perioperative antibiotic therapy.

    Science.gov (United States)

    Burkitt, Kelly H; Mor, Maria K; Jain, Rajiv; Kruszewski, Matthew S; McCray, Ellesha E; Moreland, Michael E; Muder, Robert R; Obrosky, David Scott; Sevick, Mary Ann; Wilson, Mark A; Fine, Michael J

    2009-09-01

    To assess the role of a Toyota production system (TPS) quality improvement (QI) intervention on appropriateness of perioperative antibiotic therapy and in length of hospital stay (LOS) among surgical patients. Pre-post quasi-experimental study using local and national retrospective cohorts. We used TPS methods to implement a multifaceted intervention to reduce nosocomial methicillin-resistant Staphylococcus aureus infections on a Veterans Affairs surgical unit, which led to a QI intervention targeting appropriate perioperative antibiotic prophylaxis. Appropriate perioperative antibiotic therapy was defined as selection of the recommended antibiotic agents for a duration not exceeding 24 hours from the time of the operation. The local computerized medical record system was used to identify patients undergoing the 25 most common surgical procedures and to examine changes in appropriate antibiotic therapy and LOS over time. Overall, 2550 surgical admissions were identified from the local computerized medical records. The proportion of surgical admissions receiving appropriate perioperative antibiotics was significantly higher (P <.01) in 2004 after initiation of the TPS intervention (44.0%) compared with the previous 4 years (range, 23.4%-29.8%) primarily because of improvements in compliance with antibiotic therapy duration rather than appropriate antibiotic selection. There was no statistically significant decrease in LOS over time. The use of TPS methods resulted in a QI intervention that was associated with an increase in appropriate perioperative antibiotic therapy among surgical patients, without affecting LOS.

  16. Transferring skills in quality collaboratives focused on improving patient logistics

    NARCIS (Netherlands)

    J.W.M. Weggelaar-Jansen (Anne Marie); J.D.H. van Wijngaarden (Jeroen)

    2018-01-01

    textabstractA quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. Our research focused on quality improvement collaboratives aiming to improve patient logistics and tried to

  17. Coaching for Quality Improvement: Lessons Learned from Quality Rating and Improvement Systems (QRIS). Research Brief

    Science.gov (United States)

    Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

    2011-01-01

    Coaching and other on-site, individualized professional development strategies (consultation, mentoring, and technical assistance) are promising approaches to support the application of new teaching practices and overall quality improvement among practitioners in early care and education settings. This Research Brief summarizes a recent report…

  18. Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data

    Science.gov (United States)

    American Psychologist, 2009

    2009-01-01

    This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QIPs) that have been promulgated by health care organizations, government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient…

  19. Exposure and roentgen-area-product in xeromammography and conventional mammography

    Energy Technology Data Exchange (ETDEWEB)

    Baxt, J H; Bushong, S C; Glaze, S; Kothari, S [Baylor Univ., Houston, Tex. (USA). Coll. of Medicine

    1976-01-01

    X-ray mammography is assuming increasing importance in the early detection of breast cancer. The principal disadvantage to conventional mammography is high patient dose. Xeromammography offers three advantages over conventional mammography: (a) lower patient dose, (b) better image quality and (c) no special mammography tube required. A transmission ionization chamber and thermoluminescent dosimeters were used to measure the roentgen-area-product and the exposure for three view examination. Average roentgen-area-product values of 6500 and 4200 R-cm/sup 2/ were observed for conventional mammography and xeromammography respectively. The medial surface of the breast received the highest radiation exposure for both types of examinations and this was shown to be 11.5 and 5.1 R respectively. Omission of the axillary view from the examination reduces the patient dose in both types by approximately 60 %.

  20. Some practical possibilities of optimization of the radiological protection of patients in mammography

    International Nuclear Information System (INIS)

    Milu, C.; Dumitrescu, A.; Marin, R.

    2006-01-01

    The mammography for the cancer breast detection is a diagnosis procedure with X-rays in a permanent development in our country and it represent an important measurement for the public health. The experience of the other countries has demonstrated that this utilisation can not be extended without an adequate program for Quality Control and Assurance (A.Q./C.Q.). This paper has been part of an Research Program co-ordinate by the IAEA-Vienna, named 'the image quality and optimization of the patient dose in the East European Countries' which has been done in 2000- 2001. The reason of the IAEA project was to establish a methodology for the implementation of an AQ program in mammography and to make an exercise about evaluation of the image quality and of the patient dose. This study has been done in a few countries of the East Europe including Romania. All of the three mammography installations from the three centers, are relative new and the results of the quality tests and the percent doses have been right: H.V.L. (in mm Al) for the Mo/Mo combination was in the 0.3-0.4 mm Al, the reproducibility of the exposure it was under ± 5%; the exposure linearity was better than ±10%; the absorbed dose at the skin was lower than 10 mGy. Even in this conditions, the missing of the adequate systems for the image processing and the corespondent viewing boxes influenced in the worse way the quality of the image. By the application of the remediation actions it was realised an important reduction of the rejected rate and an improve of the quality image. Significant reductions of the patient dose have been obtained in one of the centre by using the automat work system (instead of the manual work system) and by using of the Mo/Rh combination in the adequate situations (big breast or very dens). It is very important in Romania to organise Workshops about quality criteria in mammography, as used in the European Union. (authors)

