Dosimetry and kVp standardization for quality assurance of mammography

• We established calibration infrastructure for mammography X-ray quality assurance.
• The expanded uncertainty of calibration factors were evaluated using ISO GUM.
• The comparison results are consistent with NIST and PTB for mammography.

Breast cancer mortality rates were significantly reduced in Taiwan after achieving early-stage monitoring with mammography screening. This study establishes an appropriate and traceable calibration infrastructure, which offers calibration services for mammography X-ray quality assurance instrumentation, which is performed clinically on a regular basis. The entrance air kerma, HVL, and kVp of mammography equipment with five different target/filter combinations can be taken as adequate indicators for the level of average glandular dose (AGD). The primary dose standard in mammography uses a free-air ionization chamber to estimate the rate of air kerma. Several correction factors were determined by Monte Carlo simulations and experiments. A secondary kVp standard in mammography is in accordance with the IEC 61676 recommendations. The calibration system of kVp meter uses a high-voltage divider, which is traceable to ITRI primary standard in Taiwan. Dose and kVp verifications were conducted by mammography instruments, which were previously calibrated by NIST and PTB. The evaluation results indicate that the capabilities of this irradiation system met the ISO 4037-1 requirements. The expanded uncertainties (k=2) were 1.03% and 1.6% when the mammography X-ray air kerma rate and kVp meter calibration factors were evaluated using ISO GUM. Experimental verification and a comparison with NIST using transfer ionization chambers yielded differences in calibration factors. Comparison with the PTB using kVp meter indicated a less than 1% difference. The results showed that dose and kVp standards were in reasonable agreement with standard uncertainty. The low uncertainties associated with the obtained results in this work show that the standardization employed can be accurately used for calibration of instrument in mammography in Taiwan.