Mammo System Displays Unique Design

A new exhibitor at last year's Radiological Society of North Americameeting piqued interest with a versatile mammography system itis introducing into the U.S. market. While Medical Marketing International's(MMI) booth space at the conference was small, the company drewdouble takes with Giotto, an Italian-made unit that looks likea cross between a conventional mammography system and a SPECTcamera.

MMI is calling Giotto the biggest leap forward in mammographyinstrumentation since the introduction of the dedicated mammographyunit. While normally such claims could be dismissed as garden-varietyRSNA hype, there is no question that the design of the systemis radically different from any other in the industry.

At the heart of Giotto's design is a gantry in which the system'sx-ray tube and bucky table are located. The tube and bucky canbe rotated within the gantry, and the gantry itself can be tiltedF 90´. Giotto thus has a wide range of positioning variationsand can perform both screening mammography and prone stereotacticbiopsy.

By tilting the gantry forward, users can take advantage ofgravity to position the breast. MMI claims that the tilt optionrelaxes the patient's pectoral muscle and brings more breast tissueinto Giotto's field-of-view. Giotto users can image up to 20%more breast tissue with the tilt option, according to the company.

Bennett X-ray's Contour mammography system also has a tiltoption. The option allows Contour users to visualize 1 to 2 cmmore breast tissue, according to the company (SCAN 12/30/92).

Giotto's technical specifications include a molybdenum anodeand a single-phase high-frequency generator with an output of10 kHz and a 23 to 40-kVp range. The system's mAs output rangeis 720 with a 0.3 mm focal spot and 120 mAs with a 0.1 mm focalspot. Source-to-image distance is 60 cm.

Giotto can be purchased with a Smit Roentgen Cytoguide breastbiopsy device, as well as a prone biopsy table. List price fora Giotto with Cytoguide and biopsy table is $150,000. Giotto receivedFood and Drug Administration marketing clearance in October.

While last year's conference was a first for MMI, sharp-eyedRSNA veterans may have recognized Giotto. The Italian manufacturerof the system, Internazionale Medico Scientifica (IMS) of Bologna,displayed the unit at the RSNA meeting four years ago. IMS decidednot to enter the U.S. market at that time, according to EdwardC. Cheek, president of Baton Rouge, LA-based MMI.

In addition to capitalizing on the growing use of stereotacticbiopsy, MMI hopes to catch mammography's swelling digital wave.IMS is developing a digital spot mammography capability for Giottoand will unveil the device at a conference in Rio de Janeiro inMay.

Cheek and several partners formed MMI to market Giotto. Cheekhas a long history in medical imaging, at both Philips and Thomson-CGR.

With MMI lined up as its exclusive U.S. distributor, IMS isnow ready to take on the U.S. The system has been on the marketfor four years in Europe, where it has an installed base of about150, Cheek said. There are six systems installed in the U.S.

MMI plans to market Giotto through dealers. The firm will promotethe unit as a cost-effective, versatile mammography system thatcan meet all of a facility's needs. For example, a customer buyinga Giotto with biopsy gun and table would not need to purchasea dedicated biopsy table, according to Cheek.

"With Giotto, when you're not doing mammography, you canconvert it to stereotactic prone biopsy within about 10 minutes,"Cheek said. "The return on investment is much shorter thanit would be otherwise."

The strategy could work. Given the health-care industry's concernsabout cost-effectiveness, an all-in-one unit like Giotto couldbe well received. But service and support after the sale are almostas important as price these days, and potential customers couldbe concerned about buying from a company that was unknown untillast year's RSNA meeting.

MMI is aware of such concerns and is building a service networkto support customers. IMS is serious about penetrating the U.S.market, according to Cheek.

"We feel very strongly in giving dealer organizationsthe service that they need," Cheek said. "As far asstaying power, IMS is fully committed."