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Siemens MAMMOMAT Novation DR Quality Control Manual
Siemens MAMMOMAT Novation DR Quality Control Manual
MAMMOMAT Novation DR
CONFIDENTIALITY STATEMENT
This document is the confidential property of Siemens AG Medical Solutions.
No part of it maybe transmitted, reproduced, published, or used by other
persons without the permission of Siemens AG Medical Solutions.
The original version of this manual was written in the English
language.
Contents
Table of Contents
List of Tables 9
List of Figures 11
1. Introduction 15
1.1 Mammography Equipment Evaluation (MEE) - Medical Physicist (MP) ........... 15
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Contents
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Contents
6. Optional Test 70
6.1 Ghost Image Evaluation....................................................................................70
6.1.1 Objective......................................................................................................................... 70
6.1.2 Required Equipment....................................................................................................... 70
6.1.3 Pre Requisites ................................................................................................................ 70
6.1.4 Procedure ....................................................................................................................... 70
6.1.5 Performance Criteria and Corrective Action ................................................................... 72
Test Form 5.2 Collimation, Dead Space and Compression Paddle Position .......... 101
Collimator Assessment ............................................................................................................ 101
Compression Paddle Overlap on Chest Wall Side .................................................................. 105
Chest Wall Missed Tissue ....................................................................................................... 106
Test Form 5.6 Image Quality and Radiation Dose .................................................. 113
Phantom image quality ............................................................................................................ 113
Mean Glandular Dose.............................................................................................................. 114
HVL Values from Test Form 5.7 HVL and Radiation Output .................................................. 114
Compression release............................................................................................................... 114
Compression thickness ........................................................................................................... 114
Test Form 5.8 Tube Voltage Measurement & Reproducibility ................................ 119
Tube voltage and reproducibility.............................................................................................. 119
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Contents
List of Tables
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Tables
List of Figures
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Figures
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Abbreviations
For notes
1. Introduction
1.1 Mammography Equipment Evaluation (MEE) -
Medical Physicist (MP)
The MEE tests of the MAMMOMAT NovationDR must be performed whenever a new
MAMMOMAT NovationDR system has been installed, reassembled, and whenever
changes that might affect performance have been made to an existing system. For
example, the MEE tests shall be performed if the system has been disassembled and
reassembled or if major components have been changed or repaired.
The MEE tests of the MAMMOMAT NovationDR involve performance of all relevant
QC procedures in this Quality Control Manual, ensuring that a basic minimum image
quality criteria is met before the system is used on patients. For each part of the MEE
tests, action levels that must be met are specified. Furthermore, the values obtained
during the MEE tests are to be used as baseline values, and then referred to during
future tests to determine if equipment performance is stable or changing.
In facilities under US jurisdiction, the MEE tests must be performed by a qualified
medical physicist who meets the final regulation requirements of CFR 900.12(a)(3).
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Introduction
Soft Copy Viewing Station
Test Frequency
3.1 Phantom Image Quality Daily
3.2 Detector Calibration As Needed Weekly
3.3. Artifact Evaluation As Needed Weekly
3.4 SNR and CNR Measurements Weekly
3.5 Repeat Analysis Quarterly
3.6 Compression Force Semi-Annually
3.7 Printer Check When required*
* Printer QA is required on days when clinical mammograms or accreditation images are to be printed.
NOTE!
NOTE!
If there is a softy copy diagnostic workstation, a QC program must
be implemented.
Follow the manufacturers recommended procedures or any other
substantially equivalent soft copy QC program.
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Introduction
Recommended Frequency of QC Tests - Medical Physicist
Test Frequency
Required Tests
4.1 Site Audit / Evaluation of Technologist MEE, Annually
QC Program
4.2 Mechanical Checks MEE, Annually
4.3 Acquisition Workstation Monitor Check MEE, Annually
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Introduction
Required Equipment - Annual Survey, MEE
CAUTION!
If the MAMMOMAT NovationDR has been without power for an
extended period of time, the detector will require one hour of warm up.
Every second week a message about calibration of the detector is
displayed, this is the maximum interval between detector calibrations.
Exposures will be locked out unless detector is calibrated every two
weeks.
CAUTION!
If the MAMMOMAT is started from being completely shut down (for
details about complete shut down, see Instructions for Use for (power
interrupted at breaker) MAMMOMAT NovationDR) the detector should
be powered on at least one hour before intended use. Otherwise,
image quality can be affected.
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Required Tests - Technologist
Phantom Image Quality
3.1.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
NOTE!
NOTE!
Make sure there is no gap between phantom and chest wall.
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Phantom Image Quality
9. Double click on the first image in the icon gallery, see Figure 3, Position 2.
XXX XXX
Fibers
Specks
Masses
3.1.4 Analysis
• Count each fiber as one point if the full length of the fiber is visible and both
its location and orientation is correct. Count a fiber as 0.5 points if not all but
more than half of the fiber is visible and its location and orientation are
correct. If a fiber-like artifact appears anywhere in the image but is not in an
appropriate location or orientation, deduct the "artifactual" fiber from the last
"real" fiber scored if the artifactual fiber is equally or more apparent.
• When studying the specks, it can be useful to take advantage of the zoom
and invert function. Each speck group shall be counted as one point. A full
speck group is counted if four or more specks are visible in the group in the
proper locations. Count a speck group as 0.5 points if two or three specks of
the group are visible. If noise or speck-like artifacts are visible in the wrong
locations in the phantom image, subtract each speck-like artifact one for one
from the last real speck counted.
• Count each mass as one point if a density difference is visible in the correct
location and the full mass is visible against the background. Count each mass
as 0.5 points if a density difference is visible in the correct location but not the
full mass is visible, so that the mass does not have a circular appearance. If
there is a mass-like artifact in the wrong location anywhere in the image,
deduct the "artifactual" mass from the last "real" mass scored if the artifactual
mass is equally or more apparent.
