by
Christina Hwang, Contributing Reporter | July 04, 2016
From the July 2016 issue of HealthCare Business News magazine
“As part of the FDA approval, 31 readers read through all types of breast tissues and demonstrated increased detection rate,” she says. “These readers, all trained on tomosynthesis and the interpretation of these images, evaluated 330 screening FFDM and tomosynthesis cases consisting of 105 malignant cases and 225 non-malignant cases. “From the study conducted, the recall rate decreased by an average of 19 percent without the need for a 2-D image.” Philips Healthcare received FDA clearance for its MicroDose spectral-imaging mammography system in 2013, which is a fullfield digital mammography system. The MicroDose SI uses a slim detector that “scans” the breast and counts the X-ray photons one-by-one with no scattered radiation, resulting in a low radiation dose while keeping the same image quality.
As for a tomosynthesis modality, Kalavathi G V, business leader of mammography at Philips Healthcare, says that the company is in the process of developing one. “Philips is developing spectral tomosynthesis using the photon-counting technology as in the current MicroDose SI product,” she says. “The technology is currently in clinical testing.”
Will 2-D-only go extinct?
Approximately 20 to 30 percent of health care facilities in the U.S. use tomosynthesis, and ACR’s Monticciolo does not believe that standard 2-D acquisition will disappear in the near future since she thinks that 2-D imaging is excellent and cost-effective — but not everyone agrees with this sentiment. “We are aware of clinician enthusiasm for [tomosynthesis], so this certainly can drive the adoption of the technology,” says Diane Robertson, director of health technology assessment information services at ECRI Institute. “If you have radiologists and breast cancer physicians who are enthused and excited about tomosynthesis, they will request it from their health system.”
Rehn predicts that given the development of second-generation tomosynthesis systems such as low-dose techniques, better interpretation tools and protocols, 3-D screening will become the new standard. According to Philpotts, the future will be tomosynthesis combined with the synthesized 2-D images so that radiologists can reduce radiation dose, but still benefit from getting all the information in the 3-D portion. “Tomosynthesis is such a positive trend in so many ways: reducing recalls; increasing cancer detection; fewer patients needing follow ups; and better positive predictive value for biopsy. It’s a much better technology. It’s more accurate for a better interpretation,” says Philpotts.
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