QC of direct radiography and computed radiography mammography systems: Image quality and average glandular dose

Today, two technologies have emerged in digital mammography: direct radiology (DR) and computed radiology (CR). The introduction of these technologies leads to different measures and limitations in the quality control (QC) of these mammography systems. The objective of this work was to carry out QC tests on DR and CR mammography systems using the EUREF protocol about image quality and average glandular dose (AGD). These evaluations were made using the same test tools for both SIEMENS DR and CR mammography systems. Image quality was compared in terms of low contrast detectability, exposure time, and ghost factors. Exposure factors were selected clinically. Entrance surface air kerma (ESAK) was calculated from the measured output for PMMA thickness of 2, 3, 4, 5, 6, and 7 cm. The AGD was determined from ESAK and the measured half-value layer (HVL), and the respective conversion factors were obtained from the protocol. Test results indicated that DR mammography system selected a longer exposure time and a higher ghost image factor. CR mammography system yielded mean contrast-detail score higher than that of the DR system, for smaller details. The contrast-detail curves of both systems are shown. They indicate that the DR system has better low contrast detectability than the CR system, as seen from the contrast-detail curve that extends further to the left toward small detail. HVL of DR mammography system is higher than that of CR system. The entrance surface air kerma and average glandular dose of both systems: direct radiography and computed radiography is shown. For both systems, AGD decreases as PMMA thickness increases; AGD for DR is higher. To conclude, both DR and CR mammography systems performed well within the stated values of the EUREF protocol. However, we found that the DR mammography system operated with higher beam quality that resulted in higher dose and better low contrast detectability. Therefore, DR should not be considered equal to CR mammography system