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Phantom Image Quality
Fibers ≥5
Masses ≥4
If any level is found to be beyond any action level stated, the source of the
problem must be identified and the problem corrected by a Siemens customer
support engineer. Consult with your MP to determine if further testing is
required.
3.2.3 Procedure
Calibration of the detector must be done:
• Weekly
• When the room temperature differs by more than ±3 °C (±5.4 F) since the last
calibration.
• When the artifact detection test (see section 3.3 Artifact Detection) fails.
NOTE!
NOTE!
Record the values in the form enclosed in Appendix 1, Test Form
3.2 Detector Calibration.
NOTE!
NOTE!
You should reject an image if it exhibits any edge cut-off (sharp white
line at the borders) due to collimation or misalignment or if there are any
artifacts from debris or obstructions.
Rectangular segments in the image are acceptable, see Figure 5.
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Detector Calibration
10. Click Accept if the image is suitable for the calibration, see Figure 6.
Or
Click Reject if the image is not suitable.
In the latter case the calibration image is discarded.
11. Continue making calibration images until you have accepted 8 exposures.
The number of accepted and discarded calibration images will be displayed.
The detector is re-calibrated on the basis of the calibration image.
12. Choose the Close patient tab card and close patient by clicking this button.
13. Proceed to section 3.3 Artifact Detection.
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Artifact Detection
3.3.3 Procedure
1. Login according to the section 2. Start Up and Login, if required.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database, see Figure 7.
Fill in: Last Name: Test_Three
First Name: Artifact_Detect
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw.
6. Mount a compression paddle simulator.
7. Assemble the collimator-mounted PMMA phantom (40 mm).
8. Double click on the first image in the icon gallery, see Figure 3, Position 2.
9. Make an exposure using the anode/filter combination used in calibration and
28 kV, 90 mAs.
10. Look at the image for clinical relevant artifacts by magnifying to full resolution. To
get full resolution click top "image" drop down menu" and choose "acquisition
size”.
If artifacts appear go to step 11.
If no artifacts appear the artifact detection test is completed.
11. If the image has white pixels contact Siemens customer service engineer.
If the image has no white pixels, go to section 3.2 Detector Calibration.
12. Choose the Close patient tab card and close patient by clicking this button.
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Signal-to-Noise Ratio (SNR) and Contrast-To-Noise Ratio (CNR) Measurements
3.4.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Four
First Name: SNR_CNR
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw.
6. Install the compression paddle.
7. Center the accreditation phantom left to right on the breast support so that it
covers all three AEC sensor regions.
8. Select the clinically used setting by selecting 2 (Opdose) on the control console.
AEC sensor 2 shall be selected at the AWS, see Figure 23.
9. Double click on the first image in the icon gallery, see Figure 3, Position 2.
10. Make an exposure.
11. Draw an ROI by choosing Tools > Circle, size to fit slightly within large mass, see
Figure 9, and record the mean pixel value in Appendix 1, Test Form 3.4 Signal-
to-Noise Ratio (SNR) and Contrast-To-Noise Ratio (CNR) Measurements.
Mass ROI
Background ROI
12. To measure the CNR, repeat the same procedure as in step 11 for the
background ROI by moving the circular ROI just to the inside of the mass as
shown in Figure 9. Move circle laterally adjacent to large mass. Record the mean
pixel value and the standard deviation (background) in Appendix 1, Test Form
3.4 Signal-to-Noise Ratio (SNR) and Contrast-To-Noise Ratio (CNR)
Measurements.
13. Choose the Close patient tab card and close patient by clicking this button.
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Signal-to-Noise Ratio (SNR) and Contrast-To-Noise Ratio (CNR) Measurements
3.4.4 Analysis
SNR should be calculated by using the values in Appendix 1, Test Form 3.4 Signal-
to-Noise Ratio (SNR) and Contrast-To-Noise Ratio (CNR) Measurements, (see also
Figure 18) and the following formula:
Deviation from the baseline value (determined during the mammography equipment
evaluation) can be calculated by using the following formula:
( Baseline – ActualValue )
Deviation = ------------------------------------------------------------------------- × 100
Baseline
3.5.2 Procedure
1. Login according to the chapter 2. Start Up and Login.
2. Open the Patient Browser and click on the Reject button, see Figure 10
Position 1.
3. View each discarded image from the previous month. Use Appendix 1, Test Form
3.5 Repeat Analysis and sort each image into the listed categories.
4. Repeat the procedure at least every 3 months.
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Repeat Analysis
3.5.3 Analysis
1. Sort the images and sum the amount of discarded images for each category.
2. Determine the total number of repeated exposures for all categories and record
in Appendix 1, Test Form 3.5 Repeat Analysis
3. Determine the percentage of discarded images for each category by dividing the
number of images in each category by the total number of discarded images.
3.6.3 Procedure
1. Place bathroom scale on breast support with weight indicator window toward you
or use other compression force measurement tool according to manufacturer’s
instructions.
2. If bathroom scale is used, place foam block or folded towel between scale and
compression paddle.
3. Press compression foot switch until Opcomp light (OC) is lit see Figure 11.
mm
F o
OC
OC F
NOTE!
NOTE!
Compression force readout is kilograms (kg).
Convert to pounds multiply by 2.2.
Convert to Newtons multiply by 10.
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Required Tests - Technologist
Printer Check
3.7.1 Objective
To assess the quality of the laser camera.
3.7.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Choose the service patient in the Patient Browser.
3. Select SMPTE image from group [1] Technical Images in the service image
patient. Open it in the Viewing task card by double clicking.
4. Send the image to the mammography laser camera/printer.
5. The printer/laser camera shall be configured to Min Density 20 (corresponding to
0.2 optical density) and Max Density to 350 (corresponding to 3.5 optical
density), if applicable.
6. Evaluate the printed SMPTE image by measuring the eleven density values from
0 to 100% with the densitometer and note the measured values in
Appendix 1, Test Form 3.7 Printer Check.