  1. Power quality improvements of wind farms

    Energy Technology Data Exchange (ETDEWEB)

    Soebrink, Kent H. [Eltra (Denmark); Stoeber, Ralf; Schettler, Frank; Bergmann, Klaus [Siemens (Germany); Jenkins, Nicholas; Ekanayake, Janaka; Saad-Saoud, Zouhir; Liboa, Maria Luiza; Strbac, Goran [UMIST (United Kingdom); Kaas Pedersen, Joergen; Helgesen Pedersen, Knud Ole [Technical Univ. of Denmark (Denmark)

    1998-06-01

    The main objective of the project was to investigate how the power quality of the electrical output of wind farms could be improved by the use of modern high power electronic technology. Although the research is of direct application to wind energy it will also be relevant to many other types of small-scale generation embedded in utility distribution networks. The operation of wind turbines with asynchronous generators requires reactive power which, if supplied form the network, leads to low voltages and increased losses. In order to improve the power factor of the generation, fixed capacitors are usually used to provide reactive power. However, if they are sized for the full requirement of the wind farm, they can cause self-excitation and potentially damaging and hazardous overvoltages if the wind turbines` connection with the network is interrupted and they become islanded. An advanced Static VAr Compensator (ASVC) uses a power electronic converter to generate or absorb reactive power. They can be used to provide reactive power with rapid control and with only modestly sized passive components (i.e. small capacitors and reactors). The objective of the project was to combine research and development of this novel form of electronic equipment with its application to increase the use of renewable energy, and wind power in particular, in the European Union. (EG) 19 refs.

  2. 40 CFR 63.175 - Quality improvement program for valves.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for valves... alternative quality improvement programs specified in paragraphs (d) and (e) of this section. The decision to... § 63.168 and § 63.175. (1) If the owner or operator elects to continue the quality improvement program...

  3. Mammography at reduced doses: present performance and future possibilities

    International Nuclear Information System (INIS)

    Muntz, E.P.; Wilkinson, E.; George, F.W.

    1980-01-01

    Reduced dose mammography is assessed with the aid of very recent work. It is concluded that there are technical and clinical reasons for believing that the reduced dose systems and their interpreters should perform more effectively than their predecessors. Review of known technologic achievements suggests a possible 6 to 7 reduction factor from present screen-film mammography dose levels without sacficifing image quality. Reasonable estimates of representative doses presently achieved by both xeroradiography and screen-film systems are given. The screen-film value is about 3 times higher than some previous

  4. Compliance with European Guidelines for Diagnostic Mammography in a Decentralized Health-Care Setting

    International Nuclear Information System (INIS)

    Jensen, A.; Mikkelsen, G.J.; Vestergaard, M.; Lynge, E.; Vejborg, I.

    2005-01-01

    Purpose: To evaluate the compliance of Danish mammography clinics with requirements concerning organization, activity volume, and assessment procedures from two European guidelines for quality assurance in diagnostic mammography (EUSOMA and EUREF). Material and Methods: We used individual records on all diagnostic mammographies performed in Denmark in 2000, and questionnaires given to Danish mammography clinics in 2000, 2002, and 2004. Results: The study showed a marked centralization of the diagnostic activity from 2000 to 2004 to a smaller number of public breast assessment centers with full multidisciplinary breast assessment. However, a relatively large number of these centers did not comply with the activity volume requirement of 2000 mammograms per clinic per year. The number of private diagnostic mammography clinics performing basic diagnostic mammography has remained fairly stable in the period 2000 to 2004. Compared with public breast assessment centers, the private diagnostic mammography clinics had a lower compliance with activity volume requirements. Conclusion: A marked proportion of Danish public breast assessment centers operate with less than optimal activity volume, suggesting that further centralization would be appropriate. The situation in private diagnostic mammography clinics may cause concern, as our study showed that the majority of these clinics did not meet the activity volume requirements

  5. Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

    International Nuclear Information System (INIS)

    Thomassin-Naggara, Isabelle; Perrot, Nicolas; Dechoux, Sophie; Ribeiro, Carine; Chopier, Jocelyne; Bazelaire, Cedric de

    2015-01-01

    Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

  6. Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

    Energy Technology Data Exchange (ETDEWEB)

    Thomassin-Naggara, Isabelle, E-mail: isabelle.thomassin@tnn.aphp.fr [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); INSERM, UMR970, Equipe 2, Imagerie de l’angiogenèse, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Perrot, Nicolas [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Centre Pyramides, Paris (France); Dechoux, Sophie [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Ribeiro, Carine [Centre Pyramides, Paris (France); Chopier, Jocelyne [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Bazelaire, Cedric de [APHP, Department of Radiology, Hôpital Saint Louis, 75010 Paris (France)

    2015-02-15

    Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

  7. EXFOR: Improving the quality of international databases

    International Nuclear Information System (INIS)

