-The definition of reference dose levels has to be linked with the definition of image quality. Unfortunately, there is still no general agreement on the definition of image quality in mammography, and most of the protocols used are based on the detectability of objects having various shapes and contrasts. To facilitate the task of assessing image quality, scoring methods are often used to produce a single number representative of the imaging chain performance. The goal of this study is to present a comparison between different ways of assessing image quality commonly used in Europe. A set of five mammograms, having different image quality levels, has been obtained with several test objects and compared. The results show large sensitivity variations among the different methods. Concerted work between radiologists and physicists is still required to define the radiological tasks and develop objective ways to measure image quality in mammography.