Evaluation of a new mammographic film: methods and considerations

In this study the performance of a new mammographic film, the XMA (Retina), was evaluated in comparison with HT (Agfa). The comparison was made in terms of sensitometric characteristics and in terms of image quality and speed when combined with four different cassettes-HDS (Agfa), Min-R 2000 and Min-R 2190 (Kodak), and AD-MA (Fuji)-using the Leeds TOR(MAX) Mammographic Quality Control phantom. The entrance surface air kerma was calculated from exposure factors and the relative speed of each screen-film combination was determined. These tests revealed that XMA requires about 40% less dose than HT when combined with the same intensifying screen, at a penalty of less than 8% in image quality. When combined with AD-MA the XMA presents the greatest speed, whereas the Min-R 2190 is the best compromise between image quality and breast dose. The above values are indicative of the dilemma that medical physicists and radiologists face when it comes to the selection of a screen-film combination for mammography. Both image quality and breast dose should be considered, but strict instructions on what weight should be assigned to each parameter have not been established yet. Health Phys. 94(4):338-344; 2008.