Mammography

Despite the increasing availability of commercial computer-assisted detection packages for breast screening, the technology remains unproven in the screening setting, according to a leading U.K. breast radiologist. Prof. Fiona Gilbert, a professor of radiology at the University of Aberdeen, is calling for a Europe-wide randomized control trial to prove the case for CAD as a second reader

Clinical acceptance of novel breast imaging techniques could hinge on concurrent development of appropriate computer-assisted detection packages, according to speakers at CARS.

A series of presenters saluted the Computer Assisted Radiology and Surgery conference Wednesday and offered their prescriptions for the future as the meeting celebrates its 20th anniversary.

The true value of widespread mammography screening is a contentious issue, with claims for its success difficult to disentangle from coexisting factors. Now, research from Denmark has produced the strongest evidence to date that screening produces significant re-ductions in breast cancer mortality.

Full-field digital mammography has turned into a superstar of x-ray, doubling in revenue and units shipped last year over 2003. Growth is expected to continue, although the pace may slow as the backlog of ordered systems shrank by year’s end to just 10% more than the number shipped.

The average dose of full-field digital mammography is less than that of screen-film mammography, according to a March report by the FDA.

Breast imagers and their allies cornered vendor representatives during a special session at the SCAR meeting Saturday and demanded more standardization and consistency in the handling of digital breast images.

The final 30 minutes of the Society for Computer Applications in Radiology’s marathon five-hour digital breast imaging forum was allotted to a manufacturers’ panel discussion. Representatives from more than 15 manufacturers fielded questions from the audience.

The final 30 minutes of SCAR’s marathon five-hour digital breast imaging forum on Saturday afternoon was allotted to a manufacturers’ panel discussion. Representatives from more than 15 manufacturers fielded questions from the audience.

A new U.K. report has highlighted uncertainties surrounding the use of computed radiography for breast screening. The findings add fuel to ongoing debates in Europe about the performance of CR mammography in clinical practice.

The Institute of Medicine has recommended sweeping changes to quality standards now being applied to breast imaging facilities. If Congress, which requested the study, enacts these changes, facilities will face a substantially greater burden in collecting patient data, potentially increasing the need for information technology.

The ability to manipulate images with digital mammography can result in fewer callbacks, and breast imaging centers could reduce costs associated with scheduling new appointments, reregistering patients, and rereviewing mammography exams.

Siemens closes in on CTI acquisitionAs of May 4, 94% of the outstanding shares of CTI Molecular Imaging had been acquired by Siemens Medical Solutions as part of that company’s bid to acquire the Knoxville, TN, firm. Siemens expects to complete the acquisition through a merger in which all CTI shares not validly tendered will be converted into the right to receive $20.50 per share. CTI would then become a wholly owned subsidiary of Siemens Medical Solutions. CTI Molecular Imaging is a supplier of PET products and services with annual revenues above $400 million and annual income near $60 million.

Refresher courses are among the most popular features of the European Congress of Radiology. The program planners have developed a knack for selecting timely topics and recruiting authoritative speakers. These courses are often better attended than the more trumpeted state-of-the-art, special focus, and New Horizons sessions. Because these courses usually start at either 8.30 a.m. or 4 p.m., the congress organizers may also view them as a subtle way of ensuring that lecture halls are full throughout the day.

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.

Planar’s Dashboard hits the roadMedical displays are proliferating, appearing not just in radiology but in far-flung corners of hospitals and physician offices. To help PACS administrators manage those displays, Planar has developed the Dome Dashboard software console. This console, which is now commercially available, simplifies the centralized management, monitoring, and control of medical imaging displays. Dashboard alerts administrators when a display slips out of alignment, such as a change in the white level or drop in DICOM calibration conformance.

Many women with early-stage breast cancer undergo successful treatment for the disease. Some women who have been treated, however, may develop recurrent cancers. Imaging surveillance can detect the recurrence in time for treatment.

Women complain that waiting for definitive results after a breast imaging exam is a nerve-racking experience. Staff at one hospital system have identified bottlenecks in the process and have reduced the critical wait time between an abnormal mammogram and a final diagnosis.

Years ago, tomosynthesis was cited as one reason radiology needed digital mammography. A digital detector could be arced around the breast to capture multiple views from different angles, stripping away tissue that obscures cancers. But despite the commercial introduction of digital mammography five years ago, the use of tomosynthesis remains limited to a few isolated medical centers.

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.

Mercury Computer Systems has emerged from the shadows of medical imaging with a portfolio of advanced processing products and services. The company, which previously served mostly as a supplier of 2D imaging components to major OEMs, has begun shopping 3D and 4D products around the imaging industry. These products vary from software only to software-hardware combinations and are designed to perform critical functions in diagnostic and interventional products, as well as PACS.

Sectra hopes to strengthen its position in women’s healthcare with the availability of osteoporosis testing as part of its digital MicroDose mammography system.

Cedara is unveiling this week a CAD system designed for ultrasound. The Canadian software developer is exhibiting the new technology at the European Congress of Radiology in Vienna as part of an extensive offering of PACS tools addressing orthopedic planning, digital mammography screening, 3D, multislice CT, and PET/CT. The ECR is the first major exhibit of Cedara’s technologies since the company announced Jan. 18 its planned acquisition by Merge Technologies.

Less than two years after its establishment, Giotto USA is planning the release of a full-field digital mammography (FFDM) system. Company executives are planning strategy around a 2005 launch of the product.

MR mammography benefits from the reputation of its cornerstone modality's ability to detect soft-tissue abnormalities, particularly cancer. And it presents the opportunity for patients to avoid the discomfort of breast compression.

Adding contrast media to high-energy digital mammography studies can generate clearer images of difficult-to-spot breast masses. The use of contrast and digital subtraction algorithms led to results similar in clarity to breast MR in a small investigational study by German researchers.

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.

Plans to digitize radiology departments often exclude mammography. But advances in digital acquisition, viewing, and network technologies may change this, according to a study presented at the 2004 EuroPACS and Management in Radiology conference.

Five years have passed since the first full-field digital mammography unit was released, yet mammographers are only beginning to embrace the electronic capture of images. Still unrealized, but progressing faster than immediately obvious, is contrast media mammography (CMM), the use of contrast agents and FFDM to visualize the bed of blood vessels that typically accompanies the growth of cancer.

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.