Apr06 eBroadcast - The Story of The Women's Center for Radiology

Digital mammography and improved image quality

The first automatic film processor in Latin America was installed at URP, as was Brazil's first whole-body CT system installed at a local hospital where URP was responsible for running it. With the advent of the revolutionary Lorad HTC-grid technology from Hologic, URP began using both Affinity and M-IV screen- film mammography equipment. Most recently, URP is one of the first sites in the region to offer Hologic's Selenia full-field digital mammography. Having seen the Hologic direct capture detector technology before the first machines were actually built, Dr. Belfer, along with mammography specialists from the breast imaging department, watched its development closely.

"When we saw the physics behind it and the idea of direct imaging we thought that this would be much better than any other detector," he explained. Rather than investing immediately in the technology, he waited until he felt it had matured enough to surpass others on the market.

"There is a huge difference between what I refer to as first generation digital and second generation digital," Dr. Belfer added. "Other digital breast images are not as impressive as what you get with the Hologic system."

“We want to differentiate the kind of images we do from the kind that others are doing. So, instead of trying to explain direct versus indirect imaging to gynecologists, it's much easier to understand first versus second generation," says Belfer. "Other digital breast images are not as impressive as what you get with the Hologic system."

After the first Selenia was installed, the URP team temporarily kept one of the screen-film machines as backup, but, as Dr. Belfer pointed out, the technological savvy of patients in the area created an immediate demand for the full-field digital equipment. "It took about six days," he said. "Everyone, including the technologists and the patients wanted to use the Selenia. They wanted to be sure they were getting the latest technology." The site soon found that just one Selenia digital mammography system wasn't enough for the patient load. They now have two systems installed and an order for a third system is underway.

Dr. Belfer and his colleagues at URP use the term 'second generation digital' to communicate the growth potential advantages of the Selenia system to referring physicians. "We want to differentiate the kind of images we do from the kind that others are doing. So, instead of trying to explain direct versus indirect imaging to gynecologists, it's much easier to understand first versus second generation."

The difference in image quality and increased speed of a screening exam is readily apparent to URP's patients, as well. Unlike in the in the U.S. medical system, the Brazilian medical system requires patients to keep their radiology films. Many patients compare films from exam to exam, and the approach is proving to be helpful in explaining the difference in image quality.

According to Dr. Belfer, "Not only are we getting comments about the difference between conventional film and digital, but also between first and second generation digital. So patients are looking at other digital mammograms. They say the other one was blurred - that's a word used very often." Patients have also mentioned that the Selenia mammogram seems more comfortable in terms of compression. "I need to tell them, there's no less compression, I swear, it's the exact same compression, the right amount of compression, but the shorter compression time may give the impression that they feel less discomfort," he noted. The Selenia FAST paddle may also be a contributing factor. The FAST paddle tilts to the natural contour of the breast, applying the compression uniformly. This not only brings the patient more comfort, but also improves the quality of the image.