    Dupont, Emmeric

    2014-01-01

    The NEA Data Bank is an international centre of reference for basic nuclear tools used for the analysis and prediction of phenomena in nuclear energy applications. The Data Bank collects, compiles, disseminates and contributes to improving computer codes and associated data. In the area of nuclear data, the Data Bank works in close co-operation with other data centres that contribute to the worldwide compilation of experimental nuclear reaction data in the EXFOR database. EXFOR contains basic nuclear data on low- to medium-energy experiments for incident neutron, photon and various charged particle induced reactions on a wide range of nuclei and compounds. Today, with more than 150 000 data sets from more than 20 000 experiments performed since 1935, EXFOR is by far the most important and complete experimental nuclear reaction database. It is widely used to further improve nuclear reaction models and evaluated nuclear data libraries. The Data Bank supervises the development of the Joint Evaluated Fission and Fusion (JEFF) file, which is one of the major evaluated nuclear data libraries used in the field of nuclear science and technology. As part of its mission, the Data Bank works to maintain the highest level of quality in its databases. One method that was proposed to check the mutual consistency of experimental data in EXFOR is to test for outlier measurements more than a few standard deviations from the mean value as, in principle, several measurements of the same reaction quantity should form a continuous distribution. More recently, another method was developed to cross-check evaluated and experimental data in databases in order to detect aberrant values. It was noted that there is no evidence, on the basis of numerical comparisons only, that outliers represent 'bad' data. The fact that such data deviate significantly from other data of the same reaction may, however, be helpful to nuclear data evaluators who focus on one or a few isotopes and may wish to

  8. Pilot program of quality control in mammography and conventional equipment in the Antioquia Department; Programa piloto de control de calidad en mamografia y equipos convencionales en el Departamento de Antioquia

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, P. [Direccion Seccional de Salud de Antioquia (Colombia); Puerta, J.A.; Morales, J. [Universidad Nacional de Colombia, Sede Medellin (Colombia); Beltran, C.C. [Asociacion Colombiana de Proteccion Radiologica (Colombia)]. e-mail: japuerta@unal.edu.co

    2006-07-01

    The Sectional Health Division of Antioquia and the National University of Colombia- Medellin Headquarters formalized an agreement for the realization of the quality control of thirty mammographs and twenty-five conventional X-ray equipment located in the one metropolitan area of Medellin, and ten municipalities of the nine regions in that the antioquen county is divided. The National University of Colombia- Headquarters Medellin possesses a program for the formation in quality control and radiological protection at master level in physics for that which endowed a radiodiagnostic laboratory for these purposes. In the Antioquia department only exists an institution, the San Vicente of Paul University Hospital that possesses a quality control program in radiodiagnostic; this hospital given its great volume of studies in radiodiagnostic has a medical physicist and of that instrumental necessary to maintain the program. The quality control programs have not been implemented in the rest of health institutions, public or private, big or small, until the moment. The project then allowed to carry out an initial evaluation of the pertinent parameters of the quality control of the facilities like its are those that refer to the state of the x-ray generator, the disposition of the installation, the dark room, the film processor and negatoscopies room; these its were carried out with base in the protocol produced in the ARCAL XLIX project in which participated six Latin American countries. The dose average in mammography, following the proposed course in the ARCAL LXXV, where its participate eleven Latin American countries was also evaluated. This study pilot serves like reference of the current state of the regional radiodiagnostic services, with base in this sampling that is representative. The obtained data gave the necessary information so that the Sectional Division of Health of Antioquia can generate tending actions to the implementation of quality guarantee programs and

  9. Quality procedure management for improved nuclear safety

    International Nuclear Information System (INIS)

    Forzano, P.; Castagna, P.

    1995-01-01

    Emergency Operating Procedures and Accident Management Procedures are the next step in the computerization of NPP control rooms. Different improvements are presently conceivable for this operator aid tool, and research activities are in development. Undergoing activities regard especially formal aspects of knowledge representation, Human-Machine interface and procedure life cycle management. These aspects have been investigated deeply by Ansaldo, and partially incorporated in the DIAM prototype. Nuclear Power Plant Procedures can be seen from essentially two viewpoints: the process and the information management. From the first point of view, it is important to supply the knowledge apt to solve problems connected with the control of the process, from the second one the focus of attention is on the knowledge representation, its structure, elicitation and maintenance, and formal quality assurance. These two aspects of procedure representation can be considered and solved separately. In particular, methodological, formal and management issues require long and tedious activities, that in most cases constitute a great barrier for procedures development and upgrade. To solve these problems, Ansaldo is developing DIAM, a wide integrated tool for procedure management to support in procedure writing, updating, usage, and documentation. One of the most challenging features of DIAM is AUTO-LAY, a CASE sub-tool that, in a complete automatical way, structures parts or complete flow diagram. This is the feature that is partial present in some other CASE products, that, anyway, do not allow complex graph handling and isomorphism between video and paper representation. AUTO-LAY has the unique prerogative to draw graphs of any complexity to section them in pages, and to automatically compose a document. This has been recognized in the literature as the most important a second-generation CASE improvement. (Author) 9 Figs., 5 Refs

  10. PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    B.P. Mahesh

    2010-09-01

    Full Text Available Quality has become one of the most important customer decision factors in the selection among the competing product and services. Consequently, understanding and improving quality is a key factor leading to business success, growth and an enhanced competitive position. Hence quality improvement program should be an integral part of the overall business strategy. According to TQM, the effective way to improve the Quality of the product or service is to improve the process used to build the product. Hence, TQM focuses on process, rather than results as the results are driven by the processes. Many techniques are available for quality improvement. Statistical Process Control (SPC is one such TQM technique which is widely accepted for analyzing quality problems and improving the performance of the production process. This article illustrates the step by step procedure adopted at a soap manufacturing company to improve the Quality by reducing process variability using Statistical Process Control.

