Clinical image quality in mammography

Image quality in mammography encompasses several interlinking domains. Certain determinants of overall image quality are physical and unchangeable, such as the detector’s pixel size. Features of the image such as exposure, contrast and noise can be considered as being determined by an interaction between the system’s technical specifications and the operator, with the operator perhaps exerting the minority influence in the context of automatic exposure control. A final group of parameters can be considered as primarily determined by the operator – the radiographer or assistant practitioner – in concert with the client/patient. These include positioning and presence or absence of blur caused by patient motion. While physical properties and technical parameters can be evaluated by objective testing, overall quality of the final clinical image, and its suitability for radiological interpretation, can currently only be assessed by more subjective means. This article will draw on the available literature to evaluate the importance of mammographic image quality, and discuss methods for assessing that quality.