Assessment of Quality Management System in Some Selected Diagnostic Mammography Units in Ethiopia

Abstract

This research work was aimed at assessing the quality management system and radiation protection of patients of four mammography facilities in Ethiopia. A questionnaire was designed to collect data to assess the status of the quality management systems at the facilities. Quality control measurements were done to verify whether the mammography machines were performing self- consistently compatible with National and International standards. The status of patient protection was evaluated by assessing the mean glandular dose with ACR Phantom in conjunction with image quality assessment using ACR accredited phantom and Leeds test object. From the analysis of the questionnaires administered the facilities did not meet the quality management system criteria. The mammographic machines performed self –consistently with respect to all the parameters tested expect with facility D which recorded a high deviation of ± 57.21% at 30 kV outside the acceptance criterion. The beam qualities were acceptable except one facility which could not meet the criteria with a HVL value of 0.29 mmAl. The image quality assessments of the four facilities were within the acceptance criteria for detectability of microcalcification, masses, fibers and spatial resolution. Estimated mean glandular dose (MGD) of values 1.0 mGy, 1.03 mGy, and 0.96 mGy at 28 kV for the selected facilities were less than the 2 mGy and 3 mGy recommendations by International Atomic Energy Agency (IAEA) and American College of Radiology (ACR) respectively. Management of the mammography facilities must establish an efficient and effective quality management system which includes plan and do (quality assurance), check (quality control) and take action (quality improvement) to govern the imaging process ensuring optimum radiation protection of the patient.