  11. A quality improvement management model for renal care.

    Science.gov (United States)

    Vlchek, D L; Day, L M

    1991-04-01

    The purpose of this article is to explore the potential for applying the theory and tools of quality improvement (total quality management) in the renal care setting. We believe that the coupling of the statistical techniques used in the Deming method of quality improvement, with modern approaches to outcome and process analysis, will provide the renal care community with powerful tools, not only for improved quality (i.e., reduced morbidity and mortality), but also for technology evaluation and resource allocation.

  12. Applying Triz for Production Quality Improvement

    Directory of Open Access Journals (Sweden)

    Swee Nikalus Shu Luing

    2017-01-01

    Full Text Available This paper aims to provide a thorough analysis on the application of TRIZ in improving the quality of canned food production. TRIZ tools such as engineering systems analysis, function analysis, cause and effect chain analysis, By-separation model and 40 Inventive Principles are applied in order to discover some feasible and elegant solutions to alleviate the problem. Findings revealed that the rejected canned products on the conveyor belt will be isolated or picked up with other good condition canned products which are lined up very closely to the rejected cans; though the visioning system is able detect the fault printing on the canned product. The main root cause is that the rejected canned product is picked up with other canned products in good condition because all cans are lined up on the belt and are very close to each other or having no gaps between the cans. Conversely, all cans on the conveyor belts are required to be very close to each other to avoid collisions that may damage the cans. The root cause is solved by applying function analysis, By-separation tool and Inventive Principles. Therefore, it can be concluded that TRIZ is a powerful tool in inventive problem solving.

  13. Improving Water Quality With Conservation Buffers

    Science.gov (United States)

    Lowrance, R.; Dabney, S.; Schultz, R.

    2003-12-01

    Conservation buffer technologies are new approaches that need wider application. In-field buffer practices work best when used in combination with other buffer types and other conservation practices. Vegetative barriers may be used in combination with edge-of-field buffers to protect and improve their function and longevity by dispersing runoff and encouraging sediment deposition upslope of the buffer. It's important to understand how buffers can be managed to help reduce nutrient transport potential for high loading of nutrients from manure land application sites, A restored riparian wetland buffer retained or removed at least 59 percent of the nitrogen and 66 percent of the phosphorus that entered from an adjacent manure land application site. The Bear Creek National Restoration Demonstration Watershed project in Iowa has been the site of riparian forest buffers and filter strips creation; constructed wetlands to capture tile flow; stream-bank bioengineering; in-stream structures; and controlling livestock grazing. We need field studies that test various widths of buffers of different plant community compositions for their efficacy in trapping surface runoff, reducing nonpoint source pollutants in subsurface waters, and enhancing the aquatic ecosystem. Research is needed to evaluate the impact of different riparian grazing strategies on channel morphology, water quality, and the fate of livestock-associated pathogens and antibiotics. Integrating riparian buffers and other conservation buffers into these models is a key objective in future model development.

  14. Cultural views, language ability, and mammography use in Chinese American women.

    Science.gov (United States)

    Liang, Wenchi; Wang, Judy; Chen, Mei-Yuh; Feng, Shibao; Yi, Bin; Mandelblatt, Jeanne S

    2009-12-01

    Mammography screening rates among Chinese American women have been reported to be low. This study examines whether and how culture views and language ability influence mammography adherence in this mostly immigrant population. Asymptomatic Chinese American women (n = 466) aged 50 and older, recruited from the Washington, D.C. area, completed a telephone interview. Regular mammography was defined as having two mammograms at age-appropriate recommended intervals. Cultural views were assessed by 30 items, and language ability measured women's ability in reading, writing, speaking, and listening to English. After controlling for risk perception, worry, physician recommendation, family encouragement, and access barriers, women holding a more Chinese/Eastern cultural view were significantly less likely to have had regular mammograms than those having a Western cultural view. English ability was positively associated with mammography adherence. The authors' results imply that culturally sensitive and language-appropriate educational interventions are likely to improve mammography adherence in this population.

  15. Evaluation of the performance characteristic for mammography by using edge device

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Won [Dept. of Radiology, Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Choi, Jwan Woo [Dept. of Radiology, Asan Medical Center, Seoul (Korea, Republic of); Jeong, Hoi Woun [Dept. of Radiological Technology, The Baekseok Culture University, Cheonan (Korea, Republic of); Jang, Seo Goo [Dept. of Medical Science, The Soonchunhyang University, Asan (Korea, Republic of); Lee, Eul Kyu [Dept. of Radiology, Inje Paik University Hospital Jeo-dong, Seoul (Korea, Republic of); Son, Soon Yong [Dept. of Radiological Technology, The Wonkwang Health Science University, Iksan (Korea, Republic of); Son, Jin Hyun; Min, Jung Whan [Dept. of Radiological Technology, The Shingu University, Sungnam (Korea, Republic of)

    2016-09-15

    The purpose of this study was to evaluation of the performance characteristic for mammography by using edge device that mammography equipment improves essential in the correct diagnosis for the maintenance. We measured the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) using the 61267 RQA-M2 based on commission standard international electro-technical commission (IEC). As a results, spatial resolution of dimensions tomo and lorad selenia mammography were maintained at 10 mm-1 and NPS and DQE including the low nyquist frequency indicated to 6.0 mm-1. Therefore, regularly QA of mammography system should be necessary. This study can be contribute to evaluate QA for performance characteristic of mammography of DDR system.

