Breast imaging expands beyond traditional boundaries

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A variety of new breast imaging technologies debuted and gained new strength at RSNA 2003. The modalities stretched from traditional mammography to digital mammography, breast ultrasound, breast MRI and even a new technology joined radiology's vocabulary -- Somography, which is an ultrasound image configured to look like a mammogram.

 GE Medical Systems at RSNA touted its added strength via the recent Instrumentarium acquisition, showcasing the Diamond film-screen system, which can be upgraded using digital stereo, digital spot, and 3-D capability with Instrumentarium's tuned-aperture computed tomography (TACT) technology.

 GE also showed a new work-in-progress version of its amorphous silicon-based FFDM system, Senographe DS, featuring a motorized gantry and a smaller tube head. The system uses the same molybdenum/rhodium tube from the Senographe 2000D.

 GE also debuted as a works-in-progress a new workstation, the Seno Advantage multimodality breast imaging workstation. Seno Advantage will allow users to view ultrasound, mammography, MR, and PET/CT images. FDA clearance is pending for the system, which GE hopes to make available early next year. It is now being sold in Europe.

 Hologic, Inc. at RSNA previewed add-on hardware and software breast tomosynthesis for its first full field digital breast tomosynthesis research system. The works in progress technology brings the promise of a full volume of data produced at the same radiation dose as a conventional screen-film or digital mammogram.

 Breast tomosynthesis allows a series of images in slices of 1 mm or less (usually 11 images over a 30 degree range) to be acquired and reconstructed for 3D viewing. Hologic says the technology has the potential to reduce or eliminate overlapping tissue, which can obscure a breast lesion. Tomosynthesis may also provide improved diagnostic information, with reduced breast compression. The technology will be offered as an add-on to Hologic's Lorad Selenia full field digital mammography system.

 "We believe that breast tomosynthesis is clearly the wave of the future for digital mammography, and Hologic plans to lead the way in development and commercialization of this tremendously exciting new technology," says Jack Cumming, Hologic chairman and CEO. "Although breast tomosynthesis is still in the early phases of research, we have been very pleased with the rate of progress in our program and the high quality of the initial images we have acquired in our research studies. Over the next several months we plan to extend our research studies to investigate other facets of this technology, the feasibility of reduced breast compression, and utilization of breast tomosynthesis for needle localization and biopsy procedures." Cumming says an FDA filing is expected in 2004.

 Eastman Kodak Co. promoted several works-in-progress products for mammography, including computer-aided detection (CAD) software, a mini-PACS and expanded mammography printing capabilities for its DryView 8900 laser imaging system. All three products are set for launch in 2004.

 The CAD technology is courtesy of Kodak's September 2003 acquisition of MiraMedica Inc. Kodak received an approvable letter from the FDA for the CAD technology and is about to commence clinical studies with the technology.

 Wido Menhardt, general manager for Kodak's CAD business segment, said that mammography is "the jumping off point" for Kodak and eventually the company will expand the CAD product to the other imaging modalities.

 A works-in-progress PACS for mammography to manage and store images from a full-field digital mammography system will include diagnostic workstations optimized for reading mammograms. The technology will be designed for a small mammography center or within a full PACS.

 Speaking of FFDM, Kodak Health Imaging President Dan Kerpelman says a FFDM system is in the company's future, but it may not be until 2005.

 "We are working on digital mammography through the workstations, through archiving, PACS, printing and CAD," he added. "As far as the actual capture solution and whether it will be CR or DR, we have an internal horse race going on about the right thing to do there. Frankly, we are waiting to triangulate with industry readiness, both in clinical terms and economic terms. Reimbursements for mammography are so depressed."

 Kodak also is working on a software upgrade to its DryView 8900 laser imaging system to print high-resolution mammography images onto