Quality control of digital breast tomosynthesis: A review on current protocols

Technological advances have driven the evolution of mammography from film-screen mammography to full field digital mammography (FFDM) and digital breast tomosynthesis (DBT). To ensure that any DBT systems complies with ALARA (as low as reasonably achievable) principle in terms of radiation dose, and to maintain the quality and consistency of the produced images, it is compulsory for a periodical quality control to be in place. While acceptance test shall be performed at the time of installation, a quality control program shall be adhered during the operation, including internal quality control (by medical physicists, radiologists, and/or technologist) and the external audit of quality by a third party. This review compares the test parameters of three standards: EUREF (European Reference Frame), ACR (American College of Radiology) and ACPSEM (Australasian College of Physical Scientist and Engineers in Medicine). The three protocols present similar set of tests, focusing on collimation tests of light beams, x-ray tube and generator tests, automatic exposure control (AEC), dose information (MGD), image quality, and physical compression. Both the acceptance test and quality control by a third party should refer to the ACR standard.