Survey of mammography practice: Initial results from Serbia

The purpose of this paper is preliminary evaluation 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 initial evaluation, five hospitals with highest workload have been selected, representing the typical mammography practice in Serbia. The methodology consists of initial image quality evaluation and assessment of relevant imaging chain parameters using dedicated Protocol for Quality Control (QC) in mammography. Evaluation of performance of mammography x-ray units and image processing units include parameters of x-ray tube and generator, mechanical safety, automatic exposure control performance, patient dosimetry, and temperature of developer, time of film processing and presence of artefacts. Image grading in three hospitals with highest workload resulted in very high percentage of images with poor quality, ranging from 13% up to 70% for cranio-caudal projection and from 8% to 66% for medio-lateral oblique projection. Overall rejection rate was less than 2 %. Patient exposure in terms of mean glandular dose ranged from 0.12 mGy to 2.8 mGy. This preliminary survey of mammography practice highlighted the need for optimization of mammography practice. Developed QC protocol, based on actual practice and resources, includes equipment testing and maintenance, staff training and QC management and allocation of responsibilities, should be applied on the national scale. (author)