Even though the regulatory agency and mammography accreditation bodies have detailed
statement/requirement for medical physicist’s tests, there are still some areas that are not
clearly defined to cause variability and ambiguity among the physicists. A mammography
unit that is fully accepted by one physicist may have many discrepancies identified by
another physicist based on interpretation of MQSA regulation and/or ACR QC manual.
Inconsistency particularly occurs when older mammography units or poor engineering
design are involved. Here comes the professional judgment, which is not discussed
frequently. Any deficiencies in the physicist report need to be corrected to cost the
facility financially or it can be tolerated to potentially hamper image quality. Oftentimes
the problems are described in term of physicist’s recommendation/comment which are
not necessarily to require any action. It is unfair to leave the decision to facilities. The
professional judgment must be reasonably balanced or compromised. The author feels
that sometime it is difficult to make such judgment. In this paper, all 11 ACR physicist
tests are analyzed for those “gray” areas. Through numerical demonstration, the physicist
test result will flip from “fail” to “pass” depending on interpretation of 1999 ACR
physicist manual. The author also believes that some areas may have urgency to resolve
for clarification/redefinition. A good example is the AEC performance evaluation when
future FDA’s criteria change to ± 0.15. The author wishes certain degree of the consensus
should be reached within the professional societies.