Preparing for EQUIP by Measuring Mammography Image Quality

摘要

Purpose To determine the feasibility of objectively critiquing mammography images and quantitatively assessing technologist performance, and to determine whether results can be compared to analyze performance. Methods The authors assessed mammography examinations performed by 3 experienced technologists using a quality improvement method to track factors that affect image quality, A total of 147 examinations were evaluated prior to the technologists receiving standardized positioning training, and an equal number of examinations were evaluated 2 months after the training. During the evaluations, data was collected that described the quality of the examinations and the technologists' behavior during the pre-exposure, acquisition, and postexposure process that affected image quality. Results The authors selected 7 out of more than 140 prominent examples to demonstrate a methodology to evaluate image quality, to use the results to empower the technologist to improve their performance in areas that indicate positioning and compression weakness, and to track the technologist's improvement over time. Technologist 1 demonstrated the most dramatic improvement between the pre- and posteducational evaluations in the length of the pectoral muscle on the mediolateral obiique projection. Technologist 3 improved inclusion of the inframammary fold region by 18% between evaluations. Posteducational evaluations also demonstrated a decrease in the percent of examinations that passed posterior nipple line measurements. Compression force did not significantly change. Discussion Identifying specific technologist actions that positively or negatively affect the quality of mammography examinations and then providing this information to the technologist with a suggested plan of corrective action can improve mammography service. Conclusion This clinical validation study for mammography quality improvement demonstrated that technologist performance affecting image quality can be measured when examination and threshold variables are controlled.