Screen-film and digital mammography. Image quality and radiation dose considerations

Factors affecting image quality and patient dose in screen-film and digital mammography have been discussed. Some proposed parameters for judging image quality and breast exposure measurements and dose calculations relating to changes in image quality factors have been reviewed. It is important to remember that the goal in making a mammogram is to obtain as much diagnostic information as possible at the lowest dose compatible with that information. As noted previously, this necessitates compromises (i.e., an optimization of factors that affect image quality). These include beam quality, compression, imaging geometry, grids, receptor characteristics, processing of the film or digital image, and display and viewing conditions. If this is done correctly, a high-quality mammogram can be obtained at a reasonably low dose to the patient. The goal is not simply to use as low a dose as possible, because if this is done there is a large risk of degrading the performance of mammography in detecting or accurately characterizing small, node-negative cancers.