By Einar Vigeland, MD, consultant radiologist

Selenia Digital Image	Screen Film Image
Dr. Vigeland says the site gets better images than analog with the Selenia direct capture system while keeping radiation dosage within Norway's recommended conservative values for analog systems

It was a bold decision for us at Vestfold Hospital, located just south of Oslo, Norway, to establish an alldigital breast care unit. Digital breast imaging was in its infancy, and few breast centers in Scandinavia-indeed few in Europe-were completely digital. Now Vestfold is part of the Norwegian Breast Cancer Screening Program, for which center radiologists examine up to 10 women per hour on a single dedicated digital mammography system.

With nearly 10,000 screening mammograms completed last year, our site is one of the highest volume sites in the world, and we're hoping for comparably high numbers this year. Most importantly, the acquired images are at least as good as those captured with sceen-film mammography.

The center had originally planned to purchase only one digital mammography system and a computed radiography system. However, a detailed financial analysis found the site could profit from two digital mammography systems and, in addition, buy a prone breast biopsy system. One digital mammography unit would be dedicated to breast screening; the second would be reserved for diagnostic cases. This combination with a prone biopsy table would ensure that optimal patient care could be delivered.

Although Hologic had just introduced Selenia, we selected their technology for a number of reasons. First, image quality was very important to the radiologists, and the Hologic selenium direct-to-digital detector produced the highest resolution images along with the largest available detector on the market. We found that the images obtained over the past 18 months have been so good that more earlystage lesions are being detected, while radiation dosages have remained within the country's recommended conservative values for analog systems.

Also important was mammography's integration with our new PACS. At Vestfold, mammograms are both archived and presented on soft copy workstations using the PACS and made available electronically throughout the radiology department. Hologic service personnel worked with Vestfold engineers to connect the Selenia system to the department's existing PACS.

Image archiving and presentation

Image archival and presentation are much easier with the digital systems, and the few employees normally required to hang images on light boxes can now concentrate their efforts elsewhere within the department.

In a short period of time Vestfold has come a long way, and we are getting more and more satisfied as time goes by. We have a strong belief that we've chosen the right system and that this is the solution for our future.

Einar Vigeland, MD has been working in breast diagnostics since 1996 both in Norway and in the UK. He's a specialist in radiology now working as the leading consultant radiologist in the breast care unit at Vestfold Hospital, Tonsberg, Norway.

Published in Hospital Post,Vol. 4-5, Sept./Oct. 2005