Deborah R. Dakins

I recently completed a task that we expect will lead to a more refined search engine for the Diagnostic Imaging Web site and those of our sister publications at CMPMedica. The project required perusing some 400-plus articles in the radiology literature from the past 30 years, covering every conceivable subcategory, and tagging those that best define each clinical application and modality. It involved some tedious parsing of wheat from chaff but provided ample opportunity for reflection on how far radiology has come.

Digital mammography is more accurate than film in detecting cancer in women under age 50, those who have dense breasts, and in pre- and perimenopasual women, according to the long-awaited results from the Digital Mammography Screening Trial (DMIST).

When it comes to evaluating 3D workstations, the proof is in the clicks-the fewer the better. That's the consensus of attendees at a workstation face-off event held during the Society of Computed Body Tomography and Magnetic Resonance annual meeting in South Beach, FL, in March.

Use of digital mammography is routine practice at Allegheny General Hospital in Pittsburgh, although the breast imaging team, headed by Dr. William Poller, is still smoothing out the kinks.

There's no doubt that computer-aided detection increases the ability to pick up breast cancers. But questions remain about which users benefit most from CAD, as cancer detection rates vary widely with breast imaging experience. Even proponents note that improvements in the technology are needed to decrease false positives while increasing accuracy in detecting cancerous masses.

Digital mammography has so much to offer that it might, almost, overcome the fact that it has yet to prove clinical superiority over screen-film mammography. Many users have, in fact, already decided that digital is worth its higher cost-about 40% of all mammography systems sold in the first half of 2004 were digital.

Digital mammography integrated with PACS has numerous advantages over screen-film mammography when it comes to image storage, transmission, archiving, and consultation, according to a study conducted at Cottage Health System in Santa Barbara, CA. But those benefits come at a cost in time and productivity.

CT is moving beyond detection and quantification of coronary artery calcium to grading of coronary stenoses, identifying not only vulnerable plaques but, more important, vulnerable patients. Yet its ultimate role in predicting risk of cardiac events remains unclear.

Digital mammography integrated with PACS has numerous advantages over screen-film mammography when it comes to image storage, transmission, archiving, and consultation, according to a study conducted at Cottage Health System in Santa Barbara, CA. But those benefits come at a cost in time and productivity.

Digital mammography has so much to offer that it might, almost, overcome the fact that it has yet to prove clinical superiority over screen-film mammography. Many users have, in fact, already decided that digital is worth its higher cost-about 40% of all mammography systems sold in the first half of 2004 were digital.

Adding a clinical breast exam to routine mammography screenings can pick up additional cancers, but at a cost. At Memorial Sloan-Kettering Cancer Center, adding CBE to screening helped identify an additional eight cancers at a cost of $106,280 each, said Dr. Kimberly Feigin, a radiologist at the New York medical center.

Adding a clinical breast exam to routine mammography screenings can pick up additional cancers, but at a cost. At Memorial Sloan-Kettering Cancer Center, adding CBE to screening helped identify an additional eight cancers at a cost of $106,280 each, said Dr. Kimberly Feigin, a radiologist at the New York medical center.

Even highly experienced radiologists can overlook cancers, a fact that bedevils breast imagers. Double reading has been shown to help inexperienced readers and increase cancer detection rates. It turns out that even old hands at mammography can also benefit from the practice.