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What This Guide Helps With
Troubleshooting image artifacts, failed phantom QC, poor contrast, noise, or image quality concerns using safe external checks first.
Step-by-Step Troubleshooting
Ensure Patient Safety First
Confirm no patient is positioned at the mammography system before troubleshooting.
If poor image quality is discovered during a patient exam, stop clinical use until image quality is verified acceptable by the site’s mammography quality process.
Expected outcome: No patient images are acquired on a system with unresolved image quality concerns.
Confirm the Reported Image Quality Issue
Ask mammography staff what was observed and when it occurred.
Determine whether the issue involves:
- Failed phantom QC
- Repeating artifacts in the same image location
- Noise or grainy image appearance
- Poor contrast
- Blurring
- Detector dropout
- Grid or line artifact
- Exposure inconsistency
- Compression-related positioning concern
Expected outcome: The failure type is clearly identified before troubleshooting begins.
Review the Most Recent Phantom QC Result
Check whether the phantom QC failure was a single event or part of a trend.
Review whether the failure involved image score, contrast, artifacts, density, noise, or positioning.
Expected outcome: Clinical Engineering understands whether the issue is isolated, repeatable, or worsening.
If QC passed after a documented repeat using the correct procedure and staff confirm image quality is acceptable, document the finding and stop.
Verify Correct Phantom and QC Setup
Confirm the correct mammography phantom was used and that it was clean, undamaged, and positioned correctly.
Check that the compression paddle, detector, and imaging field were set up according to the site’s approved QC workflow.
Expected outcome: Setup error, phantom damage, or incorrect positioning is ruled out.
If correcting the phantom setup resolves the failed QC, document the cause and stop.
Inspect the Compression Paddle and Breast Support Surface
Visually inspect the compression paddle, bucky surface, detector cover, and breast support area.
Look for cracks, scratches, adhesive residue, dust, fluid marks, tape, paper, positioning markers, or foreign material.
Expected outcome: External objects or surface contamination are removed as possible artifact sources.
If cleaning or removing debris resolves the artifact, document the finding and return the device to use only after acceptable QC.
Check for Repeating Artifact Location
Ask staff whether the artifact appears in the same place on every image or changes with positioning.
A fixed-location artifact may suggest detector, grid, paddle, cover, or processing concern. A moving artifact may suggest positioning, object contamination, or accessory-related cause.
Expected outcome: The artifact pattern helps separate external setup problems from likely system faults.
Confirm the Correct Paddle, Magnification Stand, and Accessories
Verify the correct compression paddle and imaging accessory are installed for the selected exam type.
Check that the paddle is fully seated, undamaged, and recognized if applicable.
Expected outcome: Incorrect or loose accessories are ruled out.
If changing to the correct accessory resolves the image issue, document the correction and stop.
Check Detector and Bucky Area for Obstruction or Damage
Inspect the detector/bucky area without removing covers or opening the system.
Look for visible damage, loose external components, abnormal gaps, or anything trapped between the paddle, detector cover, and patient contact area.
Expected outcome: Obvious external detector-area issues are identified without internal disassembly.
Verify Workstation Display and Image Processing Conditions
Confirm the issue is visible on more than one approved review location if possible.
Check whether the artifact appears on the acquisition workstation, PACS, printed image, or only one display.
Expected outcome: The issue is separated between acquisition/image generation and display or viewing workstation problems.
If the image is acceptable on the acquisition system but poor only on one display, escalate the display, PACS, or workstation concern separately.
Check Exposure Mode, Technique, and Exam Selection
Confirm staff used the correct exam view, breast thickness range, exposure mode, target/filter selection, and clinical protocol.
Do not change clinical protocols unless directed by the mammography quality lead, physicist, or manufacturer support.
Expected outcome: Incorrect technique selection or workflow error is ruled out.
Check for Recent Service, Cleaning, or Environmental Changes
Ask whether the issue began after:
- Room cleaning
- Detector/bucky cleaning
- Paddle replacement
- Software update
- Power event
- Recent service
- Phantom replacement
- Room temperature or humidity change
Expected outcome: A recent change is identified that may explain the new image quality issue.
Verify System Power and Startup Status
Confirm the system completed startup normally and has no active warnings, exposure errors, detector messages, generator messages, or calibration prompts.
Expected outcome: The system is not being used while reporting a condition that could affect image acquisition.
If active system faults are present, remove the device from clinical use and escalate for service.
Repeat a Controlled QC Image Only If Safe and Authorized
If site policy allows, have qualified mammography staff repeat the phantom QC using the approved procedure.
Clinical Engineering should support the equipment checks but should not substitute for required mammography QC interpretation.
Expected outcome: The image quality concern is confirmed or cleared through the site’s approved QC process.
Document the Final Image Quality Status
Record whether the artifact was resolved, QC passed, QC failed again, or the system remains clinically unacceptable.
Include exact symptoms, accessory changes, cleaning performed, phantom condition, error messages, and whether the issue repeated.
Expected outcome: The work order clearly supports return to service or escalation.
If the Problem Persists
If the MAMMOMAT Inspiration continues to show image artifacts, failed phantom QC, poor contrast, detector dropout, repeated noise, or unexplained image quality problems after external checks, common user-accessible causes have been ruled out.
The device should be:
- Removed from service
- Labeled Out of Service
- Held from patient imaging
- Escalated for Siemens service, physicist review, or bench/system evaluation according to site policy
Persistent mammography image quality problems may involve detector calibration, image processing, generator performance, grid function, acquisition software, or internal imaging chain issues. Knowing when to stop is proper troubleshooting.
Clinical Use Tip
Do not troubleshoot image quality problems during active patient positioning or exposure. If image quality is questionable, stop patient imaging and follow the facility’s mammography QC and patient recall policies before returning the unit to service. Move the patient to a backup device or approved alternate workflow first when therapy continuity or clinical imaging must continue.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Mammography staff reported failed phantom QC and a repeating artifact on MAMMOMAT Inspiration images."
Cause
What was observed during troubleshooting.
Example:
"External inspection found residue on the compression paddle surface that appeared in the imaging field during phantom testing."
Resolution
What action was taken.
Example:
"Cleaned the paddle and breast support surface, verified correct phantom setup with mammography staff, and unit passed repeat QC per site process."
Helpful Details to Include (If Known)
- Whether phantom QC passed or failed
- Exact artifact description and image location
- Whether artifact was fixed or moving
- Phantom condition and positioning
- Compression paddle used
- Detector/bucky surface condition
- Any system warnings or error messages
- Recent service, cleaning, or power events
- Whether issue appeared on acquisition workstation or PACS only
- Environmental factors such as room temperature, humidity, cleaning, or recent power events
- Indicator lights, detector messages, generator messages, calibration prompts, or workstation warnings
- Accessories swapped, cleaned, reseated, or removed during troubleshooting
- Final device status
Final Thought
Mammography image quality issues require careful, safety-focused troubleshooting because poor images can affect diagnosis and may lead to repeat exposures. Start with external causes such as phantom setup, paddle condition, detector surface contamination, accessories, and viewing workflow. Escalate when the problem repeats or QC remains unacceptable, and document the complaint, cause, and resolution clearly.
That is successful troubleshooting.