This report presents (1) a broad topical review and a tutorial of the possibilities for image quality control (IQC) with digital systems, and (2) results and initial experience for IQC with two commercial digital imaging systems, but with limited discussion on any particular method. Digital imaging systems used for mammographically guided digital stereotactic breast biopsy were evaluated extensively at the University of Arizona. Measurements were made of linearity, sensitivity, signal-to-noise ratio, and square-wave modulation. Images of phantoms such as the American College of Radiology Accreditation Phantom and the contrast detail mammography Phantom were evaluated as well as images of the x-ray source's focal spot. The evaluation also included the cathode ray tubes for the imaging systems. The data collected show that digital imaging systems have an important advantage over film-screen systems because they provide a digital signal as output that can be used for quantitative analysis. As a result, IQC can become a much more quantitative discipline than presently practiced, providing more information on the imaging systems under evaluation, and providing better control over their properties during actual operation.