  16. Mammography: MedlinePlus Health Topic

    Science.gov (United States)

    ... Questions (National Cancer Institute) Mammography for Women with Breast Implants (American Cancer Society) Also in Spanish Mammography: What You Need to Know (Food and Drug Administration) Nipple Aspirate Test Is ... Specifics Breast Tomosynthesis (American College of Radiology, Radiological Society of ...

  17. Mammography screening: A major issue in medicine.

    Science.gov (United States)

    Autier, Philippe; Boniol, Mathieu

    2018-02-01

    -detected cancers. Overdiagnosis leads to overtreatment and inflicts considerable physical, psychological and economic harm on many women. Overdiagnosis has also exerted considerable disruptive effects on the interpretation of clinical outcomes expressed in percentages (instead of rates) or as overall survival (instead of mortality rates or stage-specific survival). Rates of radical mastectomies have not decreased following the introduction of screening and keep rising in some countries (e.g. the United States of America (USA)). Hence, the epidemiological picture of mammography screening closely resembles that of screening for neuroblastoma. Reappraisals of Swedish mammography trials demonstrate that the design and statistical analysis of these trials were different from those of all trials on screening for cancers other than breast cancer. We found compelling indications that these trials overestimated reductions in breast cancer mortality associated with screening, in part because of the statistical analyses themselves, in part because of improved therapies and underreporting of breast cancer as the underlying cause of death in screening groups. In this regard, Swedish trials should publish the stage-specific breast cancer mortality rates for the screening and control groups separately. Results of the Greater New York Health Insurance Plan trial are biased because of the underreporting of breast cancer cases and deaths that occurred in women who did not participate in screening. After 17 years of follow-up, the United Kingdom (UK) Age Trial showed no benefit from mammography screening starting at age 39-41. Until around 2005, most proponents of breast screening backed the monitoring of changes in advanced cancer incidence and comparative studies on breast cancer mortality for the evaluation of breast screening effectiveness. However, in an attempt to mitigate the contradictions between results of mammography trials and population data, breast-screening proponents have elected to

  18. Bi-directional x-ray phase-contrast mammography.

    Directory of Open Access Journals (Sweden)

    Kai Scherer

    Full Text Available Phase-contrast x-ray imaging is a promising improvement of conventional absorption-based mammography for early tumor detection. This potential has been demonstrated recently, utilizing structured gratings to obtain differential phase and dark-field scattering images. However, the inherently anisotropic imaging sensitivity of the proposed mono-directional approach yields only insufficient diagnostic information, and has low diagnostic sensitivity to highly oriented structures. To overcome these limitations, we present a two-directional x-ray phase-contrast mammography approach and demonstrate its advantages by applying it to a freshly dissected, cancerous mastectomy breast specimen. We illustrate that the two-directional scanning procedure overcomes the insufficient diagnostic value of a single scan, and reliably detects tumor structures, independently from their orientation within the breast. Our results indicate the indispensable diagnostic necessity and benefit of a multi-directional approach for x-ray phase-contrast mammography.

  19. Radiation hazards of X-ray mammography

    International Nuclear Information System (INIS)

    Bailar, J.C. III

    1978-01-01

    X-ray mammography delivers significant amounts of ionizing radiation to the breast, and the female breast is more susceptible to radiation carcinogenesis than any other human organ. On the other hand, breast cancer is least likely to cause serious illness and death when it is detected at a very early stage. The risks and benefits of mammography can be estimated. This paper summarizes current risk estimates, then proceeds to a comparison of risks and benefits. As for breast cancer mortality, the addition of mammography to a programme of annual breast examinations of average U.S. women is of questionable value for women under age 50 but it is probably beneficial for older women. However, the break-even point is closely related to the average radiation exposure of breast tissue, and would be earlier in a few centres now using optimum techniques and equipment. For women with below-average risks of breast cancer, the age would be higher, and for a few women with a high probability of developing breast cancer it would be lower. Breast cancer screening programmes have been improved significantly since criticisms were first publicized in mid-1975. Partial improvements include reduction in radiation exposure (at least in some centres), guidelines from the National Cancer Institute (NCI) and the American Cancer Society (ACS) for restricting the screening of women under age 50, and changes in the patient consent form signed by participants in the NCI-ACS programme. Professional and public awareness of the need to balance the benefits of screening with its risks and costs has rapidly and markedly increased. Future improvements should further define the optimum design and application of breast cancer screening programmes

  20. How changing quality management influenced PGME accreditation: a focus on decentralization and quality improvement

    NARCIS (Netherlands)

    Akdemir, Nesibe; Lombarts, Kiki M. J. M. H.; Paternotte, Emma; Schreuder, Bas; Scheele, Fedde

    2017-01-01

    Background: Evaluating the quality of postgraduate medical education (PGME) programs through accreditation is common practice worldwide. Accreditation is shaped by educational quality and quality management. An appropriate accreditation design is important, as it may drive improvements in training.

