J Korean Radiol Soc. 2003 Dec;49(6):507-511. Korean.
Published online Dec 31, 2003.
Copyright © by The Korean Society of Radiology
Original Article

Clinical Image Evaluation of Mammograms: A National Survey

Woo Kyung Moon, Tae Jung Kim, Joo Hee Cha, Kyung Soo Cho, Eun Wan Choi, Yu Jin Lee, Mi Hye Kim, Boo Kyung Han, Yeon Hyeon Choe, Eun Kyung Kim, Hye Young Choi, Soo Young Chung, Sun Yang Chung, Nariya Cho, Jung Gi Im and Kyung Mo Yeon
    • Department of Radiology, Seoul National University College of Medicine and the Institute of Radiation Medicine, SNUMRC, Korea.
    • Kimmihye Breast Clinic, Korea.
    • Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Korea.
    • Department of Diagnostic Radiology, Radiological Institute of Radiological Science, Yonsei University College of Medicine, Korea.
    • Department of Diagnostic Radiology, College of Medicine, Ewha Womans University, Korea.
    • Department of Radiology, Hallym University College of Medicine, Korea.
    • Department of Diagnostic Radiology, College of Medicine Pochon CHA University, Korea.
    • Department of Diagnostic Radiology, Gachon Medical School Gil Medical Center, Korea.

Abstract

Purpose

The goal of this study was to survey the overall quality of mammographic images in Korea.

Materials and Methods

A total of 598 mammographic images collected from 257 hospitals nationwide were reviewed in terms of eight image quality categories, namely positioning, compression, contrast, exposure, sharpness, noise, artifacts, and examination identification, and rated on a five-point scale: (1=severe deficiency, 2=major deficiency, 3=minor deficiency, 4=good, 5=best). Failure was defined as the occurrence of more than four major deficiencies or one severe deficiency (score of 1 or 2). The results were compared among hospitals of varying kinds, and common problems in clinical image quality were identified.

Results

Two hundred and seventeen mammographic images (36.3%) failed the evaluation. Poor images were found in descending order of frequency, at The Society for Medical Examination (33/69, 47.8%), non-radiology clinics (42/88, 47.7%), general hospitals (92/216, 42.6%), radiology clinics (39/102, 38.2%), and university hospitals (11/123, 8.9%) (p<0.01, Chi-square test). Among the 598 images, serious problems which occurred were related to positioning in 23.7% of instances (n=142) (p<0.01, Chi-square test), examination identification in 5.7% (n=34), exposure in 5.4% (n=32), contrast in 4.2% (n=25), sharpness in 2.7% (n=16), compression in 2.5% (n=15), artifacts in 2.5% (n=15), and noise in 0.3% (n=2).

Conclusion

This study showed that in Korea, 36.3% of the mammograms examined in this sampling had important image-related defects that might have led to serious errors in patient management. The failure rate was significantly higher in non-radiology clinics and at The Society for Medical Examination than at university hospitals.

Keywords
Mammography; Breast radiography, quality assurance


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