European Protocol (phys.-techn.)

The European Protocol for the Quality Control of the Physical and Technical Aspects of Mammography Screening is included in the 4th edition of the “European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis (European Communities, 2006).

This dedicated chapter in PDF-format which covers protocols for both screen-film mammography and digital mammography can be downloaded here:

End 2013, the official supplement (or update) regarding this European Protocol for the Quality Control of the Physical and Technical Aspects of Mammography Screening of the 4th edition of the European Guidelines has been published and released by the European Commission. This supplement can be downloaded at (Search topic: breast cancer), or by using the following link:

The latest corrections/updates on the European protocol for the quality control of the physical and technical aspects of mammography screening chapter, 2b digital mammography can be found in the document below.

Additional software and documents to this protocol can be found in the download section of this website.

Breast Tomosynthesis Quality Control Protocol (phys.-techn.) version 1.01

Since 2011 the European physico-technical steering group has been working on a quality control protocol for breast tomosynthesis systems. Several feedback sessions have been organized with individual physicists, representatives of the industry and international regulatory organizations. As a result the protocol has been adapted and texts have been written and rewritten for clarification. We thank everybody for their feedback and cooperation.

We are pleased to announce that version 1.01 of this protocol has been made available. We believe that this facilitates and will harmonize QC measurements on breast tomosynthesis systems. However, in this version an overall image quality measurement is still lacking. Currently no methods to quantify this overall image quality exist, therefore image quality measurements using readily available phantoms and measurements in projection images are proposed to cover important aspects of image quality. We are still working on methods to quantify overall image quality, but due to the large number of breast tomosynthesis systems already installed in Europe we decided to publish the protocol via the internet as it is. We believe that guidance is highly required.

Breast Tomosynthesis Quality Control Protocol (phys.-techn.) version 1.03

Updated version of European breast tomosynthesis QC protocol (version 1.03)

Changes compared to version 1.01:

  • The dose reference values have been changed to limiting values.
  • The limiting dose value for 20 mm PMMA thickness has changed from 1.0 mGy to 1.2 mGy. This has been done because feedback was received and was noted that the value of 1.0 mGy was difficult to achieve with sufficient image quality for DBT systems.
  • Some text has been added regarding the mode in which mages have to be made in some methods of measurement.


A series of ImageJ plugins for Quality Assurance compliant with the European Guidelines & EUREF Protocol for Digital Mammography (FFDM) and Digital Breast Tomosynthesis (DBT) can be found here:

Please note that this software has not been developed by EUREF. The functioning and correctness of the software is the responsibility of the developers as mentioned on their website.