NOTE!
NOTE!
This procedure or the printer/laser camera manufacturer's QC
procedure must be followed whenever the printer/laser camera is used
to print mammographic images or accreditation images.
4.1.2 Procedure
1. List all compression paddles that will be used routinely in Appendix 2, Test Form
4.1 Site Audit / Evaluation of Technologist QC Program
2. Identify the modes chosen for technique selection and note in Appendix 2, Test
Form 4.1 Site Audit / Evaluation of Technologist QC Program
3. Define the clinical techniques (used to image accreditation phantom) and note in
Appendix 2, Test Form 4.1 Site Audit / Evaluation of Technologist QC Program
4. Determine if other target/filter combinations are used clinically and note in
Appendix 2, Test Form 4.1 Site Audit / Evaluation of Technologist QC Program.
5. Make sure that the compliance to the technologist QC tests refered in Table 1 is
met.
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Initial Checks - Physicist
Mechanical Inspection
4.2.2 Procedure
1. Wipe the breast support and compression paddle with a wet lint free non-woven
cotton cloth or cotton (100%) pad. For moistening, use water or lukewarm diluted
aqueous solution of household dishwashing liquid. (No visual damages should be
observed. No artifacts should be seen on the calibration images.)
NOTE!
NOTE!
Do not spray the unit! The cleaning fluid must under no
circumstances penetrate into the unit.
2. Check that the cables are free from visual damages. Note the outcome in
Appendix 2, Test Form 4.2 Mechanical Inspection.
3. Check that the control panel lights up to show that the power is switched on. Note
the outcome in Appendix 2, Test Form 4.2 Mechanical Inspection.
4. Turn the swivel-arm system 180° so that the tube head is upside down. Lower the
system as close to the floor as possible. Check that the error indication lamp on
the generator console (see Figure 12) is lit. Raise and turn the swivel-arm system
back again and check that the lamp goes out. Note the outcome in
Appendix 2, Test Form 4.2 Mechanical Inspection.
5. Check the motorized movements for smooth running and normal function. Note
the outcome in Appendix 2, Test Form 4.2 Mechanical Inspection.
6. Check that the height adjustment and rotation of the swivel-arm system are
blocked, when the displayed compression force is ≥ 3 kg (7 lbs). Note the
outcome in Appendix 1, Test Form 4.2 Mechanical Inspection.
7. Check the self-braking of the compression motor. Run the compression paddle
against the FD object table, until the applied compression force reaches 15 kg
(33 lbs). After 1/2 minute in this condition, this value must not change by more
than 2 kg (4 lbs). Note the outcome in Appendix 2, Test Form 4.2 Mechanical
Inspection.
8. Check that the manual compression/decompression functions properly. Note the
outcome in Appendix 2, Test Form 4.2 Mechanical Inspection.
9. Check that the decompression button on the control console functions correctly.
Note the outcome in Appendix 2, Test Form 4.2 Mechanical Inspection.
10. For power driven compression, the compression device must apply a force with a
maximum value between 111 N (approx. 12 kg, 11 on the display of the stand)
and 200 N (approx 20 kg, 20 on the display of the stand). Note the outcome in
Appendix 2, Test Form 4.2 Mechanical Inspection.
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Mechanical Inspection
11. There should be no sharp edges or cracks that could create sharp edges on the
compression paddles, detector, etc. which may injure the patient. Note the
outcome in Appendix 2, Test Form 4.2 Mechanical Inspection.
12. All foot switches should operate correctly. Note the outcome in Appendix 2, Test
Form 4.2 Mechanical Inspection.
13. All attachments should latch securely and their locks should function effectively.
Note the outcome in Appendix 2, Test Form 4.2 Mechanical Inspection.
14. Use a luminance meter to measure the light intensity from the X-ray field on the
object table in the four areas described in Figure 14. Note the outcome in
Appendix 2, Test Form 4.2 Mechanical Inspection.
Light field
1 2
4 3
Figure 14 Light Field Luminance Measurement
15. The location of the exposure control should confine the operator to the protected
area during exposure. Note the outcome in Appendix 2, Test Form
4.2 Mechanical Inspection.
16. Check the emergency stop button for proper function. Note that with the button
depressed, all motorized movements shall be blocked. Note the outcome in
Appendix 2, Test Form 4.2 Mechanical Inspection.
4.3.3 Procedure
1. Clean the monitor
a) The monitor surface should be cleaned with a soft tissue material, such as
cotton or lens cleaning paper.
b) If necessary, stubborn stains can be removed by moistening part of a cloth
with water to enhance its cleaning power.
3. Select the Viewing task card on the right edge of the monitor.
4. Select the Service images in the local data base in the Patient Browser.
5. Open the image labeled “Group [1] Technical Images”. Double click on the image
for display. Make sure that the SMPTE is covering the entire viewing area i.e. the
window should not be divided in four viewing areas.
Check that the window width is set to 4096 and that the window center is set to
2048. Display image in acquisition size under Image > Acquisition Size. Erase
text using View > No Text.
6. The gray scale is shown as a series of squares in the central part of the SMPTE
image, ranging from black (0%) to white (100%). The 0% and 100% squares each
contain smaller squares within them that represent signal level steps of 5% and
95% respectively (see Figure 15). You should be able to differentiate the inner
square from the larger square that contains it. The 5% square is normally quite
difficult to differentiate. If this is not possible then perform this test again with
dimmed room light.
5% 95 %
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Acquisition Workstation Monitor Check
7. Visually check the monitor’s performance by looking for streaking, fluttering and
shadows.
8. The spatial resolution (linearity) and aliasing (distortion) of the monitor are
considered to be within acceptable limits if the high contrast bar patterns in the
test image can be seen as patterns of white and black pairs. To use the pattern,
inspect all six of the high contrast patterns in each corner (see Figure 16) of the
images as well as in the center. You should be able to differentiate all the lines in
all the high contrast patterns.
