Workflow diverts trajectory of breast imaging-specific PACS

The accelerated adoption of digital mammography has turned the evolution of mammography PACS in a new direction. In the past, the genealogy of mammography PACS could be traced as an offshoot of full-field digital mammography more than of general medical imaging PACS. Early mammography PACS typically placed more emphasis on the development of reading tools than workflow functionality. That appears to be changing.

“The widening use of digital mammography, through either FFDM or computed radiography, has resulted in more customers placing requests on the system from a broader variety of workflow scenarios,” said Justin Dearborn, CEO of Merge Healthcare.

Mammography PACS are now being pressed to handle the full workflow of a general PACS but with the same speed as a specialty workstation, Dearborn said.

The need for speed is critical in mammography review, particularly for dedicated mammographers. One extra click on each exam can have a negative cumulative impact when hundreds of studies must be read in a single session. In the past, mammographers attempting to concentrate on reading relied on staff to load priors and take notes. Now, dedicated mammography miniPACS are morphing into general PACS with mammography capabilities. Mammographers can enjoy the same automated reading workflow features that general imagers have had access to for years. Time is saved.

“The drivers are improved clinical outcomes, lower cost, efficiency, and accuracy,” said Doug Dill, director of marketing for DR Systems.

UNIQUE ASPECT

Breast imaging is unique in that it includes screening and diagnostic mammograms, along with supplemental imaging such as ultrasound and breast MR. Ideally, a PACS should provide the means necessary to accommodate exam review without the need for a dedicated mammography workstation.

“Over the past few years, the rate of FFDM adoption has swiftly increased, with the market now at 50% penetration,” said Jeanine Rader, director of women's healthcare for Fujifilm Medical Systems.

Vendors are being pushed to deliver systems with graphical user interfaces that provide breast imagers with the diagnostic tools, functionality, and performance to manage screening exams and associated priors, as well as patient clinical history, Rader said. The emphasis is turning toward enhancing radiologist productivity, since digital breast exams take longer to read than film mammograms.

“Workstations dedicated to a single image capture modality are quickly being replaced by multimodality workstations that eliminate the need for radiologists to move between stations,” said Stephen Archer, director of worldwide marketing, mammography solutions, at Carestream Health.