During the mammography equipment evaluation, must the medical physicist test the AEC performance in all equipment configurations used clinically by the facility or can it be limited to the contact configuration? What action limits apply?
During a mammography equipment evaluation, the AEC must be operable in all equipment configurations (contact, magnification, and various image receptor sizes) used clinically by the facility. The term "operable," means the AEC must meet the performance requirements of 900.12(e)(5)(i) within the 2 to 6 cm range. Compliance with this requirement may be demonstrated by any of the following three methods:
1. Confirming AEC performance in the contact configuration. In the contact configuration, the AEC must maintain the film optical density (OD) over the 2 to 6 cm range within the action limit of +/- 0.15 OD of the MOD (See question 3 for additional guidance).
Confirming AEC performance in all other clinically used configurations. This can be done by demonstrating that the AEC meets the density and reproducibility limits established by the manufacturer for those other configurations.
Note: Method #1 can be used only in those cases where the manufacturer has established AEC performance standards for the non-contact configurations provided.
2. Confirming AEC performance in the contact configuration. In the contact configuration, the AEC must maintain the film optical density over the 2 to 6 cm range within the action limit of +/- 0.15 OD of the MOD.
Confirming AEC performance in all other clinically used configurations. This can be done by comparing the contact configuration MOD with measurements obtained using the 4 cm thick phantom in the other configurations used clinically at the facility. When results across different configurations are compared, the facility may use the action limit of +/- 0.30 OD.
3. Confirming AEC performance by demonstrating that the AEC maintains the MOD within +/- 0.15 OD in all configurations used clinically by the facility. The action limit applies only within each specific configuration tested and does not apply to data collected across the different configurations.
Note: During mammography equipment evaluations, facilities that measure AEC performance only in the contact configuration will be subject to citation. 21 C.F.R. 900.12(b)(10)