The image quality in digital mammography is described by specifying the thickness and diameter
of disks with threshold visibility. The European Commission recommends the CDMAM phantom as a tool to
evaluate threshold contrast visibility in digital mammography [1, 2]. Inaccuracy of the manufacturing process
of CDMAM 3.4 phantoms (Artinis Medical System BV), as well as differences between software used to analyze
the images, may lead to discrepancies in the evaluation of threshold contrast visibility. The authors of this work
used three CDMAM 3.4 phantoms with serial numbers 1669, 1840, and 1841 and two mammography systems
of the same manufacturer with an identical types of detectors. The images were analyzed with EUREF software
(version 1.5.5 with CDCOM 1.6. exe fi le) and Artinis software (version 1.2 with CDCOM 1.6. exe fi le). The
differences between the observed thicknesses of the threshold contrast structures, which were caused by differences
between the CDMAM 3.4 phantoms, were not reproduced in the same way on two mammography units
of the same type. The thickness reported by the Artinis software (version 1.2 with CDCOM 1.6. exe fi le) was
generally greater than the one determined by the EUREF software (version 1.5.5 with CDCOM 1.6. exe fi le), but
the ratio of the results depended on the phantom and diameter of the structure. It was not possible to establish
correction factors, which would allow correction of the differences between the results obtained for different
CDMAM 3.4 phantoms, or to correct the differences between software. Great care must be taken when results of
the tests performed with different CDMAM 3.4 phantoms and with different software application are interpreted.
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