Dosimetry and image quality in digital mammography facilities in the State of Minas Gerais, Brazil

According to the National Register of Health Care Facilities (CNES), there are approximately 477 mammography systems operating in the state of Minas Gerais, Brazil, of which an estimated 200 are digital apparatus using mainly computerized radiography (CR) or direct radiography (DR) systems. Mammography is irreplaceable in the diagnosis and early detection of breast cancer, the leading cause of cancer death among women worldwide. A high standard of image quality alongside smaller doses and optimization of procedures are essential if early detection is to occur. This study aimed to determine dosimetry and image quality in 68 mammography services in Minas Gerais using CR or DR systems. The data of this study were collected between the years of 2011 and 2013. The contrast-to-noise ratio proved to be a critical point in the image production chain in digital systems, since 90% of services were not compliant in this regard, mainly for larger PMMA thicknesses (60 and 70 mm). Regarding the image noise, only 31% of these were compliant. The average glandular dose found is of concern, since more than half of the services presented doses above acceptable limits. Therefore, despite the potential benefits of using CR and DR systems, the employment of this technology has to be revised and optimized to achieve better quality image and reduce radiation dose as much as possible. (C) 2015 Published by Elsevier Ltd.