  1. European radiographers' challenges from mammography education and clinical practice - an integrative review.

    Science.gov (United States)

    Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

    2017-06-01

    This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

  2. Experiences from the evaluation of two global quality indicators in a radiology service

    International Nuclear Information System (INIS)

    Hernandez Lopez, L. Y.; Valdes Arce, Y.; Fleitas Estevez, I.

    2013-01-01

    The main objective in radiology is to obtain images of good quality for certain diagnosis, without unnecessarily irradiating the patient. This paper shows the results of the reject films and clinical image quality evaluations in the radiology service of the Hospital 'Abel Santamaria Cuadrado', Pinar del Rio, Cuba. Data were collected during March and September of 2012. Reject films analysis was done for conventional and mammography studies. Clinical image quality evaluated following the European Guidelines on Quality Criteria. The results show that reject films rate decreased from 6% on March to 1.3% on September, after applying corrective actions; while chests studies have the highest reject rate. The mean causes for rejections were maladjustments in the collimation system, equipment faults, sub exposure and overexposure. For mammography studies the initial reject rate was 29.3% and decreased to 5.9% on September. Mean causes for rejection were related to faults in the automatic processor and the mammography x-ray unit. Image quality also improved: only 48.3% of chest images and 10% of mammography images were considered to be acceptable for diagnosis at the first moment; while these percentages increased to 68.3% and 70% for chest and mammography studies, respectively in the September's evaluation. The study demonstrated that the frequently evaluation of the quality's indicators allows to identify the main causes of the image's detriment to propose corrective actions. Still in situations of insufficient resources it is possible to improve quality with simple interventions on the main faults detected. (Author)

  3. Do competition and managed care improve quality?

    Science.gov (United States)

    Sari, Nazmi

    2002-10-01

    In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts. Copyright 2002 John Wiley & Sons, Ltd.

  4. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence or? the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  5. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  6. Title IV Quality Control Project, Stage II. Management Option II: Delivery System Quality Improvements.

    Science.gov (United States)

    Advanced Technology, Inc., Reston, VA.

    Stage Two of the Title IV Quality Control Project is an integrated study of quality in five related Federal financial aid programs for postsecondary students. Section 1 of the paper establishes a framework for defining quality improvements, in order to identify the types of changes that would tend to improve quality across all facets of the…

  7. Do farm audits improve milk quality?

    NARCIS (Netherlands)

    Flores-Miyamoto, A.; Reij, M.W.; Velthuis, A.G.J.

    2014-01-01

    Milk quality is assessed using bulk milk analysis and by farm audits in the Netherlands. However, the extent of the effect that dairy farm audits have on milk quality is unknown. Data from over 13,000 audits performed on 12,855 dairy farms from February 2006 to April 2008 were merged with laboratory

  8. A history of industrial statistics and quality and efficiency improvement

    NARCIS (Netherlands)

    de Mast, J.; Coleman, S.; Greenfield, T.; Stewardson, D.; Montgomery, D.C.

    2008-01-01

    The twentieth century witnessed incredible increases in product quality, while in the same period product priced dropped dramatically. These important improvements in quality and efficiency in industry were the result of innovations in management and engineering. But these developments were

  9. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement plan (QIP... PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a.... (iii) Appropriate improvements to control methods. (iv) Other steps appropriate to correct control...

  10. Improving Quality Higher Education in Nigeria: The Roles of Stakeholders

    Science.gov (United States)

    Asiyai, Romina Ifeoma

    2015-01-01

    This paper discusses the roles of stakeholders in improving quality of university education in Nigeria. Internal and external stakeholders are identified and the various roles they could play in improving the quality of university education are discussed. The paper contends that continuous and holistic improvement in university education system…

  11. Application of improved quality control technology to pressure vessels

    International Nuclear Information System (INIS)

    Kriedt, F.

    1985-01-01

    Within the last decade, ASME Boiler and Pressure Vessel Code Section VIII-1 instituted requirements for a formal written quality control system. The results, good and bad, of this requirement are discussed. The effects are far reaching from a national economic standpoint. Quality control technology has improved. These improvements are discussed and compared to existing requirements of the CODE. Recommended improvements are suggested

  12. Thyroid absorbed dose using TLDs during mammography

    International Nuclear Information System (INIS)

    Gonzalez A, M.; Melendez L, M.; Davila M, P.

    2015-10-01

    Full text: In this study, the mean glandular dose (MGD) and the thyroid dose (D Thy) were measured in 200 women screened with mammography in Cranio caudal (Cc) and mediolateral oblique projections. All mammograms were performed with Giotto-Ims (6000-14-M2 Model) equipment, which was verified to meet the criteria of quality of NOM-229-Ssa-2002. During audits performance and HVL, for each anode filter combinations was measured with the camera Radcal mammography equipment 10 X 6-6M (HVL = 0.26 mm Al). D Thy measurements were performed with TLD dosimeters (LiF:Mn) , that were read with the Harshaw 3500 TLD reader. The MGD, was obtained according to the UK and European protocols for mammographic dosimetry using a plane parallel chamber (Standard Imaging, Model A-600) calibrated by a radiation beam UW-23-Mo (= 0.279 mm Al HVL). A comparative statistical analysis was carried out with the measured MGD and D thy. The thyroid mean dose was 0.063 mGy and 0.078 mGy for Cc and mediolateral oblique respectively. There is a linear correlation between the MGD and the D Thy slightly influenced by the anode-filter combination. Using a 95% for the confidence interval in MGD (1.07 mGy), the 90% of measurements are in agreement with the established uncertainty limits. The D Thy are lower than the MGD. There is no risk for cancer induction in thyroid in women due to mammography screening. (Author)