9. Choose the Close patient tab card and close patient by clicking this button.
5.1.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_One
First Name: Detector Uniformity
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw.
6. Install the collimator-mounted plexi (40 mm).
7. Install the compression paddle. Set at height of 4.5 cm.
8. Double click on the first image in the icon gallery, see Figure 3, Position 2.
9. Make an exposure with 28 kV, AEC mode H and the anode/filter combination that
the system has been calibrated with, see section 4.1 Site Audit / Evaluation of
Technologist QC Program.
10. Check that there are no defective columns and no grid lines in the image.
Optimize window and center (start with W = 500 and C = 600).
11. Choose Postprocessing sub tab card.
12. Choose rectangular ROI Tool.
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Detector Uniformity and Artifact Detection
13. Make an ROI (Region Of Interest) by choosing Tools > Rectangle with the size
of the ROI approximately 10x10 mm according to Figure 17 and located appro.
20 mm of the edges as shown in Figure 17. (Annotation can be removed by
clicking on View > No Text.)
Mean Value
15. Move the ROI four times until you have measured all five areas shown in Figure
17.
16. Look at the image for clinical relevant artifacts by magnifying to full resolution.
To get full resolution click top "image" drop down menu and choose "acquisition
size”. Activate zoom/pan under image menu. Image may be panned when cursor
is displayed as crossed arrows.
If artifacts appear go to step 17.
If no artifacts appear go to step 18.
17. If the image has white pixels go to step 19.
If the image has no white pixels, make a calibration, see section 3.2 Detector
Calibration. If artifacts still appear, call Siemens customer service engineer
otherwise go to step 12.
18. If no artifacts can be detected, continue with the examinations.
19. For pixel correction, please call Siemens customer service engineer.
20. Choose the Close patient tab card and close patient by clicking this button.
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Collimation, Dead Space and Compression Paddle Position
5.2.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Two
First Name: Chest Wall Missed Tissue
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button see Figure 7.
5. Choose procedure FD QC Raw, see Figure 3, Position 1.
6. Install the 24 x 30 Compression paddle.
8. Tape the coin (3) on the breast support so that its edge is exactly tangent to the
chest wall edge of the FD object table. See Figure 19.
9. Tape a coin on the lower surface of the 24x30 compression paddle tangent to the
chest wall edge.
10. Place a film or CR cassette 24x30 or larger on top of the FD object table and turn
it so the mid points of each edge of the light field are within the film in the cassette,
see Figure 20.
11. Install the compression paddle and set the compression paddle position about
4-5 cm above the breast support. Wait until collimation according to paddle size
is done and remove paddle.
12. Turn on the light field.
13. Place 4 coins (1, 2, 4, 6) on the film cassette as markers on the mid point of each
light field edge so that the edges of the coins are tangent to the outer light field
edges. Place coin (7) on the film cassette, see Figure 20.
14. Install the compression paddle 24 x 30
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Collimation, Dead Space and Compression Paddle Position
15. Double click on the first image in the icon gallery, see Figure 3, Position 2.
16. Using a film cassette make an exposure with 28 kV, 50 mAs and using the clinical
target/filter combination (see section 4.1 Site Audit / Evaluation of Technologist
QC Program). For CR cassettes use appropriate technique.
17. Develop the film in the cassette and mark it with anode/filter combination used.
18. On the acquisition workstation monitor measure the distance e for coin 7,
distance x for coin 3 and y for coin 5 and measure the distance g for coin 1, 2, 4,
6 in Figure 20.
Also measure the distance f for coin 1, 2, 4 and 6 on the developed film or CR
cassette with a ruler, according to Figure 20 and note in Appendix 2, Test Form
5.2 Collimation, Dead Space and Compression Paddle Position.
19. Repeat steps 7- 18 with 28 kV, 50 mAs, using alternative filter/anode combination.
20. Remove all coins.
21. Tape a coin on the lower surface of the 20x22 compression paddle tangent to the
chest wall edge (coin 5). Place coin 7 on to the detector.
22. Install the compression paddle and set the compression paddle position about
4-5 cm above the breast support.
23. Make an exposure with 25 kV, 20 mAs, and using the clinical target/filter
combination (see section 4.1 Site Audit / Evaluation of Technologist QC
Program).
24. On the acquisition workstation monitor measure the distance e and y for the coin
and note in Appendix 2, Test Form 5.2 Collimation, Dead Space and
Compression Paddle Position.
25. Repeat step 22 to 23 with 25 kV, 20 mAs, using alternative filter/anode
combination.
26. Repeat step 20 to 24 with all standard compression paddles.
27. Choose the Close patient tab card and close patient by clicking this button.
NOTE!
NOTE!
Do not use Flex paddles for this test.
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AEC Thickness Tracking Test
5.3.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Three
First Name: AEC Tracking
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw. AEC Sensor 1 shall be used, see Figure 23.
6. Put the 20 mm PMMA on the breast support (Figure 21).
PMMA
8. Use the anode/filter combination with which the system is calibrated, see section
4.1 Site Audit / Evaluation of Technologist QC Program and AEC mode H for all
exposure.
13. Repeat the same procedure from step 8 - 13 for all thicknesses and techniques
listed in step 8.
14. Choose the Close patient tab card and close patient by clicking this button.
15. Calculate the mean value for the mean of the SNR values for the different
thicknesses. Fill in the values in the table.
16. Calculate the maximum deviation from the mean value of the pixel value and SNR
measurements using the following formula:
If any level is found to be beyond any action level stated, the source of the
problem must be identified and the problem corrected by a Siemens customer
support engineer. Consult with your MP to determine if further testing is
required.
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Spatial Resolution
5.4.2 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Four
First Name: Spatial Resolution
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw.
