Breast Imaging: Building Digital into Mammography

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Breast imaging was big news at RSNA 2004. Much of the buzz focused on digital mammography technology. While the results of the Digital Mammographic Imaging Screening Trial (DMIST), a comparison of digital and film mammography in nearly 50,000 women, won't be available until spring 2005, interest in digital remains high - largely because of the potential for productivity gains.

There are some new digital systems and quite a few more in the works, but technologies to aid and facilitate the transition to digital mammography really stole the show. These include everything from multi-modality, multi-vendor workstations that allow users to read ultrasound, MRI and digital mammography images from a variety of systems and vendors, and feature integrated CAD capabilities to PACS optimized for mammography. Technologies that simplify the comparison of current digital mammograms to prior analogs were also big. And vendors were serving up more cost-effective digital options via CR-based systems and new analog systems that can be upgraded to digital to conquer the big price tag barrier of full-field digital mammography systems for many sites. CD creation systems to share digital mammograms and other patient information with clinicians as well as patients were also spotlighted.
And while mammography remains the workhorse of breast cancer screening and diagnosis, it benefits greatly from several adjuncts. Other options to complement mammography, discriminate benign form malignant findings and possibly detect breast cancer earlier are getting closer to the market. One of these, breast tomosynthesis, which has received a fair share of buzz in the last few years, could be on the market by RSNA 2005. Several other new breast-scanning technologies are also on the verge of FDA approval.   

Finally, a few vendors showcased new systems and features to simplify and improve the stereotactic breast biopsy process.

(Note: companies appear in alphabetical order.)

Agfa Corp. launched its new mammography diagnostic workstation, the IMPAX MA3000.

Designed to enhance the way digital mammography images are retrieved, displayed, archived and distributed, the IMPAX MA3000 mammography diagnostic display station is a multi-modality workstation that delivers 'one-stop' review and results distribution for all digital breast-imaging studies and supports complete access to other general imaging exams from a single workstation. The digital display station was developed based on Agfa's PACS model of information management; it includes PACS workflow features and tools with added specialized screening workflow and diagnostic tools, such as comparative review. Previous studies can be compared side-by-side to current images, allowing user and modality preferences for display, review and comparison of images to be defined for greater user flexibility. The IMPAX MA3000 mammography diagnostic workstation comes with full integration capability with PACS, RIS and HIS and reporting applications. When deployed as part of a PACS network, images can easily be retrieved and reviewed from anywhere on the network with other data.

Bioptics Corp. introduced the PiXaray plug-and-play digital mammography cassette that enables an upgrade from film-based to digital mammography. The cassette is based on a high-performance, flat-panel detector and high-resolution scintillator technologies. PiXaray is packaged as a standard mammography film cassette for a convenient and cost-efficient upgrade to digital mammography. The technology is available for investigational use only.

Cedara Software showcased its I-ReadMammo workstation and I-Acquire/MG mammography scanning console.

According to Cedara, I-Read Mammo eliminates the need to switch between workstations by supporting mammography systems from multiple vendors on a single workstation. The system also saves reading time by automating display and review of images from multiple modalities such as ultrasound and MRI and integrating CAD. I-Read Mammo integrates with Cedara's film digitizing application for viewing old film images with new digital images and it improves productivity by allowing radiologists to prescribe the image layout, presentation and view order.

Cedara's I-Acquire/MG mammography scanning console supports multiple mammography detectors, optimizes workflow by focusing the tech on a single console and facilitates image processing with image manipulation tools and proprietary enhancement technology. The system offers