David C. Spelic, Ph.D.
US Food and Drug Administration
Division of Mammography Quality and Radiation Programs
10903 New Hampshire Ave
Silver Spring, MD 20993
This graphic displays average values for mean glandular dose and estimates of image quality in mammography for the period from the early 1970’s to 2005. Doses in mammography have consistently decreased with time, with the most substantial reductions in dose occurring from the early 1970’s to the early 1980’s. Image quality data is presented from the mid-1980’s to present, and shows consistent improvement with time.
The early studies of 1974 and 1976 reported substantial contributions from xeromammography and direct-film procedures. Even during the first year of MQSA inspections in 1995, there were a number of facilities still using xeromammography. Technological improvements such as efficient screen-film technologies, molybdenum target-based x-ray units for mammography, and improvement in film processing quality contributed to further reduction in dose during the eighties and into the nineties. Dose and image quality trends have leveled off in recent years as the technical aspects of mammography became optimized. For further discussion on trends in dose and image quality in mammography refer to the article posted on the FDA’s website.
Average values for mean glandular dose are either reported by, or derived from data reported by the following sources:
|Bicehouse HJ. Survey of Mammographic Exposure Levels and Techniques Used in Eastern Pennsylvania. 7th Annual National Conference on Radiation Control, 1975. DHEW Publication (FDA) 76-8026.|
|Butler PF, Jensen JE. Breast Exposure: Nationwide Trends; A Mammographic Quality Assurance Program- Results to Date. Radiologic Technology 50(3), 1978; pp 251-257.|
|Breast Exposure: Nationwide Trends. In: Internal project progress report. Rockville MD: Bureau of Radiological Health, US Department of Health and Human Services, Food and Drug Administration, 1981.|
1985, 1988, 1992
|Conway BJ, Suleiman OH, Rueter FG, Antonsen RG, Slayton RJ. National Survey of Mammographic Facilities in 1985, 1988, and 1992. Radiology 1994; 191: 323-330.|
1995 to present
|Mammography Quality Standards Act (MQSA) inspection findings.|
Image Quality scores are reported from the following sources:
NOTE: All image quality scores are reported without artifact subtraction.
|RMI 152 phantom with 'C' insert; 1985 Nationwide Evaluation of X-ray Trends (NEXT) survey data.|
|RMI 156 phantom with 'C' insert; 1988 NEXT survey data.|
|RMI 156 phantom with 'D' insert; 1992 NEXT survey data.|
1995 to present
|Mammography Quality Standards Act (MQSA) inspection findings|