Comparison of Contrast to Noise Ratio and Signal Difference to Noise Ratio Based on QA and QC Guidelines in CR Mammography

The measurement methods of contrast to noise ratio (CNR) and signal difference to noise ratio (SDNR) in digital mammography are different among several quality assurance (QA) guidelines, that is, the type of pixel value (PV), phantom shape, location of aluminum plate, and the size of region of interest (ROI) principally differ in data acquisition. We compared CNR (SDNR) obtained from three QA guidelines. They are the European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services (EUREF), the International Electrotechnical Commission (IEC), and the International Atomic Energy Agency (IAEA). In EUREF and IEC, CNR was calculated using linearized pixel value (LPV). In IAEA, because the type of pixel value to use in SDNR was not specified, SDNR was calculated using PV and LPV, and CNR was calculated using LPV. Target/filter combinations are molybdenum/molybdenum (Mo/Mo) and molybdenum/rhodium (Mo/Rh). Applied various tube voltages are 25, 30, and 35 kV, and various phantom thicknesses are 20, 45, and 70 mm of polymethyl methacrylate (PMMA). The PV-SDNR of IAEA showed the largest value among the three methods, following LPV-CNR of IEC, LPV-CNR of EUREF at 20 mm PMMA thickness. In IAEA, SDNR changed by the kind of pixel value (PV or LPV). When CNR is calculated, every researcher should describe the type of guidelines, the kind of pixel value, and formula for calculation.