Survey of image processing settings used for mammography systems in the United Kingdom: how variable is it?

TL;DR

This study surveyed mammography system setups across the UK, revealing significant variability in image processing and software versions that could impact AI and human interpretation of breast images.

Contribution

It provides a comprehensive overview of the variability in mammography system configurations and highlights implications for AI deployment and image interpretation consistency.

Findings

Multiple software versions per system model

Large differences in image processing settings

Variability in dose levels and equipment components

Abstract

The aim was to undertake a national survey of the setup of mammography imaging systems in the UK, we were particularly interested in image processing and software version. We created a program that can extract selected tags from the DICOM header. 28 medical physics departments used the program on processed images of the TORMAM phantom acquired since 2023 and this produced data for 497 systems. We received data for 7 different models of mammography systems. We found that currently in use each model had between 2 and 7 different versions of software for the acquisition workstation. Each of the systems had multiple versions of image processing settings, a preliminary investigation with TORMAM demonstrated large differences in the appearance of the image for the same X-ray model. The Fujifilm, GE and Siemens systems showed differences in the setup of the dose levels. In addition to these settings there were differences in the paddles used and grid type. Our snapshot of system set up showed that there is a potential for the images to appear differently according to the settings seen in the headers. These differences may affect the outcomes of AI and also human readers. Thus the introduction of AI must take these differences into consideration and the inevitably changes of settings in the future. There are responsibilities on AI suppliers, physics, mammographic equipment manufacturers, and breast-screening units to manage the use of AI and ensure the outcomes of breast screening are not adversely affected by the set-up of equipment.