Pat Montgomery

Mammography providers continue to cope with high patient volumes, low reimbursement, and pressure to increase efficiency and productivity. In this issue, the help that full-field digital mammography can contribute is explored.

Robert J. Pizzutiello, Jr, MS, is president, Upstate Medical Physics, Victor, NY. He describes a team approach to technology assessment for digital mammography in his article "FFDM: Team Technology Assessment." By involving the radiologists, technologists, information specialists, and support staff who will provide digital mammography services, imaging providers are more likely to obtain a realistic assessment. Because digital mammography increases productivity, decreases film-related and space costs, and gains increased Medicare reimbursement, cost analyses are likely to favor its adoption.

In the article by Ralph Schaetzing, the assessment factors relevant to a comparison of cathode-ray tube (CRT) displays with newer, flat-panel liquid-crystal displays (LCDs) are outlined. LCDs are replacing CRTs in much of medical imaging, and this trend appears likely to hold true for digital mammography as the cost of LCD ownership continues to decrease.

The Agfa supplement article on workflow points out that the aging of the population has led to increased demand for mammography (and, in turn, to scheduling backlogs). Digital mammography reduces long waits for mammography due to enhanced patient throughput, improved technologist efficiency, and better radiologist productivity. Nonetheless, many facilities choose to make a gradual transition to fully filmless mammography because they want to incorporate older analog equipment in the new digital workflow pattern. Here, five institutions describe their reasons for gradual implementation of digital mammography and their status today, from mostly analog to completely digital.

A sidebar at the end of the article above by Carol Daus covers the successful training program in digital mammography conducted by Indiana University Hospital, Indianapolis.

Clearly, both patient throughput and interpretation speed are improved by digital mammography, as reported in the article on data flow and network infrastructure. Digital mammograms are associated with large volumes of data, but integrating these studies into an enterprise picture archiving and communications system (PACS) is usually a better option than isolating them in a stand-alone system. Facilities may want outside help in planning infrastructure to accommodate the electronic medical record, in compliance with privacy regulations, or in ensuring adequate network and archive capacity for digital mammography.

As the article on "Building a Better Workstation" explains, new workstations for digital mammography are being tested at Florida Hospital, Orlando. At the system's Celebration Health site, 9,000 digital breast studies are being interpreted each year. The vendor-neutral workstations, approved by the US Food and Drug Administration in 2004, incorporate features that improve workflow and provide diagnostic assistance. Dual advanced displays are used to facilitate comparison of current and prior studies (including CT, MRI, and ultrasound), and the workstations are fully compatible with enterprise PACS.

Agfa is prepared to help imaging providers investigate and implement digital mammography. As a step in that investigation, Agfa is pleased to sponsor this Intelligence Report #23.

Pat Montgomery is Marketing Manager, Women's Care Agfa Healthcare, Americas, Greenville, SC