6. Mount the compression paddle.
7. Select the clinically used setting by selecting Opdose program 3 on the control
console. AEC sensor 3 shall be selected at the AWS (sensor 3 shall be covered
with the PMMA phantom). Be sure that the resolution phantom doesn’t cover the
AEC sensor area, see Figure 23.
8. Place the 40 mm PMMA phantom parallel to the chest wall edge. Place the line
pair phantom on the phantom with the bars at an angle of approximately 45
degrees (see Figure 22) to the tube axis, about 1 cm from the chest wall and with
the largest pattern toward the chest wall.
45
AEC 3
9. Double click on the first image in the icon gallery, see Figure 3, Position 2.
10. Make an exposure.
11. Examine the image and starting with the largest bars determine the highest line-
pair resolution where the bars can be clearly seen. Make a magnification to full
resolution of the image using Image > Acquisition size. Optimize window/level.
Start at W = 500 and C = 250 (Magnifier window over the patterns may help). Note
the outcome in Appendix 2, Test Form 5.4 Spatial Resolution.
12. Choose the Close patient tab card and close patient by clicking this button.
MAMMOMAT NovationDR 55
SPB7-250.623.50.05.24
Required Tests - Physicist
SNR, CNR and AEC repeatability
5.5.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Five
First Name: AEC
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw.
6. Install the compression paddle.
7. Center the accreditation phantom left to right on the breast support so that it
covers all three sensor regions.
8. Place the dosimeter to the side of the phantom and with its center at 40 mm from
the chest wall edge of the patient support. Refer to Figure 24. Put the dose meter
at the same level as the top surface of the accreditation phantom.
9. Check that the phantom covers all three regions of the AEC sensors by
compressing the compression paddle. See Figure 24.
10. Select the clinically used setting by selecting 2 (Opdose) on the control console.
AEC sensor 2 shall be selected at the AWS, see Figure 23.
11. Double click on the first image in the icon gallery, see Figure 3, Position 2.
12. Make an exposure and record the mAs and entrance dose in Appendix 2, Test
Form 5.5 SNR, CNR and AEC repeatability.
13. Repeat steps 11 to 12 until 5 exposures have been made.
14. Select an ROI (Region Of Interest) by choosing Tools > Circle or click on the
Postprocessing sub tab card.
15. Set the size of the ROI to be slightly smaller than the largest mass, about 0.4 cm².
See Figure 9.
16. Measure the mean pixel value and standard deviation adjacent to the largest
mass. See Figure 9 (Try to measure the same area for all images).
17. For image number 5 also measure the contrast to noise value (CNR). Measure
the mean pixel value inside the largest mass. Record values in Appendix 2, Test
Form 5.5 SNR, CNR and AEC repeatability.
18. Choose the Close patient tab card and close patient by clicking this button.
MAMMOMAT NovationDR 57
SPB7-250.623.50.05.24
Required Tests - Physicist
SNR, CNR and AEC repeatability
5.5.4 Analysis
SNR should be calculated by using the values in Appendix 2, Test Form 5.5 SNR,
CNR and AEC repeatability, (see also Figure 18) and the following formula:
Calculate the mean value of the mAs, entrance air kerma or exposure, mean pixel
value and SNR. Record these values in Appendix 2, Test Form 5.5 SNR, CNR and
AEC repeatability
Calculate the coefficient of variation for the mAs and air kerma/exposure and the
maximum deviation from the mean for mean pixel value and SNR.
NOTE!
NOTE!
The SNR and CNR values measured by the medical physicist during
installation or MEE should be communicated to the QC Technologist
and will define the base line values for these measurements.
If any level is found to be beyond any action level stated, the source of the
problem must be identified and the problem corrected by a Siemens customer
support engineer. Consult with your MP to determine if further testing is
required.
NOTE!
NOTE!
HVL Values will be required to calculate Radiation Dose.
5.6.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Six
First Name: Mean Glandular Dose
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC processed.
6. Install the compression paddle.
7. Center the phantom left to right and place dosimeter next to phantom and about
4 cm from chest wall edge, see Figure 24. Try to get the dosimeter at the same
height as the phantom top. Compress phantom until OpComp indicator light is lit,
see Figure 11.
MAMMOMAT NovationDR 59
SPB7-250.623.50.05.24
Required Tests - Physicist
Image Quality and Radiation Dose
8. Choose Opdose 2 on the control console. Select AEC sensor 2 at AWS, see
section 4.1 Site Audit / Evaluation of Technologist QC Program.
9. Use H mode.
10. Double click on the first image in the icon gallery, see Figure 3, Position 2.
11. Select the automatic decompression button on the control console.
12. Make an exposure and check if an automatic release of the compression paddle
was performed and note in Appendix 2, Test Form 5.6 Image Quality and
Radiation Dose.
NOTE!
NOTE!
Record all values in the appropriate place in section 5.6 Image Quality
and Radiation Dose and calculate the mean glandular dose. Other
accepted methods for calculating mean glandular dose may also be
used.
13. Examine the image at acquisition size (To get full resolution click top “image” ->
“acquisition size.) optimize window level settings. Determine how many fibers,
specks and masses can be visualized. Always count the number of visible objects
from the largest object of a given type downward. Note the results in
Appendix 2, Test Form 5.6 Image Quality and Radiation Dose.
XXX XXX
Fibers
Specks
Masses
14. If a problem exists while looking at the image on the AWS send the image to the
diagnostic reviewstation or printer and then examine the image.
15. Record the thickness reported in the image annotation, see Appendix 2, Image
Quality and Radiation Dose.
16. Optional: Repeat radiation dose and image quality tests for D Mode. (Unless D
Mode is the clinical Technique).
17. Choose the Close patient tab card and close patient by clicking this button.
5.6.4 Analysis
• Count each fiber as one point if the full length of the fiber is visible and the
location and orientation of the fiber are correct. Count a fiber as 0.5 point if
not all but more than half of the fiber is visible and its location and orientation
are correct. If a fiber-like artifact appears anywhere in the image but is not in
an appropriate location or orientation, deduct the "artifactual" fiber from the
last "real" fiber scored if the artifactual fiber is equally or more apparent.
