Mammography Processing And Quality Management

Question 1

What type of maintenance includes actions taken on a regular basis to prevent deterioration of image quality or any breakdown in the imaging chain?

Answer 1

Preventative maintenance

Question 2

Give an example of how a good quality assurance program will benefit the patient?

Answer 2

Improve overall efficiency and delivery of service, therefore improve patient satisfaction and reduction of repeats, and therefore, radiation dose to the patients, consistency in image production, and increase cost effectiveness of equipment.

Question 3

Name one federal agency responsible for ensuring the safety and quality of imaging practices within the United States.

Answer 3

OSHA, EPA, FDA, NCDRH, CDC or MQSA

Question 4

Identify some of the causes of repeats.

Answer 4

Competence of technical staff, equipment problems, specific difficulties associated with particular examinations, or a combination of these.

Question 5

How often is the compression test performed?

Answer 5

Semiannually

Question 6

What is the minimum and maximum allowed compression?

Answer 6

25-45lbs (111-200 N)

Question 7

What does the modulation transfer function (MTF) measure?

Answer 7

Checks the consistency of the contrast-to-noise ratio (CNR) and ensures adequate contrast over a specific spatial frequency range

Question 8

What are some of the areas checked by the flat field test?

Answer 8

It’s an image quality test to check consistency of the image quality for brightness, non-uniformity, high-frequency modulation (HFM), signal-to-noise ratio (SNR) and bad region of interest (ROI) and bad pixel verification

Question 9

What does the CNR measure?

Answer 9

It measures how well the system images micro calcification or mass and is capable of differentiating them from the background density.

Question 10

Collimation must cover the entire image receptor but should not extend beyond any edge of the image receptor by more than what percent of the SID.

Answer 10

2% of the source-to-image receptor distance (SID)

Question 11

Who is responsible for medical auditing and patient communcation?

Answer 11

The interpreting physician-the radiologist

Question 12

Which assessment is used to ensure that the x-ray field aligns with the light field and the collimation covers the entire image receptor?

Answer 12

Collimation assessment

Question 13

How is the effect of subjective judgement reduced when viewing the phantom image test?

Answer 13

Phantom images should be viewed by the same person, using the same type of magnifier, at the same time of day, under the same viewing conditions.

Question 14

For a statistically meaningful reject/repeat analysis, what is the recommended patient volume?

Answer 14

250

Question 15

Ideally, the overall repeat rate should not exceed what percentage?

Answer 15

2%

Question 16

What is the MQSA’s recommended next step, taken if the compression test fails?

Answer 16

Identify the source of the problem and take corrective action before any additional mammography examinations are performed.

Question 17

List the general tests

Answer 17

• Visual check list
• Phantom image test
• Repeat analysis
• Viewboxes and viewing conditions
• Compression force test

Question 18

Analog quality control test

Answer 18

• Darkroom cleanliness
• Processor quality controls
• Screen cleanliness
• Fixer retention test
• Dark room fog test
• Screen-film contrast

Question 19

Digital quality control test

Answer 19

• Monitor cleaning
• Laser image QC test
• Detector calibration
• Flat field and artifact evaluation
• System resolution tests including modulation transfer function (MTF), signs to noise (SNR), and contrast to noise (CNR)

Question 20

Analog tests summary

Answer 20

Daily tasks
*Darkroom cleanliness/processor quality control
Weekly tasks
*Viewbox and viewing conditions/phantom images
Monthly tasks
*Visual checklist
Quarterly tasks
*Repeat analysis of fixer retention
Semiannually
*Darkroom fog testing/screen-film contact/compression

Question 21

Digital test summary

Answer 21

Daily - Monitor cleaning and Workstation viewing and viewing conditions
Weekly
*Flat field test
*Brightness/nonuniformity/high-frequency modulation (HFM)
*MTF and CNR measurement
*CNR-differentiate micro-cal from background image
MTF -modulation transfer function - consistency of CNR
Artifact evaluation of detector and printer
*SMPTE and compression indicator - only on some digital units
*Communication between AWS and detector/printer
*Phantom image check
Monthly
*AOP mode and SNR check
*Automatic optimization of parameters
*SNR- image obscured by random signal variations
*Visual check list
Quarterly- Repeat analysis check
Semiannually - Compression force test

