Introduction

A high-quality mammogram optimizes a radiologist’s ability to identify abnormalities with high sensitivity and high specificity [1]. Artifacts reduce the quality of mammograms and may mimic or obscure abnormalities and cause interpretation errors. Recognizing artifacts improves the quality of mammographic interpretation and prevents the characterization of artifacts as breast pathology. It also allows correction of the artifact and may contribute to its prevention on future mammograms. It is even more valuable to prevent artifacts from occurring than to recognize them after they have occurred. In this chapter, we illustrate the appearance of artifacts in digital mammography, review the causes of these artifacts, and discuss methods to eliminate artifacts in digital mammography. We present artifacts that we have encountered at The University of Texas MD Anderson Cancer Center. References to laws and regulations refer to United States laws. Those of other countries may vary. Indeed, United States law can vary over time or from state to state.

Classification of artifacts in digital mammography

Artifacts are grouped into the following five categories according to the origin of the artifact: those related to the detector, the gantry, the patient, the processing algorithm, and the image storage [2–4]. To recognize and properly classify a specific artifact, it is important to be aware of the methods used to obtain, display, and store the image. For example, patient-related artifacts are common to all forms of mammography, including both film-screen and digital mammography, whether acquired with direct digital radiography (DR) or computed radiography (CR). Processing-related artifacts may be seen with all forms of mammography as well, but those occurring with analog and digital acquisition techniques will have distinct differences in form. Storage-related artifacts occur with digital storage of images, no matter how the images were originally acquired.