• When studying the specks, it can be useful to take advantage of the zoom
and invert function. Each speck group shall be counted as one point. A full
speck group is counted if four or more specks are visible in the group in the
proper locations. Count a speck group as 0.5 point if two or three specks of
the group are visible. If noise or speck-like artifacts are visible in the wrong
locations in the phantom insert, subtract each speck-like artifact one for one
from the last real speck counted.
• Count each mass as one point if a density difference is visible in the correct
location and the full mass is visible against the background. Count each mass
as 0.5 point if a density difference is visible in the correct location but the full
mass is not visible, so that the mass does not have a circular appearance. If
there is a mass-like artifact in the wrong location anywhere in the image,
deduct the "artifactual" mass from the last "real" mass scored if the artifactual
mass is equally or more apparent.
MAMMOMAT NovationDR 61
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Required Tests - Physicist
Image Quality and Radiation Dose
Fibers ≥5
Masses ≥4
If any level is found to be beyond any action level stated, the source of the
problem must be identified and the problem corrected by a Siemens customer
support engineer. Consult with your MP to determine if further testing is
required.
5.7.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Seven
First Name: HVL
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC processed.
6. Install the spot compression paddle to collimate the X-ray beam.
7. Raise the compression paddle to its highest position and place the 2 mm steel
plate on the object table.
NOTE!
NOTE!
It is important that the 2 mm steel or lead is covering the detector during
the entire test.
8. Place the dosimeter on the object table. Make sure the receptive area is fully
within the X-ray field, use the light field as a guidance.
9. Set 28 kVp and anode/filter combination see section 4.1 Site Audit / Evaluation of
Technologist QC Program (Opdose 2, clinical technique) and set mAs = 50.
10. Double click on the first image in the icon gallery, see Figure 3, Position 2.
MAMMOMAT NovationDR 63
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Required Tests - Physicist
HVL and Radiation Output
11. Make an exposure. Note the dosimeter reading in Appendix 2, Test Form
5.7 HVL and Radiation Output period.
12. For Mo/Mo place 0.3 mm aluminum sheets on top of the compression paddle. For
Mo/Rh place 0.4 mm aluminum and for W/Rh place 0.5 mm aluminum on top of
the compression paddle. Make sure the Al sheets cover the whole active detector
area of the dosimeter.
13. Make another exposure. Record the dosimeter reading and the Al thickness in
Appendix 2, Test Form 5.7 HVL and Radiation Output.
14. Place an additional 0.1 Al sheet on top of the compression paddle.
15. Repeat steps 13 to 14 until the dosimeter reading is less than half the first
exposure reading that you made without any Al sheets.
16. Remove all Al sheets, make an exposure and record the dosimeter reading. If the
value differs more than 2% from the first exposure reading, repeat from step 11.
17. Make one more exposure using 28 kVp 400mAs Mo/Mo. Record the radiation air
kerma/exposure and exposure time in Appendix 2, Test Form 5.7 HVL and
Radiation Output
18. Note the time of the exposure that is displayed in the Image Attributes ... by
clicking on the right mouse button on the image icon.
20. Choose the Close patient tab card and close patient by clicking this button.
21. Calculate the HVL values for each anode/filter combination following the formula
and note the values in Appendix 2, Test Form 5.7 HVL and Radiation Output.
( t b ⋅ ln [ 2D a ⁄ D 0 ] ) – ( t a ⋅ ln [ 2D b ⁄ D 0 ] )
HVL = ---------------------------------------------------------------------------------------
-
ln [ D a ⁄ D b ]
where
D0 = air kerma/exposure reading without aluminum
Da = air kerma/exposure reading just greater than half of D0
Db = air kerma/exposure reading just less than half of D0
ta = aluminum layer thickness corresponding to Da
tb = aluminum layer thickness corresponding to Db
ln is short for the natural logarithm
The HVL for all anode filter combinations must be greater or equal to kVp/100.
If any level is found to be beyond any action level stated, the source of the
problem must be identified and the problem corrected by a Siemens customer
support engineer. Consult with your MP to determine if further testing is
required.
MAMMOMAT NovationDR 65
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Required Tests - Physicist
Tube Voltage Measurement & Reproducibility
5.8.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_Eight
First Name: Tube Voltage
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC processed.
6. Make sure that the Mammomat system has been powered on for at least
15 minutes.
7. Install the compression paddle simulator.
8. Place the 2 mm steel plate on the detector.
9. Place the detector part of the digital kVp meter on top of the steel plate. Care
should be taken to position the detector in accordance with the manufacturer's
recommendations. (Alternative procedure: place kVp meter on top of
compression paddle. Center active area in the beam.)
10. Double click on the first image in the icon gallery, see Figure 3, Position 2.
11. Make 4 exposures at the clinical kVp (see section 4.1 Site Audit / Evaluation of
Technologist QC Program) using 50 mAs and Mo/Mo.
For each measurement, record the tube voltage value kVp from the kV meter in
Appendix 2, Test Form 5.8 Tube Voltage Measurement & Reproducibility.
12. For each of the following kVp's one exposure is required:
26kVp, 28kVp, 30kVp, 32kVp and 34kVp (50 mAs, Mo/Mo).
For each measurement, record the tube voltage value kVp from the kV meter in
Appendix 2, Test Form 5.8 Tube Voltage Measurement & Reproducibility.
13. Choose the Close patient tab card and close patient by clicking this button.
5.8.4 Calculations
These calculations can be easily performed with an inexpensive calculator.
1. Formula for Accuracy (expressed in percent):
kV p
meas – kVp set
---------------------------------------------- × 100
kVp set
MAMMOMAT NovationDR 67
SPB7-250.623.50.05.24
Required Tests - Physicist
Tube Voltage Measurement & Reproducibility
b) Subtract each individual measurement sample from the mean value kVpmean and
square each difference.
