Mammography

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It’s been a long time coming. Nearly a decade has passed since ATL took a serious run at advancing the medical art of breast cancer diagnosis. The company, long-since absorbed by Philips Healthcare, developed a novel algorithm designed for its Ultramark 9 HDI, later adapted for its HDI 3000 and 5000.

Full-field digital mammography was built on solid-state technology.The first such machines, introduced eight years ago,were based on flat-panel detectors, a tradition that continueduntil the commercial introduction of computed radiography afew years ago.

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Findings from a large study by British researchers suggest mammography screening interpretations by a single radiologist using computer-aided detection are just as good as double reads and could yield better cancer detection rates than single reads without CAD. Despite higher recall rates, single reads with CAD could offer staffing costs trade-offs.

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Tomographic ultrasound imaging on 4D volumes of fetal chest obtained with spatiotemporal image correlation and color Doppler shows good retrieval of diagnostic cardiac planes in fetuses with ventricular septal defects, according to an Italian study.

Throughout its 30-year history, Diagnostic Imaging has tracked issues surrounding the adoption and development of new imaging technology. Rarely, however, have we looked closely at the question of the learning curves associated with this new technology. This month marks an exception. Our cover story on digital mammography recall rates (page 30) explores why some facilities may be seeing a jump, albeit temporary, in digital mammography recalls and suggests some solutions for keeping those rates down.

Breast cancer is the most common malignancy in adult women. One woman in 11 will contract the disease during her lifetime. The primary goal of treatment is cure, through surgery either alone or in combination with radiotherapy and/or chemotherapy. Surgical management options include breast conservation, mastectomy, and palliative treatment.

As imaging centers convert their workflow to capitalize on the benefits of digital mammography, some radiologists are concerned about the possibility of an increase in the number of patients recalled. Discrepancies between prior screen-film exams and current digital images lead many radiologists to act "better safe than sorry" in their diagnostic interpretation of full-field digital mammography images.

Breast cancer is the most common malignancy in adult women. One woman in 11 will contract the disease during her lifetime. The primary goal of treatment is cure, through surgery either alone or in combination with radiotherapy and/or chemotherapy. Surgical management options include breast conservation, mastectomy, and palliative treatment.

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A recent advisory by the FDA urging breast imaging facilities to ensure compatibility between full-field digital mammography systems and PACS exposed an ongoing problem: Interoperability issues persist as some vendors fail to comply with healthcare digital imaging standards.

FDG-PET/CT's power for staging and restaging breast cancer is attracting attention. It could also detect recurrence in more than two-thirds of these patients and change the management plan in up to a third, according to German investigators.

The FDA is considering a national registry for thermal ablation treatment of breast cancer. The proposed registry would compile information on all thermal ablation devices and therapies for small carcinomas and address inconsistencies that potentially diminish the value of previously published feasibility protocols.

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Women with diagnostic mammograms flagged as probably benign usually undergo short-interval follow-up. But at 12 months, this second look may not boost cancer detection.

It is a safe bet that conventional mammography will give way to 3D imaging and other advanced technologies in the not-too-distant future. The gamble lies in picking which technology will emerge the clear winner as the primary screening tool for breast cancer: digital breast tomosynthesis or dedicated breast CT.

Now that computer-aided detection has become part of routine clinical work for cancer screening in mammograms and is being applied in the differential diagnosis of cancer in the lung and colon, it's only a matter of time before it rates as the standard of care for diagnostic examinations in daily clinical work.

Groundbreaking research has confirmed that Pittsburgh Compound B binds to the beta-amyloid deposits in the brains of patients with Alzheimer's disease. The finding is a major step toward an early, definitive diagnosis of the memory-stealing condition.