Table 4 Biggest challenges of breast imaging practice according to selected studies

a) Challenges of technical performance

1. cleaning and artefacts: working surfaces, screens, cassettes and processing units

2. AEC: change from manual to AEC, service adjustment to AEC

3. periodic test performance

4. exposure parameters: inappropriate use

5. image receptor: change, damaged or scratched or broken receptors

6. film-screen combination: not spectrally matched or broken

7. viewing conditions

8. breast compression: variations between patients during imaging rounds, between practitioners, imaging sites in association with dose, breast thickness and MGD; use of rigid and flexible compression paddles; different types of practitioner viewpoints and behaviour in using compression force

9. use of positioning sheets

10. implementation of QC programs

b) Challenges of quality of practices

1. positioning

2. image contrast

3. image artefacts

4. variations in image quality in using FS, CR and DR systems

5. use of DRLs: DRLs are defined for standard sized patients which does not always apply to reality

6. implementation of repeat/reject analysis

7. image (FS or DI) processing

8. image labelling and documentation

9. variability in the assessment systems of image quality

c) Challenges of patient centeredness

1. giving seamless and multiprofessional diagnostic services

2. association of heavy workload with deficiencies in patient-centred services: lack of time for the patient

3. promoting breast screening adherence in a radiographer’s work

4. patient-centred viewpoint in the use of compression force