Image quality standards in digital mammography: A consensus statement

Area of Science:

• Radiology
• Medical Imaging
• Quality Assurance

Background:

• Mammogram image quality assessment faces challenges due to inter- and intra-observer variability.
• This inconsistency impacts the reliability of quality assessments in screening programs.

Purpose of the Study:

• To establish a standardized framework for describing mammogram image quality.
• The goal is to reduce subjectivity and enhance observer consistency in quality assessments.

Main Methods:

• A scoping literature review identified 19 initial image quality criteria.
• A modified Delphi survey with 23 multidisciplinary experts refined these criteria.
• Consensus was reached through expert ranking and focus group discussions.

Main Results:

• Consensus was achieved on criteria including image identification, artifacts, uniformity, symmetry, contrast, radiation dose, and depiction of specific breast regions.
• Areas requiring further guidelines include additional/alternative images, compression force descriptions, and retake criteria for folds/air projections.

Conclusions:

• A checklist for mammogram image quality assessment was developed.
• The study provides cut-off values for good, suboptimal, and insufficient quality.
• A standardized tool is offered to improve mammographic image quality interpretation consistency in screening.