5.9.1 Objective
To assess the quality of the laser camera.
5.9.3 Procedure
1. Login according to the section 2. Start Up and Login.
2. Choose the service patient in the Patient Browser.
3. Select SMPTE image from group [1] Technical Images in the service image
patient. Open it in the Viewing task card by double clicking.
4. Send the image to the mammography laser camera/printer.
5. The printer/laser camera shall be configured to Min Density 20 (corresponding to
0.2 optical density) and Max Density to 350 (corresponding to 3.5 optical
density), if applicable.
6. Evaluate the printed SMPTE image by measuring the eleven density values from
0 to 100% with the densitometer and note the measured values in
Appendix 2, Test Form 5.9 Printer Check.
NOTE!
NOTE!
This procedure or the printer/laser camera manufacturer's QC
procedure must be followed whenever the printer/laser camera is used
to print mammographic images or accreditation images.
MAMMOMAT NovationDR 69
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Optional Test
Ghost Image Evaluation
6. Optional Test
6.1 Ghost Image Evaluation
6.1.1 Objective
Ghosting could be described as "shadows" of the previous exposure.
The ghost image caused by a 2600 mR exposure will decay to less than 3% in a
subsequent 8 mR exposure after 180 sec. Contrast is defined as the difference
between the digital pixel value measured within the ghost image and outside the ghost
image relative to the average pixel value inside and outside the ghost image. The
digital pixel value will be the average of pixel values inside a square of 10x10 mm.
The objective of this test is to ensure that the ghosting is within an acceptable level.
6.1.4 Procedure
1. Login according to the section 2. Start Up and Login.
2. Enter a new patient by pressing Patient Registration icon, see Figure 1,
Position 1.
3. Create a new patient record in the local database.
Fill in: Last Name: Test_One
First Name: Ghosting
Patient ID: day+time when the test is performed
(example: 200411281350)
DOB: 05 05 1955
Gender: Other
4. Press Exam button.
5. Choose procedure FD QC Raw.
6. Cover the FD object table with the 2 mm steel.
Position 2 Position 3
Steel bar
Paper clip
Position 1 Position 4
Second exposure Third exposure after 180 seconds
MAMMOMAT NovationDR 71
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Optional Test
Ghost Image Evaluation
15. Measure the mean values PV1 and PV2 by using the paper clips as a guidance if
the ghost image is not visible as shown in Figure 27 third exposure. Select an ROI
(Region of Interest) by choosing Tools > Circle size approximately 10x10 mm.
Measure the mean value of a region at the plexi and note the value in
Appendix 2, Test Form 6.1 Ghost Image Evaluation.
NOTE!
NOTE!
PV1 and PV2 are the compensated mean pixel values,
PVi Mean = Pixel value i - Offset Value (Offset Value is 50).
MAMMOMAT NovationDR 73
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Appendix 1 to MAMMOMAT NovationDR QC Manual
For notes
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
mAs:
Fibers ≥5 l l
Speck
Groups
≥4 l l
Masses ≥4 l l
Comments: _______________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
MAMMOMAT NovationDR 75
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Appendix 1 to MAMMOMAT NovationDR QC Manual
For notes
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Year
Month
Day
Time
Temperature
Performed by
Year
Month
Day
Time
Temperature
Performed by
Year
Month
Day
Time
Temperature
Performed by
MAMMOMAT NovationDR 77
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Appendix 1 to MAMMOMAT NovationDR QC Manual
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Review: ____________________________________ Date: ______________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
l l
l l
l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
MAMMOMAT NovationDR 79
SPB7-250.623.50.05.24
Appendix 1 to MAMMOMAT NovationDR QC Manual
For notes
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
MAMMOMAT NovationDR 81
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Appendix 1 to MAMMOMAT NovationDR QC Manual
Mean Mean SD Dev. SNR CNR Deviation Deviation Performance Passed Failed
Back- Mass Back- SNR CNR criteria
ground ground
Baseline
1st SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
2nd SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
3rd SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
4th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
5th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
6th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
7th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
8th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
9th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
10th SNR: ≥ 40 l l
Dev SNR: ± 15%
Dev CNR: ± 15%
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
MAMMOMAT NovationDR 83
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Appendix 1 to MAMMOMAT NovationDR QC Manual
9. Artifact(s) other
than grid or detector
10. Mechanical failure
11. Electrical failure
12. Software failure
13. Inappropriate
image processing
14. Other failure
15. Unknown failure
16. Double exposure
Total num-
ber of dis-
carded
images/
repeated
images
Yes No
Corrective actions l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Maximum Force
Automatic
Force between
12 and 20 kg
l l
Maximum Force
Manually (optional)
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
MAMMOMAT NovationDR 85
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Appendix 1 to MAMMOMAT NovationDR QC Manual
For notes
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual. Your physicist can help with this test at
system installation.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
MAMMOMAT NovationDR 87
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Appendix 1 to MAMMOMAT NovationDR QC Manual
Printer Check
Min Density
Max Density
MAMMOMAT NovationDR 89
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Appendix 1 to MAMMOMAT NovationDR QC Manual
If your values do not meet the values specified above, then please refer to the printer
manufacturer's quality control procedure. You can create your own baseline with the
measured values that result from the initial install of the printer that was installed per
the manufacturer's QC procedure.
Compliance Yes No
Date _______________ l l
Date _______________ l l
Date _______________ l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
MAMMOMAT NovationDR 91
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Appendix 2 to MAMMOMAT NovationDR QC Manual
For notes
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
MAMMOMAT NovationDR 93
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Appendix 2 to MAMMOMAT NovationDR QC Manual
Yes which?
