Classification of Artifacts in Clinical Digital Mammography
Digital mammography is now fully introduced in the radiological examination of the breast.
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CONTENTS
KEY POINTS 4.1
Introduction
4.2 4.2.1 4.2.2 4.2.3
Classification 56 Technologist-Related Artifacts 56 Mammography Unit Related Artifacts Software-Related Artifacts 62
4.3
Conclusion
References
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Digital mammography is now fully introduced in the radiological examination of the breast. This was only possible after the setup of a dedicated quality control program of the digital mammography systems. Quality assurance not only includes the technical quality procedures, but also all the activities of the radiologists and technologists to ensure high-quality of the mammogram. The detection and registration of artifacts are part of this quality assurance. The artifacts are divided into patient-related artifacts, technologist-related artifacts, mammography unit related artifacts, software-related artifacts, and viewing conditions related artifacts. As some artifacts can cause interpretation problems, early recognition is important, and this is only possible with a close collaboration between all persons involved in the quality assurance of digital mammography.
4.1 Introduction
Chantal Van Ongeval, MD Hilde Bosmans, PhD Jurgen Jacobs, MsC Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium
Quality assurance (QA) refers to all systematic activities undertaken by the breast imaging staff to ensure high-quality mammography (Hogge 1999). Physical–technical quality control (QC) procedures are often a very visible part of QA (Bloomquist et al. 2006a; Yaffe et al. 2006; Euref 2006), but next to the strictly technical issues, clinical images deserve investigations too. Radiologists and technologists should actively participate in QA. Only then, a strictly implemented QA routine can guarantee optimal radiological images. Part of the QA routine is the evaluation of the clinical images for artifacts.
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C. Van Ongeval et al.
We refer to Bassett (1995) for defining an artifact: any variation in mammographic density not caused by true attenuation differences in the breast. It is important to learn about artifacts to recognize them on mammograms and to avoid diagnostic mistakes. In film-screen mammography (FSM), most artifacts were linked to film or developer. Digital mammography has different physical–technical characteristics, and surely other artifacts are associated with the new technology. Some artifacts are not well understood yet. Artifacts can originate in the different steps of the imaging chain but also in the handling of the system. Physical–technical periodic QC based on simple test object measurements can certainly detect some of them, but other artifacts may go undetected. Until now, we know one report that discusses the different kinds of artifacts in digital mammography (Ayyala et al. 2008). In this chapter, we will describe different artifacts that appeared in our images over the last years, when digital mammography was introduced for both diagnostic and screening purposes.
4.2 Classification Following the classification proposed by Hogge et al.
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