  13. Performance tests of a special ionization chamber for X-rays in mammography energy range

    Energy Technology Data Exchange (ETDEWEB)

    Silva, J.O., E-mail: jonas.silva@ufg.br [Universidade Federal de Goiás (UFG), Goiânia (Brazil). Instituto de Física; Caldas, L.V.E. [Instituto de Pesquisas Energéticas e Nucleares (IPEN-CNEN/SP), São Paulo, SP (Brazil). Centro de Metrologia das Radiações

    2017-07-01

    A special mammography homemade ionization chamber was developed to be applied for mammography energy range dosimetry. This chamber has a total sensitive volume of 6 cm{sup 3} and is made of a PMMA body and graphite coated collecting electrode. Performance tests as saturation, ion collection efficiency, linearity of chamber response versus air kerma rate and energy dependence were determined. The results obtained with this special homemade ionization chamber are within the limits stated in international recommendations. This chamber can be used in quality control programs of mammography energy range. All measurements were carried out at the Calibration Laboratory of IPEN. (author)

  14. Early identification of iflammantory rheumatic bone disease via mammography technique

    International Nuclear Information System (INIS)

    Singer, F.; Jakic, L.

    1981-01-01

    A decisive improvement of early X-ray diagnosis of inflammatory rheumatic osseus changes becomes possible by means of an appropriate combination of film and foil of the type which has been in use in mammography for a long time. (orig.) [de

  15. Pain and discomfort during mammography

    DEFF Research Database (Denmark)

    Aro, A R; Absetz-Ylöstalo, P; Eerola, T

    1996-01-01

    was the most powerful factor explaining pain and discomfort among women with earlier mammography. However, it had no effect among women without earlier mammography, for whom screening-related nervousness and perceptions of staff were crucial. Suggested interventions include better information before screening......The aim of this prospective study was to investigate associations of mammography pain and discomfort with sociodemographics, personal history and psychological and situational factors. Subjects were women with a negative screening finding (n = 883) from a random sample of 50-year-old Finnish women...... attending their first breast cancer screening. Questionnaires were sent 1 month before the screening invitation and 2 months after screening. Sixty-one per cent reported painful and 59% uncomfortable mammograms (4% severely). Linear regression analyses showed that anticipation of pain and discomfort...

  16. Diagnostic accuracy and recall rates for digital mammography and digital mammography combined with one-view and two-view tomosynthesis: results of an enriched reader study.

    Science.gov (United States)

    Rafferty, Elizabeth A; Park, Jeong Mi; Philpotts, Liane E; Poplack, Steven P; Sumkin, Jules H; Halpern, Elkan F; Niklason, Loren T

    2014-02-01

    The purpose of this study was to compare two methods of combining tomosynthesis with digital mammography by assessing diagnostic accuracy and recall rates for digital mammography alone and digital mammography combined with one-view tomosynthesis and two-view tomosynthesis. Three hundred ten cases including biopsy-proven malignancies (51), biopsy-proven benign findings (47), recalled screening cases (138), and negative screening cases (74) were reviewed by 15 radiologists sequentially using digital mammography, adding one-view tomosynthesis, and then two-view tomosynthesis. Cases were assessed for recall and assigned a BI-RADS score and probability of malignancy for each imaging method. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. Screening recall rates were compared using pooled logistical regression analysis. A p value of tomosynthesis, and DM plus two-view tomosynthesis was 0.828, 0.864, and 0.895, respectively. Both one-view and two-view tomosynthesis plus DM were significantly better than DM alone (Δ AUCs 0.036 [p = 0.009] and 0.068 [p tomosynthesis, and DM plus two-view tomosynthesis were 44.2%, 27.2%, and 24.0%, respectively. Combined with DM, one-view and two-view tomosynthesis both showed significantly lower noncancer recall rates than digital mammography alone (p tomosynthesis showed a significantly lower recall rate than digital mammography with one-view tomosynthesis (p tomosynthesis compared with digital mammography alone. Compared with digital mammography, diagnostic sensitivity for invasive cancers increased with the addition of both one-view (Δ12.0%, p tomosynthesis. The addition of one-view tomosynthesis to conventional digital mammography improved diagnostic accuracy and reduced the recall rate; however, the addition of two-view tomosynthesis provided twice the performance gain in diagnostic accuracy while further reducing the recall rate.