Question 22

Test on beam quality assessment (half-value layer measurement) is performed by the:
A. mammography
B. medical physicist
C. technologist
D. radiologist

Answer 22

B - the beam quality assessment in a general test performed by the medical physicist

Question 23

In quality control, the standards refers to
A. action taken on a regular basis
B. action taken to eliminate potential problems
C. reference calibrations or measurements to check accuracy.
D. measurement variations allowed

Answer 23

C. Standards are reference objects or devices with known values used to check the accuracy of other measurement devices

Question 24

The person responsible for overseeing all the activities of the mammographer and the medical physicist;
A. quality control  radiographer
B. state inspector
C.MQSA inspector
D. radiologist

Answer 24

D. It is the radiologist’s responsibility to oversee the activities of all personnel responsible for the quality assurance process.

Question 25

``` QC duties of the mammography include testing or monitoring of all the following except: A. phantom image B. screen-film contact C. collimation assessment D. compression ```

Answer 25

C. Collimation assessment tests are preformed by the medical physicist

Question 26

``` The ability of an x-ray tube to always produce the same intensity of radiation when the same set of technical factors are used to make an exposure is called A. radiation output B. exposure time C. exposure reproducibility D. kv accuracy ```

Answer 26

C. The exposure reproducibility is a check of the AEC. The system should deliver a constant optical density regardless of compressed thickness and composition. The KV accuracy ensures that the KV selected is within +-5% of the indicated KV. The radiation output is the selected kV and mA. the exposure time, the milliseconds of the actual exposure.

Question 27

The MQSA standards were enacted: A. because mammography was overregulated B. to address the poor quality mammograms that were available C. to enforce continuing education for radiologic technologist D. to enforce continuing education for radiologist

Answer 27

B. MQSA was enacted to ensure quality patient care and imaging for patients needing a mammogram. The MQSA involves regular checks of the training and continuing education of radiologist, technologists, and medical physicist.

Question 28

The repeated image is: A. any image that is rejected B. an image that is repeated and results in radiation dose to the patient C. the magnified image requested by the radiologist D. an image taken during quality control tests

Answer 28

B. All repeated images that result in an additional exposure to the patient are considered repeated images. Images that are used in quality control and do not cause additional patient dose are considered rejects not repeats.

Question 29

``` The person responsible for performing evaluations of and generating reports on the mammography unit is the : A. rad tech B. mammography C. medical physicist D. radiologist ```

Answer 29

C. It is the responsibility of the medical physicist to regularly check the mammography unit and component parts and generate reports as needed.

Question 30

``` A test used to determine if the time of exposure indicated by the control panel is the same as that delivered by the x-ray time is performed by the: A. technologist B. physicist C. quality assurance technologist D. radiologist ```

Answer 30

B. Test on the x-ray tube are generally performed by the medical physicist.

Question 31

``` A quality control test performed to check the random disturbance in digital signals that obscures or reduces image clarity A. detector calibration B. SNR C. flat field evaluation D. monitor calibration ```

Answer 31

B. The signal-to-noise ratio (SNR) is a randome disturbance that obscures or reduces image clarity. Decreased SNR will give the image a grainy or mottled appearance. The modulation transfer function (MTF) checks the consistency of contrast-to-noise ratio (CNR) and ensures adequate contrast over a specific spatial frequency range. The detector evaluation ensures adequate and consistent quality images acquired by the detector and displayed on the acquisition work station (AWS) or printer.

Question 32

QC tests Phantom images

Answer 32

Weekly

Question 33

QC tests Fixer retention analysis

Answer 33

Quarterly

Question 34

QC test Repeat analysis

Answer 34

Quarterly

Question 35

QC test Darkroom fog

Answer 35

Semiannually

Question 36

QC test. Film-screen contact

Answer 36

Semiannually

Question 37

QC test Compression

Answer 37

Semiannually

Question 38

QC test Processor quality control

Answer 38

Daily