In 2006, approximately 213,000 American women will be diagnosed with new-onset breast cancer and nearly 41,000 will die from this disease.1 Appropriate screening and early detection remain the keys to decreasing this mortality rate.
In 2006, approximately 213,000 American women will be diagnosed
with new-onset breast cancer and nearly 41,000 will die from this
Appropriate screening and early detection remain the keys to
decreasing this mortality rate. Recently, several new products have
been introduced that were designed to help clinicians detect and
treat breast cancer at the earliest possible stage, when the
survival rate is the highest.
DynaCAD for breast MR
One area of breast imaging that has received increased attention
lately is magnetic resonance (MR) imaging. To assist radiologists
in the reading of these extremely data-intensive studies, Invivo
Corporation (Pewaukee, WI) recently introduced the DynaCAD (Figure
1), a digital imaging workstation with a computer-aided detection
(CAD) system designed specifically for breast MR imaging.
"With DynaCAD, we are looking at changes in signal intensity
within the tissue over time," explained Bernadette M. Kaufman,
RT(R)(MR), Product Manager, Breast Care, Invivo Corporation. "We
inject patients with an MR contrast and watch the breast tissue
perfuse and repeat the dynamic series over and over during the
course of about 5 minutes and watch that enhancement over
The system has 2 modules, one for diagnosis and one for
interventional planning. "For the diagnostic portion of the study,"
Kaufman continued, "the radiologist is able to look at the data
obtained from the dynamic sequence and map it into a curve to
digitally observe the patterns and tissue behavior. Color overlays
are added to the images to draw the radiologist's eye to areas of
abnormal enhancement or increased signal."
"The other portion is for interventional planning," she
continued. "We can take a patient who has a known cancer, map out
exactly where the lesion lies in reference to other anatomic
structures or the chest wall, and insert either a wire or an
interventional biopsy device, such as a semiautomatic gun, an
automatic gun, or a vacuum-assisted device. The software allows
this mapping to be done reproducibly and in a short period of
The system provides automatic calculation of subtracted images,
multiplanar reformatted images (MPR), and dynamic maximum intensity
projections (MIP); 2-dimensional and 3-dimensional image
registration for the correction of motion artifacts; and kinetic
analysis tools (angiogenesis maps, time-intensity curves) for
evaluation. The system also performs an automated search for
regions of interest based on criteria set by the user.
"Another thing that it can do is automatic subtraction," said
Kaufman. "The breast is a fatty kind of tissue, and when we inject
MR contrast into it and do a T1-weighted sequence, the lesion
appears bright and the fat also appears bright. If we can subtract
the precontrast from the postcontrast, what we end up with is the
lesion isolated by itself that draws the radiologist's eye to any
area of suspicion."
The latest version of the software includes a Breast Imaging and
Reporting Data System (BI-RADS) function and a histogram tool. "The
histogram tool allows the user to take an area of interest and draw
a volume around it," explained Kaufman, "and the system calculates
the amount of enhancement within that volume. When monitoring
neoadjuvant chemotherapy, this is important because you want to
understand if the tumor is responding to therapy."
"Bruce Porter, MD, of First Hill Diagnostic Imaging, Seattle,
WA, is a well-known lecturer on the subject of breast cancer, and
he talks about breast imaging less like imaging a body part and
more like imaging a disease," concluded Kaufman. "And that is what
this is all about. It's about not just getting the breast in there
and taking a picture; it's about staging the exam; it's about being
a company that provides a solution for monitoring the patient over
the entire course of her disease."
New vacuum-assisted breast biopsy system for MR
Suros Surgical Systems, Inc. (Indianapolis, IN) recently
introduced a new vacuum-assisted breast biopsy system designed
exclusively for use with MR guidance, the ATEC (Automated Tissue
Excision and Collection) Breast Biopsy and Excision System Emerald
"This was designed exclusively for MR imaging," said Tony
Wibbler, Director of Marketing at Suros. "It's based on the core
technologies that we use for the Sapphire and Pearl ATEC Units, but
it eliminates some of the technology to allow it to be more
According to the company, this new system allows clinicians to
perform MR-guided breast biopsies in 30 minutes or less, thereby
freeing up valuable magnet time. It can be used with both the grid
and pillar-and-post methods for lesion targeting, making it
compatible with all leading magnet and coil manufacturers.
