The relationship between age of digital mammography systems and number of reported faults and downtime.

PURPOSE: To investigate the relationship between age of mammographic x-ray equipment, and number of reported faults and related consequences. METHODS: A centralised online fault reporting database is used by all UK breast screening programmes to collate faults with mammography equipment. Data on faults occurring in 2018 and 2019 for digital x-ray imaging systems were analysed. The effect of the age of mammography systems on the number of equipment faults, and the consequences of these faults was examined. The number of days downtime, number of cancelled appointments, number of repeated images, and number of recalled participants were used to quantify the severity of faults. RESULTS: This analysis covers a two year period and includes 4271 faults and 522 individual x-ray sets. On average, an x-ray set was 6.1 years old at the time when a fault occurred. 77% of x-ray sets experienced five of fewer annual faults. X-ray sets of nine years old had the highest average number of annual faults. Systems of ten years old had the highest average number of days downtime per year, and the highest average number of cancellations per year. The indicated primary use of 48% of the x-ray sets included in this analysis was screening, but a disproportionate 87% of cancelled appointments occurred due to faults on these units compared to those used primarily for assessment, or for a mixture of assessment and screening. CONCLUSIONS: Information from this unique dataset can be used to support guidance on equipment replacement programmes for mammographic x-ray sets.

Standardised quantitative radioiodine SPECT/CT Imaging for multicentre dosimetry trials in molecular radiotherapy.

The SEL-I-METRY trial (EudraCT No 2015-002269-47) is the first multicentre trial to investigate the role of 123I and 131I SPECT/CT-based tumour dosimetry to predict response to radioiodine therapy. Standardised dosimetry methodology is essential to provide a robust evidence-base for absorbed dose-response thresholds for molecular radiotherapy (MRT). In this paper a practical standardised protocol is used to establish the first network of centres with consistent methods of radioiodine activity quantification. Nine SPECT/CT systems at eight centres were set-up for quantitative radioiodine imaging. The dead-time of the systems was characterised for up to 2.8 GBq 131I. Volume dependent calibration factors were measured on centrally reconstructed images of 123I and 131I in six (0.8-196 ml) cylinders. Validation of image quantification using these calibration factors was performed on three systems, by imaging a 3D-printed phantom mimicking a patient's activity distribution. The percentage differences between the activities measured in the SPECT/CT image and those measured by the radionuclide calibrator were calculated. Additionally uncertainties on the SPECT/CT-based activities were calculated to indicate the limit on the quantitative accuracy of this method. For systems set-up to image high 131I count rates, the count rate versus activity did not peak below 2.8 GBq and fit a non-paralysable model. The dead-times and volume-dependent calibration factors were comparable between systems of the same model and crystal thickness. Therefore a global calibration curve could be fitted to each. The errors on the validation phantom activities' were comparable to the measurement uncertainties derived from uncertainty analysis, at 10% and 16% on average for 123I and 131I respectively in a 5 cm sphere. In conclusion, the dead-time and calibration factors varied between centres, with different models of system. However, global calibration factors may be applied to the same system model with the same crystal thickness, to simplify set-up of future multi-centre MRT studies.