Mammography

The live audience for Diagnostic Imaging’s Netseminar “Emerging Trends in Breast Ultrasound” had a number of questions for the faculty. Below, Dr. William Svensson responds to their queries:

Imaging threats-some averted, others coming or at hand-punctuated the week.Features: CT took it on the chin during the first half of 2000, creating what one exec called the “toughest period in the industry for a decade.” It’s not looking good for Slovakia-or the rest of Europe, for that matter-as the Old World braces for fallout from a European directive that threatens to bring MR imaging to a standstill. The U.S. imaging community dodged a bullet, as Congress reauthorized the State Children’s Health Insurance Program. A pending “Medicare Severity DRG” could give CT vendors a shot in the arm, as hospital administrators look for ways to ensure that staff diagnose patients within the first 24 hours of admittance.

Small-field-of-view positron imaging, optimized for breast cancer detection, is jockeying for position among several adjuncts to x-ray mammography. A proponent of the technology, Dr. Kathy Schilling, believes it has an edge over MRI.

I read Greg Freiherr's column "Why the NEJM study on CAD is wrong" on your website. Please always keep in mind the following about computer-aided detection:

Some years ago, we converted everything but mammography to PACS. It was the best move our department ever made. Recently, we finished the change by converting to digital mammography. I've had more fun at funerals.

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Doppler ultrasound breast tumor exams conducted prior to chemotherapy can reliably predict the outcome of treatment, according to research conducted in India. Most breast cancer is treated with chemotherapy prior to surgery. The traditional way to assess the success of this chemotherapy is to study tissue samples collected at surgery. In this study, researchers developed a scoring method using Doppler ultrasound to predict chemotherapy success.

Both ultrasound alone and ultrasound-guided fine-needle aspiration biopsy of lymph nodes are reliable ways to stage invasive lobular carcinoma, a form of breast cancer occurring in only 10% to 15% of cases. Although preoperative assessment can be quite challenging with this cancer, research from the University of Texas M.D. Anderson Cancer Center in Houston found ultrasound to be as effective for staging invasive lobular carcinoma as it is for the more common invasive ductal carcinoma.

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Medical organization nixes CT lung screeningAnalysts predict boom in breast disease managementForesight digitizes legacy scanners

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Large-screen photographs of cotton bolls, snakeskin, cacti, and trees saddled with the overgrowth of new limbs often star in provocative lectures about early-stage breast cancer by Dr. Laszlo Tabar, a pioneer in mammography education.

Ductal carcinoma in situ often takes on an innocent guise in the mainstream media. It may be referred to as "precancerous" or "mostly harmless." Some say this common malignancy is overdiagnosed and overtreated.

The Stanford International Symposium on Multidetector-Row CT has gained such momentum in its nine-year history that the next meeting will be in a larger venue in Las Vegas. The growing importance of multislice CT is reflected in the wide range of topics presented this year.

A 10-year study of imaging volume demands on a PACS at the Medical University of South Carolina shows how significant a factor multislice CT has become in image data storage.

Naviscan PET Systems hopes to ride a building wave of interest in new breast imaging technologies with its high-resolution, small field-of-view positron system. The FDA-cleared device has obvious application as an adjunct in the diagnosis of breast cancer. But it may be able to do much more.

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Competitors to x-ray mammography may be mounting a serious challenge to the long-standing technology. Research has determined that MR and nuclear medicine can detect ductal carcinoma in situ (DCIS), which can develop into an invasive form of breast cancer, much earlier than mammography can.

Demand for digital computer-aided detection drove a 58% increase in revenue at iCAD in the second quarter to $6.1 million and caused net loss to decrease by two-thirds to $866,000.

Radiologists may be adept at rejecting hundreds of false positives flagged by computer-aided detection software, but they also have a strong tendency to dismiss correctly identified cancers, mistakenly believing the findings are benign, according to new research.

Big-ticket items are suffering this year as reimbursement cuts resulting from the Deficit Reduction Act have had a wider and longer lasting effect than initially expected. Particularly hard hit has been PET/CT. The hybrid juggernaut had defied the odds for several years, marching forward with ever higher sales despite utilization rates at individual sites that allowed plenty of unused capacity.

The latest lung CAD software offers high sensitivity and minimizes false positives greatly. But the lack of full integration with PACS continues to stall routine clinical use in some centers.

Pending tomosynthesis platform may stem price erosion seen with Selenia