"We found that many of our customers needed a second unit more
than anything," explained Wibbler. "They needed one unit to do
everything, so our key product, the Sapphire Unit, can be used with
all 3 breast-biopsy modalities: ultrasound, stereotactic, and MR.
But in some cases, that system is cost prohibitive. So, most of our
customers now buy 2 units, the Pearl and the Emerald."
Wibbler explained that some facilities need a second unit
because of the geographic distance between the MR magnet and the
other imaging modalities, while clinics that perform only MR don't
want to pay for added technology that they cannot use. "The Emerald
provides a great opportunity for those who don't actually perform
ultrasound or stereotactic biopsies, such as freestanding MR
clinics," concluded Wibbler. "This way they are paying for just
exactly what they need."
New film digitizer from Array
Despite the growing interest in a range of breast imaging
modalities, mammography-both analog and digital-remains the gold
standard for breast cancer screening. As more imaging centers begin
to migrate to digital technology for mammography, however, the
question of how to efficiently incorporate prior analog images into
the digital workflow becomes more important. Many imaging groups
are electing to digitize prior images and enter them into the
picture archiving and communication system (PACS) to avoid having
the radiologist move back and forth between a digital display and a
lightbox when comparing a digital mammogram with a prior analog
study. Typically, film digitizers consist of a scanner and a
personal computer (PC) used to control it. Array Corporation USA
(Hampton, NH) recently introduced a self-contained, tabletop,
touch-screen film digitizer designed to be used without a PC
controller, the 2908 MammoPro (Figure 2).
"We believe it to be the first fully self-contained digitizer in
the world," said Thomas J. Nardozzi, President of Array Corporation
USA. "Most digitizers require a PC to control them that stands
outside the actual device. With the 2908, the host PC is buried
The new compact unit features the same scanner that resides in
the ImageChecker DMax CAD system for digital mammography from R2
Technology, Inc. (Sunnyvale, CA) (recently purchased by Hologic,
Inc. [Bedford, MA]). It has a 50-micron resolution and an optical
density range of up to 4.4OD. The system can scan both 18 × 24 and
24 × 30-inch films at a rate of 30 seconds per film for the smaller
size. The DICOM-compatible system can also be used to burn CDs for
image storage and portability. The 2908 MammoPro can be operated
using the included touch screen; however, a mouse and keyboard are
available as options. The entire unit measures approximately 26
inches wide by 33 inches high by 16 inches deep.
"The 2908 MammoPro is devoted specifically to mammography," said
Nardozzi. "There are other digitizers that are doing mammography,
but dedication toward the proposition of high image quality as well
as productivity is at the heart of what the 2908 is. It's good to
know that the product has already been seen and accepted in the
marketplace via the R2 products," he concluded, "and now the
clients have an opportunity to access something very focused and
dedicated specifically to the purpose of relevant priors."
The company expects to begin product shipment this month.
Fuji to distribute iCAD digital mammography
FUJIFILM Medical Systems USA, Inc. (Stamford, CT) and iCAD, Inc.
(Nashua, NH) have signed an agreement under which Fuji will offer
iCAD's SecondLook Digital and TotalLook products optimized for the
Fuji Computed Radiography for Mammography (FCR
) product line.
"The agreement with iCAD allows Fuji to offer a comprehensive
solution to our customers," said Andy Vandergrift, National
Marketing Manager, Women's Healthcare at Fuji. "We plan to offer
the standard-of-care iCAD products with our multiple digital
"We believe there are significant cancer detection and workflow
benefits to combining digital mammography with computer-aided
detection," added Ken Ferry, President and CEO of iCAD, "and our
newest version of SecondLook Digital for Fuji is specifically
optimized for FCR
. iCAD's computer-aided detection has been shown to find cancers at
an earlier, more treatable stage, helping to improve patient care
and reduce costs."