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Preparing and Submitting Hard-Copy Films: Mammography (Revised 2-26-2024)

Revision History

Complete the Clinical Test Image Data Form in your Testing Package (one for each examination and mammography unit tested). Your supervising radiologist must review and approve image selections and printed films prior to submitting them to the ACR. 

Process the image using the film processor normally used to process mammograms. The ACR does not require automatic flashing of films by the mammographic unit. The FDA requires that the image identification be permanent and legible but does not require a flash ID system to do it. The ACR strongly recommends a flash card since it is the most permanent method for image identification (see p. 26, 1999 ACR Mammography Quality Control Manual).

The ACR accepts clinical images on both the 18 x 24 cm and 24 x 30 cm film sizes. As described in the 1999 ACR Mammography Quality Control Manual, it is important that the appropriate size film be selected to match the size of the breast. Although the ACR prefers smaller format film, we will accept digital mammography clinical and phantom images submitted on 14 x 17 inch film if this is the same format that you use to provide hardcopies to your patients.  

Printed digital images must be as close to “true size” as possible (i.e., with no minification or magnification).

Label the film/image with the appropriate bar-coded label. Bar-coded identification labels should be affixed to the clinical and phantom images and the Test Image Data form. These labels are for a specific unit and are marked “Fatty Exam Images,” “Dense Exam Images,” “Clinical Exam 1 or 2 Images” (for validation image checks), “Phantom Image” and “Test Image Data.” Be sure to put the appropriate label on the appropriate item. If you are accrediting a DBT unit, you will test that unit twice, once for FFDM, and once for DBT. If you are accrediting both FFDM computed radiography (CR) and screen-film on a single mammography unit, you will test that unit twice, once for CR and once for screen-film. Be sure to use the labels marked for the correct “unit.” Do not cover the patient ID information or any part of the breast with the label.

Return the required forms and documents, along with your clinical and phantom images, to the following address:

Mammography Accreditation Program

American College of Radiology

1892 Preston White Drive

Reston, VA 20191-4397

Please note that your submission contains HIPAA data, so we strongly recommend that you send your submission via a traceable method with a signature required for delivery. The images submitted for review will be returned once the accreditation evaluation is complete. However, you should maintain copies of all images as well as a record of the patient names whose clinical images were sent for accreditation purposes until you receive official notification your accreditation is approved

Revision History for this Article



Description of Revision(s)



Article created; FAQs incorporated; No criteria changes


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Updated ACR Mailing address from 1891 to 1892

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