Reliable quality assurance of X-ray mammography scanner by evaluation the standard mammography phantom image using an interpretable deep learning model

Objective: Mammography is the initial examination to detect breast cancer symptoms, and quality control of mammography devices is crucial to maintain accurate diagnosis and to safeguard against degradation of performance. The objective of this study was to assist radiologists in mammography phantom image evaluation by developing and validating an interpretable deep learning model capable of objectively evaluating the quality of standard phantom images for mammography.Materials and Methods: A total of 2,208 mammography phantom images were collected for periodic accreditation of the scanner from 1,755 institutions. The dataset was randomly split into training (1,808 images) and testing (400 images) datasets with subgroups (76 images) for the multi-reader study. To develop an interpretable model that contains two deep learning networks in series, five processing steps were performed: mammography phantom detection, phantom object detection, post-processing, score evaluation, and a report with a comment about ambiguous results. Results: For phantom detection, the accuracy and mean intersection over union (mIOU) were 1.00 and 0.938 in the test dataset, respectively. During phantom object detection, a total of 6,369 out of 6,400 objects were detected as the correct object class, and the accuracy and mIOU were 0.995 and 0.813, respectively. The predicted score for each object showed a consensus of 97.40% excluding ambiguous points and 59.10% for ambiguous points of the groups.Conclusions: The interpretable deep learning model using large-scale data from multiple centers shows high performance and reasonable object scoring, successfully validating the reliability and feasibility of mammography phantom image quality management.