A comparative study of the use of CDMAM test object on three different mammography units in use by the public health service of Malta

Abstract

Background: Mammography plays a critical role in breast cancer screening and early detection. Mammography units are essential for identifying early-stage abnormalities, significantly impacting patient outcomes. Quality control using CDMAM phantoms ensures the high performance and accuracy of these units. Digital mammography offers superior image quality and diagnostic capabilities compared to traditional methods. In Malta, advanced mammography units provide both Two-Dimensional (2D) and Three-Dimensional (3D) imaging, ensuring comprehensive screening services. The CDMAM test object evaluates the contrast-detail resolution, contributing to high standards of breast cancer screening within public health. Objectives: To assess the contrast detail resolution of three distinct mammography units using the CDMAM test object. Research Methodology: Eight images of the CDMAM phantom were captured per unit in 2D and 3D modes, and analyzed using CDCOM software, resulting in contrast detail score diagrams, contrast-detail curves, and IQF inverse numbers. Results: All units surpassed the achievable values for threshold thickness at 62.5%. Unit 1 excelled in 2D imaging for detecting smaller diameters, crucial for early cancer detection, while Unit 3 exhibited the best overall contrast detail performance, making it the superior system for comprehensive imaging needs. Based on IQFinv values, Unit 3 demonstrated the best contrast detail performance in 2D imaging, followed by Unit 1 and Unit 2. Although Unit 1 had the lowest IQFinv in 3D imaging, this test is not recommended for 3D imaging due to the lack of an appropriate test object. Conclusions and Recommendations: All three units exhibit good contrast detail performance. The 2006 EUREF guidelines are outdated, highlighting the need for new benchmarks. With advancements like the CDMAM 4.0 phantom, future research should compare CDMAM 3.4 and 4.0 for optimal diagnostics. Additionally, specific DBT phantoms testing should be incorporated.