Verification of Microstructure Qualities of ACR-Approved Mammography Phantoms by Refraction-Enhanced Synchrotron Radiation Imaging

Images of microcalcification specks showed large variation in conventional radiographs of phantoms which are approved for mammography image quality standard by the American College of Radiology (ACR). This kind of variation is not appropriate for image quality standards because the number of specks are visually counted in images and that number is important in image quality evaluation. Our study using synchrotron radiation (SR) imaging revealed the overlapping of micro-sized air bubble(s) to some specks, and also the structural deformation or crackings. Eight phantoms approved by ACR from two different makers and an air-bubble phantom were examined. SR imaging was performed at a synchrotron radiation facility, SPring-8, in Japan. The image-detector was a fluorescent-screen optical-lens coupling system using a CCD camera with a spatial resolution of 6 $\square$m. Objects when imaged with longer sample-to-detector distance show edge enhancement due to a difference in refraction indices, that is refraction enhancement. Refraction-enhanced SR images revealed that some of specks carried foreign objects, which were proven to be air. In phantoms provided by one maker, attaching/overlapping airs were observed for 62 out of 150 specks (41%) , with a higher incidence for the smallest specks. A speck becomes hardly visible in a conventional radiograph when air(s) overlaps the majority part of a speck, though depending on the size of the air-inclusion and on its configuration. Those airs might have been adsorbed on a speck surface before being embedded and then introduced into the matrix together with specks. Our study using SR imaging has clearly shown the nature of defects in some mammography phantoms which seriously degrade the quality as an image standard.