Abstract

Ho ELM, Ng KH, Wong JHD, Wang HB
Megah Medical Specialists Group, Petaling Jaya, Malaysia Department of Radiology, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia Division of Engineering, Ministry of Health, Putrajaya, Malaysia

The purpose of this study is to survey the status of quality assurance in mammography practice in Malaysia using the Ministry of Health QAP requirement and the American College of Radiology Quality Control in Mammography (ACR 1999) as the standard. The results will provide baseline information for establishing mammography accreditation and serve as the basis for total quality improvement. Interpretive accuracy and positioning factors were not evaluated in this study.

Fifty centres (9 government, 3 teaching and 38 private) participated in this survey. Data on mammography unit, processor, image receptor, clinical technique factors, and mean glandular dose were obtained. A pre-exposed sensitometric test film was processed using the local processor. Image quality was assessed using the RMI 156 phantom at 28kV. The viewbox luminance was measured.

Twenty (40 %) of the centres have dedicated processors. The mean developer temperature and cycle time were 34.1oC and 107.7 seconds respectively. The mean base plus fog level, speed index and contrast index were 0.20, 1.20 and 1.33 respectively. 43 (86%) of the centres passed the image quality test (passing criteria are visibility of 4 fibrils, 3 specks groups and 3 masses). 35 (70%) met the requirement of density (minimum background OD of 1.20; and minimum disc to background OD contrast of 0.40). Only 12 out of 96 (12.5%) view boxes complied with the ACR recommended luminance level of greater than 3000cd/m2. The average mean glandular dose is 1.02 mGy (Malaysian limit is 3 mGy).

This QA in mammography survey demonstrates that Malaysia is on the right track but
with room for total quality improvement in mammography practice.