To survey the current overall quality of mammograms and to improve Korean standards in comparison to the American College of Radiology (ACR) standards for clinical image evaluations.

A total of 104 mammograms, collected from 63 hospitals and clinics, were examined following the revised new Korean standards and ACR standards for clinical image evaluation. The pass and failure rates of the mammogram were evaluated according to each of the standards compared. The pass threshold for the Korean standards was analyzed using the ROC (receiver operating characteristic) curve in association with the ACR standards. The categories of the Korean standards were evaluated in association with failure of the ACR standards.

Among the 104 mammograms, 99.0% passed the Korean standards, whereas 86.5% passed the ACR standards. A score of 75.5 was the pass threshold for the Korean standards. Moreover, the Korean standards categories associated with the failure of ACR standards included positioning, compression, and contrast/exposure (p < 0.05).

The pass rate of the image evaluation for each mammogram following the Korean standards was 99%, compared to 86.5% for the ACR standards. Hence, the Korean standards were not as stringent. Consequently, stricter regulations are suggested for improvement in the quality of mammograms.