Digital mammography offers fundamental advantages over film-based mammography. These include the possibility for acquiring quality images at lower radiation dose image recording, processing and archiving as well as the use of artificial intelligence for improving diagnostic outcome. Other practical advantages include cost reduction, use of environmentally friendly technology, and the option of obtaining remote expert diagnostic opinion. Image quality in mammography is critical. A switch from screen-film technology to a digital system is preferable only if high quality images can be guaranteed. This publication provides guidance on the establishment of digital mammography facilities and the upgrade of existing facilities. It focuses on planning, designing and operating the high quality mammography service within available resources.

• 1. INTRODUCTION
  • 1.1. Background
  • 1.2. Objective
  • 1.3. Scope
  • 1.4. Structure
• 2. A ROAD MAP FOR A MAMMOGRAPHY FACILITY
  • 2.1. Implementation scenarios
    • 2.1.1. No medical imaging facility
    • 2.1.2. Limited resources — no mammography
    • 2.1.3. Hospital with an SFM facility
    • 2.1.4. Hospital with a CRM facility
    • 2.1.5. Tertiary care hospital with breast imaging
• 3. RESOURCES AND NEEDS
  • 3.1. Project management
  • 3.2. Core considerations
    • 3.2.1. Needs analysis
    • 3.2.2. Facility design
    • 3.2.3. Infrastructure and room
    • 3.2.4. Equipment
    • 3.2.5. Authorization needs
    • 3.2.6. Staff
    • 3.2.7. Staff training
    • 3.2.8. Procurement
    • 3.2.9. Site-specific training
    • 3.2.10. Quality
    • 3.2.11. Maintenance
  • 3.3. Specific needs for DDM
    • 3.3.1. DDM equipment
    • 3.3.2. Review workstation
    • 3.3.3. Data archiving
    • 3.3.4. Image printing
    • 3.3.5. Environmental requirements
    • 3.3.6. Quality
    • 3.3.7. Maintenance
    • 3.3.8. Staff training
  • 3.4. Specific needs for CRM
    • 3.4.1. CRM equipment
    • 3.4.2. Computed radiography reader
    • 3.4.3. Review workstation
    • 3.4.4. Data archiving
    • 3.4.5. Image printing
    • 3.4.6. Quality
    • 3.4.7. Maintenance
    • 3.4.8. Staff training
  • 3.5. Specific needs for an SFM
    • 3.5.1. SFM equipment
    • 3.5.2. Infrastructure and room
    • 3.5.3. Quality
    • 3.5.4. Maintenance
    • 3.5.5. Staff training
  • 3.6. Costing and implementation
    • 3.6.1. Total cost of ownership
    • 3.6.2. Cost of storage
    • 3.6.3. Workload
    • 3.6.4. Contingencies
• 4. TRANSITION FROM SFM TO CRM AND DDM
  • 4.1. General considerations
  • 4.2. Radiation dose considerations
  • 4.3. Impact of transition
  • 4.4. Fixed installations versus mobile services
• 5. CONCLUSIONS
• Appendix I BREAST CANCER
• Appendix II MAMMOGRAPHY TECHNOLOGY
  • II.2.1. Components of a mammography system
    • II.2.2. DDM technology
    • II.2.3. CRM technology
    • II.2.4. Comparison among mammography technologies
• Appendix III OTHER BREAST IMAGING MODALITIES
• Appendix IV MAMMOGRAPHY EQUIPMENT PERFORMANCE
• Appendix V QUALITY MANAGEMENT
  • V.2.1. Characterization of a digital detector
    • V.2.2. CRM evaluation
    • V.2.3. Dose and imaging performance of the system
• APPENDIX VI EDUCATION OF PROFESSIONALS IN MAMMOGRAPHY
  • VI.1.1. Example: Canada
    • VI.1.2. Example: Mexico
    • VI.1.3. Example: Belgium (Europe)
    • VI.2.1. Example: United States of America
    • VI.2.2. Example: Belgium (Europe)
    • VI.2.3. Example: Mexico
    • VI.2.4. Example: United Kingdom
    • VI.3.1. Example: United States of America
    • VI.3.2. Example: Europe
    • VI.3.3. Example: United Kingdom
    • VI.3.4. Example: Mexico
• Appendix VII EVALUATION OF MAMMOGRAPHY SERVICE
• REFERENCES
• ABBREVIATIONS
• GLOSSARY
• CONTRIBUTORS TO DRAFTING AND REVIEW