No
Yes No
l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
MAMMOMAT NovationDR 95
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Appendix 2 to MAMMOMAT NovationDR QC Manual
Comments: ________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
MAMMOMAT NovationDR 97
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Appendix 2 to MAMMOMAT NovationDR QC Manual
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Visual Inspection:
Yes No
Streaking l l
Performance criteria: No
Fluttering l l
Performance criteria: No
Shadows l l
Performance criteria: No
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Detector uniformity
Mo/Mo Mo/Rh W/Rh
Anode/Filter combination used
l l l
MAMMOMAT NovationDR 99
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Appendix 2 to MAMMOMAT NovationDR QC Manual
Comments: ______________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
l l
l l
l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Collimator Assessment
a=f-e
b=f-g
ar is a on the right side.
al is a on the left side.
an is a on the nipple side.
ac is a on the chest wall side.
br is b on the right side.
bl is b on the left side.
bn is b on the nipple side.
bc is b on the chest wall side.
If a is positive the X-ray field is larger than the detector area.
If a is negative the X-ray field is smaller than the detector area.
If b is positive the X-ray field is larger than the detector area.
If b is negative the X-ray field is smaller than the detector area.
a is the deviation between the X-ray field and the light field.
b is the deviation between the X-ray field and the detector area.
α = value for dead space (See Compression Paddle Overlap on Chest Wall Side )
e = ________________ mm
x = ________________ mm
y = ________________ mm
Mo W
| ar | + | al | ≤ 13 mm
l l
| an | + | ac | ≤ 13 mm
l l
Mo W
| br | + | bl | ≤ 13 mm
l l
Mo W
| bn | + | bc | ≤ 13 mm
l l
Mo W
| br | + | bl | + | bn | + | bc | ≤ 26 mm
l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
≤ 6.5 mm l l l l
≤ 6.5 mm l l l l
≤ 6.5 mm l l l l
≤ 6.5 mm l l l l
≤ 6.5 mm l l l l
Comments: ____________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ______________________________________________________________
______________________________________________________________
Room: ______________________________________________________________
Type of test: ______________________________________________________________
Performed by: ______________________________________________________________
Date: ______________________________________________________________
Mean l l
SD l l
SNR > 40 ≤ 15 % l l
For notes
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Spatial Resolution
Anode/Filter kV mAs Best resolution Performance Passed Failed
combination visible (lp/mm) criteria
Mo / Mo ≥ 7 lp/mm l l
W / Rh ≥ 7 lp/mm l l
Comments: _______________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
For notes
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
1st
2nd
3rd
4th
5th
Mean value
(mAs)
SD Dev. (mAs)
Coefficient of
variation
(mAs)
≤ 5% l l
Mean value
(Entrance air kerma)
SD Dev.
(Entrance air kerma)
Coefficient of
variation
(Entrance air kerma)
≤ 5% l l
Mean value of
“Mean”
Mean value of
SNR
Max. deviation
“Mean” from Mean value ≤ 15% l l
Max. deviation
SNR from Mean value ≤ 15% l l
Comments: ________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
mAs:
Fibers ≥5 l l
Speck
Groups
≥4 l l
Masses ≥4 l l
Comments: _______________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
D Large
Compression release
Yes No
l l
Compression thickness
Where K is the incident air kerma (without backscatter) calculated at the upper surface
of the PMMA. The factor g, corresponds to a glandularity of 50%, and is derived from
the values calculated* and is shown below for a range of HVL. The c-factor corrects
for the difference in composition of typical breasts from 50% glandularity* and is given
here for typical breasts in the age range 50 to 64. Note that the c and g-factors applied
are those for the corresponding thickness of typical breast rather than the thickness of
PMMA block used. Where necessary interpolation may be made for different values
of HVL. The factor s shown in the second table corrects for any difference due to the
choice of X-ray spectrum*.
* [D.R. Dance, C.L. Skinner, K.C. Young, J.R. Beckett. C.J. Kotre:
Additional factors for the estimation of mean glandular breast dose using the
UK mammography dosimetry protocol
Physics in Medicine and Biology 45, 3225-3240, 2000]
D=Kgcs H
l l
≤2 ≤3
D=Kgcs D
l l
Comments: ___________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Anode/Filter Mo/Mo kVp ______ Mo/Rh kVp ______ W/Rh kVp ______
Exposure reading
without Al (D0)
Exposure reading
0.2 mm Al
Exposure reading
0.3 mm Al
Exposure reading
0.4 mm Al
Exposure reading
0.5 mm Al
Exposure reading
0.6 mm Al
Second exposure reading
without Al (must not differ
more than 2% from D0)
Observe that all fields may not be needed for the different anode/filter combinations.
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Radiation Output
mGy reading from the dose meter
Comments: _________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
2nd exposure
________ kVp,
<2%
l l
50 mAs, Mo/Mo
3rd exposure
________ kVp,
<2%
l l
50 mAs, Mo/Mo
4th exposure
________ kVp,
<2%
l l
50 mAs, Mo/Mo
26 kVp Accuracy: ≤ 5 % kV l l
28 kVp Accuracy: ≤ 5 % kV l l
30 kVp Accuracy: ≤ 5 % kV l l
32 kVp Accuracy: ≤ 5 % kV l l
34 kVp Accuracy: ≤ 5 % kV l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
Printer Check
Min Density
Max Density
If your values do not meet the values specified above, then please refer to the printer
manufacturer's quality control procedure. You can create your own baseline with the
measured values that result from the initial install of the printer that was installed per
the manufacturer's QC procedure.
Compliance Yes No
Date _______________ l l
Date _______________ l l
Date _______________ l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
NOTE!
NOTE!
Record the measured values on a copy of Appendix 1 pages and file it
along with the QC-manual.
Site: ___________________________________________________
___________________________________________________
Room: ___________________________________________________
Type of test: ___________________________________________________
Performed by: ___________________________________________________
Date: ___________________________________________________
mAs: _________
Ghost image factor <3% l l
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Contact Address: