Abstract:
Background and purpose Inadequate positioning together with inconsistent criteria can lead to unnecessary repeat imaging and perhaps missed breast cancers. Image quality is evaluated by both radiographers and radiologists, however, it is unclear how image quality and positioning criteria are applied and validated. Method Australian and New Zealand certified breast imaging radiologists (n=27) and mammographic radiographers (n=125) participated in a bespoke questionnaire via paper and online dissemination. The questionnaire rated the importance of known positioning criteria for both mediolateral and craniocaudal (CC) projections, focusing on knowledge and the frequency of application for the CC projection in clinical practice. Preliminary Results Radiographers were considered the most responsible practitioner for the assessment of positioning image quality by 92% of radiographers and 63% of radiologists. The ‘1 cm rule’ was known by 76% of radiographers and 48% of radiologists, indicating lack of familiarisation with this criterion. For the CC projection there was a general agreement on importance of inclusion of the pectoral muscle, medial bias when positioning, and visualisation of retroglandular fat. Conversely inclusion of postero-lateral tissue, even if medial tissue is compromised, was rated as more important by radiologists (35%) than by radiographers (21%). Radiographers’ rated the ‘1 cm rule’ to be more useful in considering positioning accuracy. Inferential analysis between the two groups is currently being undertaken. Conclusion There are variations in published positioning criteria and differences are identified in radiologists’ and radiographers’ knowledge and preferences for applying positioning criteria. Bibliography BreastScreen Australia. National Accreditation Standards. Australia: Joint Australian, State and Territory Government Program; 2015. Ministry of Health. BreastScreen Aotearoa Policy and Quality Standards. Wellington, New Zealand.: Ministry of Health; 2016. Mount J. Reject analysis: A comparison of radiographer and radiologist perceptions of image quality. Radiography. 2016;22(2):e112-e7.
