October 12, 2007
Digital Mammography
New technology arrives for the early detection of breast cancer
DAVENPORT, IOWA - Long before a lump may be felt, a mammogram can be the first line of defense against breast cancer.
This month, Genesis Health System and Radiology Group Imaging Center, LLC will introduce digital mammography to the Quad Cities region and bring the most advanced technology in the early detection of a disease that strikes 1 in 8 women.
In a $3.5 million investment, Genesis and Radiology Group are installing a total of seven mammography units at five different sites and will have them fully operational by Oct. 25. Currently, the technology is available in less than than 35 percent of health care facilities across the nation.
“With digital mammography, we can provide our patients the highest quality of care in the prevention and early detection of breast cancer,” says Rob Nelson, M.D., Vice President of Clinical Services, Genesis Medical Center, Davenport. “Found at its earliest, most treatable stages, the five-year survival rate is better than 90 percent. That’s why early detection is so important. We expect this technology to make a life-saving difference.”
Genesis will have five machines at its Center for Breast Health locations: two machines at the East Rusholme Street campus; and one each at the Genesis Imaging Center in Bettendorf and at Genesis hospital campuses in DeWitt and Silvis.
Radiology Group Imaging Center, LLC will install two digital mammography units at its Davenport imaging facility.
Doctors will interpret mammograms from computers – not film. There will be no film to develop, store and transport. Electronic images will remove multiple manual processing steps. Images will be stored on a computer and readily available to the diagnostic and screening facilities.
Gone will be the need to transport radiographic films back and forth between facilities.
Better image quality
However, it’s the image quality produced by digital machines and the ability to manipulate images for better viewing that gives digital mammography the proven advantage – particularly in women who are younger than 50, who have dense breasts, or who are pre-menopausal.
Much like a digital photo, the benefit of digital mammography is that radiologists can adjust the image to make it as clear as possible. Film mammography can’t be altered once the image is obtained.
“With digital mammography, the radiologist can view and manipulate the images on high-resolution computer monitors that enhance visualization of the breast tissue,” says Robert Hartung, M.D., of Radiology Group. “We can magnify the images; increase or decrease the contrast; and invert the black and white values while reading the images. We can zoom in on specific areas to help detect small calcifications, masses and other changes that may be signs of early cancer.”
Because of the limitations of film, dense breasts have long been a diagnostic challenge for radiologists. Dense breast tissue makes it more difficult to detect calcifications and subtle pattern changes that can indicate disease. Digital mammography has been shown to improve detection in these patients, who have a measurable increased risk in developing breast cancer.
“Right now with film, for example, if we want to look at some calcifications in more detail the patient has to come back, and we have to do a mechanical procedure to magnify a portion of the breast,” Dr. Hartung says. “With digital, we will be able to magnify some of these electronically.”
Transferring images
Locally, health professionals will move images between the Radiology Group Imaging Center on 53rd Street and the Genesis hospital on East Rusholme Street on a new secure and private fiberoptic link, installed this summer along Eastern Avenue for that very purpose.
This will allow for speedy and efficient transfer of large, digital images and bring more ready access to patient images at both facilities.
“Now when we obtain a mammogram, the recording medium – the film – is also the storage medium and the reviewing medium,” Dr. Hartung says. “You have to have the file to be able to review the images. And if you need to have a second opinion or want to take the films someplace else, you have to physically carry them.
“With the digital mammography, the acquisition is digital, so you can view the images on any computer screen. For diagnosis, however, you have to use a FDA-approved, high-resolution computer screen.”
The fiberoptic link was created because digital mammography images are so huge. Each is 40 megabytes, Dr. Hartung explains.
“We will be moving a minimum of eight images for each patient, probably 12-16 images when you include the prior images that we have to have for comparison. So, we needed to have some high-speed, secure way of moving all of this data. Genesis and Radiology Group decided to co-invest in a private fiberoptic link that connects the two facilities.”
The testing procedure
Women who have had a film mammogram will find the digital test itself pretty much the same. They will still go through the brief discomfort of having their breast compressed.
“Women hate compression, but the more we can compress the breast, two very important things happen,” Dr. Hartung says. “We decrease the radiation dose to the breast because the dose is directly related to how thick the breast is. The second thing is we stop motion. It takes very little motion, sometimes just the beating heart, to move the breast enough to blur out visualization of a small calcification that could be important.”
The hope, however, is that digital mammography will cut the exam time and reduce the number of repeat images or “call backs.” With film, mammogram technologists have to leave the patient’s room to run films through a processor – a minimum of 90 seconds per film – and then review them. If there is anything that needs to be repeated, they have to go back into the room, and re-position, reexpose and re-develop.
With the digital technique, the technologist never has to leave the patient and can determine image quality in “real time.” High-resolution monitors are in the same room, and it takes only 20-30 seconds to process each image.
“The process is essentially the same,” Dr. Nelson says. “But the likelihood of having to repeat an exam is less because the accuracy of the digital image is greater for certain women. The capabilities of digital mammography result in fewer repeat views, which means less exposure to the patient. We anticipate that fewer women will experience the anxiety of having to come back for additional tests.”
Learn More
Hear more details about digital mammography from Dr. Robert Hartung, M.D., of Radiology Group Imaging Center. Go to the Genesis Web site at www.genesishealth.com, and click on “Genesis Today” in the rotating ad box.
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