Traceability and quality control in mammography: measurements and models

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)