  17. Decision making and counseling around mammography screening for women aged 80 or older.

    Science.gov (United States)

    Schonberg, Mara A; Ramanan, Radhika A; McCarthy, Ellen P; Marcantonio, Edward R

    2006-09-01

    Despite uncertain benefit, many women over age 80 (oldest-old) receive screening mammography. To explore decision-making and physician counseling of oldest-old women around mammography screening. Qualitative research using in-depth semi-structured interviews. Twenty-three women aged 80 or older who received care at a large academic primary care practice (13 had undergone mammography screening in the past 2 years) and 16 physicians at the same center. We asked patients and physicians to describe factors influencing mammography screening decisions of oldest-old women. We asked physicians to describe their counseling about screening to the oldest-old. Patients and/or physicians identified the importance of physician influence, patient preferences, system factors, and social influences on screening decisions. Although physicians felt that patient's health affected screening decisions, few patients felt that health mattered. Three types of elderly patients were identified: (1) women enthusiastic about screening mammography; (2) women opposed to screening mammography; and (3) women without a preference who followed their physician's recommendation. However, physician counseling about mammography screening to elderly women varies; some individualize discussions; others encourage screening; few discourage screening. Physicians report that discussions about stopping screening can be uncomfortable and time consuming. Physicians suggest that more data could facilitate these discussions. Some oldest-old women have strong opinions about screening mammography while others are influenced by physicians. Discussions about stopping screening are challenging for physicians. More data about the benefits and risks of mammography screening for women aged 80 or older could inform patients and improve provider counseling to lead to more rational use of mammography.

  18. The process of managerial control in quality improvement initiatives.

    Science.gov (United States)

    Slovensky, D J; Fottler, M D

    1994-11-01

    The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs.

  19. Student laboratory reports: an approach to improving feedback and quality

    Science.gov (United States)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  20. Quality improvement teaching at medical school: a student perspective

    OpenAIRE

    Nair, Pooja; Barai, Ishani; Prasad, Sunila; Gadhvi, Karishma

    2016-01-01

    Pooja Nair, Ishani Barai, Sunila Prasad, Karishma Gadhvi Department of Medicine, Imperial College School of Medicine, Imperial College London, London, UK Abstract: Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. Keywords: quality improvement, medical school, patient safety, patient satisfaction, medical student, clinical audit

  1. Quality improvement teaching at medical school: a student perspective

    Directory of Open Access Journals (Sweden)

    Nair P

    2016-03-01

    Full Text Available Pooja Nair, Ishani Barai, Sunila Prasad, Karishma Gadhvi Department of Medicine, Imperial College School of Medicine, Imperial College London, London, UK Abstract: Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. Keywords: quality improvement, medical school, patient safety, patient satisfaction, medical student, clinical audit

  2. Dosimetric investigations in mammography

    International Nuclear Information System (INIS)

    Metges, P.J.; Lorrain, S.

    1981-01-01

    The development film-screen detectors in radiological equipment has led us to study how to improve standard mammographic pictures (focus 0.3 x 0.3 mm, focus-film distance: 65) of thick and dense breasts by the use of an anti-scatter grid and by magnification. A dosimetric study was necessary to assess the doses delivered during mammographic examinations carried out according to various procedures. The results led to modify breast examination procedures and use an anti-scatter grid for breasts thicker than 4 cm or known as dense. The dose increase due to a better quality image is the lowest provided depth penetration is increased by 2 kV as compared to a standard picture. Absorbed doses on the X-ray axis, at 3 cm depth, are below 0.1 rad [fr

  3. Lake Tahoe Water Quality Improvement Programs

    Science.gov (United States)

    Information on the Lake Tahoe watershed, EPA's protection efforts, water quality issues, effects of climate, change, Lake Tahoe Total Maximum Daily Load (TMDL), EPA-sponsored projects, and list of partner agencies.

  4. Productivity quality improvement at UNC Geotech

    International Nuclear Information System (INIS)

    Jenkins, W.A.

    1987-01-01

    The program to improve productivity is presented in a series of view graphs. Key elements of the program are: CEO leadership and commitment; measurable improvements; specific annual goals; system for sharing benefits of improvements; practical training for employees; and intent to institutionalize

  5. Patterns and determinants of mammography screening in Lebanese women.

    Science.gov (United States)

    Elias, Nadia; Bou-Orm, Ibrahim R; Adib, Salim M

    2017-03-01

    The associations of ever using and/or repeating a mammography test with psychosocial and socio-demographic factors were surveyed in 2014 among Lebanese women ≥ 40. A sample of 2400 women was selected across Lebanon. Variables with significant bivariate associations with various types of behaviors were entered in multivariate analysis. Of the total, 105 women (4·4%) had never heard of mammography as a tool for early breast cancer detection. Among the remaining 2295, 45% had ever used it, of whom 10% had obtained it for the first time within the 12 months preceding the survey. Repeaters were 67% of 926 women who had the time opportunity to do so (median lifetime frequency: 2). Older age, higher socio-economic status (SES) and living within the Greater Beirut (GB) area were significantly associated with ever-use. Within GB, psychosocial factors such as perceived susceptibility and benefits were most strongly associated with ever-use. Outside GB, socio-economic advantage seemed to mostly affect ever-use. Only 4% reported opposition from husbands to their mammography, and husband's support was significant for adherence to mammography guidelines mostly outside GB. Higher education emerged also as a significant socio-demographic determinant for ever-repeating in all regions. Perceived comfort of the previous test strongly affected the likelihood of repeating it. Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.

  6. Computer-Assisted Visual Search/Decision Aids as a Training Tool for Mammography

    National Research Council Canada - National Science Library

    Nodine, Calvin

    2000-01-01

    The primary goal of the project is to develop a computer-assisted visual search (CAVS) mammography training tool that will improve the perceptual and cognitive skills of trainees leading to mammographic expertise...