· Wireless DR Lightens the Load
· Case in Point: The Dollars and Sense of Digital Mammo
· Product Debut: Second Look Mammo Earns Raves

Wireless DR Lightens the Load

No matter the degree of patient mobility, new technology from Siemens Healthcare, Malvern, Pa, offers more convenience, less stress, and a single solution designed to meet all the clinical demands of the growing digital radiography market.

Siemens? Ysio is a new DR system with a wireless detector for maximum positioning flexibility.

The recently FDA-approved Ysio is a new-generation DR system with a wireless detector for maximum positioning flexibility. It can be customized to suit an individual patient’s needs, having the option for one or two detectors, with or without a patient table and with fully automated or synchronized movements.

“Ysio ushers in a new age of DR systems that are easy to use, easy to learn, and easy on the patient,” said Claus Grill, vice president, angiography, cardiac, and x-ray systems. “The solution lightens user workload by simplifying today’s radiographic routine and can be configured to the needs of customers with its wireless detector and intuitive control via an interactive color touch screen.”

According to Siemens, the versatile Ysio serves radiography needs no matter the imaging volume, protocols, or patient profiles, and its performance features are made for short examination times. This, the company says, increases daily patient throughput.

The unit is available in a number of configurations based on preference—as a wall stand with an integrated detector, a wall stand and table system with a wireless detector, or as a mixed detector solution. Users can handle the wi-D like a cassette, moving it from the table and to directly underneath or next to patients for exposures that are difficult or impossible to take using a fixed detector. According to Siemens, patients with restricted mobility can be x-rayed without leaving a wheelchair.

Serving as an integrated command center, the Ysio permits users to control workflow from registration to image data management. The fully automated version includes more than 500 automated system positions and power-assisted movements, and all models sport a unique table design, wi-D, and a color touch screen panel called MaxTouch. This screen displays icons that support easy access to key technical factors during examinations.

After the user presses a button on the wireless remote, the x-ray tube moves into position, and it can be configured to bypass room fixtures. In short, the Ysio is a tailored solution in terms of space planning. Its power-assisted servo movements assist in reducing the strain of heavy workloads; and via remote control, the collimation can be adjusted from anywhere in the room.

With a 660-pound weight capacity and a low table height of 21 inches, its ergonomic table design allows for a full spectrum of patients, from children to the elderly. Since the detector is situated close to the patient, there are virtually no distortions, according to Siemens. Also, images acquired with the wi-D can be previewed in 5 seconds, without having to change or process cassettes. Siemens’ DiamondViewPlus optimizes image quality with contrast enhancement and noise reduction.

The first installation site in the United States will be Central Baptist Hospital in Lexington, Ky.

“Ysio’s flexible combination of the system’s wi-D and touch-screen user interface will greatly simply our workflow, enabling us to improve clinical outcomes without sacrificing patient care,” said Bill Broaddus, the hospital’s director of radiology.

—Elaine Sanchez

The Dollars and Sense of Digital Mammo

PresGar, the nation’s largest privately owned medical imaging service company, made the move to digital last October, when it integrated its first new mammography system with PowerServer PACS technology from RamSoft Inc.

Less than a year later, seven more systems had been added in New York, Virginia, Ohio, and Florida by August, with a ninth implementation scheduled for later this year. In each center, film-screen mammography was removed, resulting in increased efficiency among mammographers and technologists and substantial savings for the company.

“It’s a home run,” said Dave Kost, imaging informatics manager for PresGar. “We couldn’t be happier.”

PresGar, based in Tampa, Fla, operates 36 imaging centers that perform approximately 350,000 exams per year. To enable optimal viewing, the business sought the help of Toronto-based RamSoft, which installed 10 of its PowerServer PACS units and three Gateway Routers.

With its collaboration with RamSoft, PresGar saved hundreds of thousands of dollars by choosing not to purchase dedicated workstations and eliminating film. PresGar says the quality of captured images has been enhanced, which improves reader confidence and minimizes liability. Additionally, the company’s technologists and mammographers have been able to complete more studies, therefore increasing revenues.

In fact, between 40 and 50 studies are completed daily at each site, compared with 18 to 20 per day a year ago. The company’s overall efficiency has increased by 30% to 40%.

“PresGar was really our first big account in terms of establishing our solution as ideal for a distributed outpatient imaging group,” said Vijay Ramanathan, president and CEO of RamSoft. “The relationship has allowed us to prove that our solution is superior to anything else in that kind of environment.”

PresGar’s major goal in going digital was capturing superior images that could be manipulated for optimal viewing. RamSoft’s mammography module automatically sorts left and right digital image series and matches them to prior films for efficient comparison.

“What we’ve done is make digital mammography function similarly to all of the other modalities offered by PresGar,” Ramanathan said. “That has eliminated the need for them to make a separate, costly investment in mammography. No longer does a company such as PresGar need to have one solution for all of the modalities and a separate solution for mammography.”

Providing a fault-tolerant, Web-based approach to PACS, the PowerServer accommodates unlimited users and workstations and is offered in several configurations. Features include study tracking from start to finish, real-time worklist flexibility, prefetching of current and prior studies, flexible viewing protocols specific to modality and body part, a digital dictation module, and a suite of tools designed to optimize images.

—E. Sanchez

Second Look Mammo Earns Raves

In MD Buyline’s most recent User Satisfaction Report, the top-scoring system in mammography CAD was Second Look Mammo from iCAD Inc, Nashua, NH. The company’s computer-aided detection software for mammography earned top marks in system performance, system reliability, installation/implementation, applications training, service response time, and service repair quality. The company also earned record-high customer service ratings in system reliability, system repair quality, and overall service and quality.

iCAD’s system scored high marks for performance, reliability, and more.

“I’ve been using Second Look Mammo for about 5 years now,” said Laurie Margolies, MD, director of breast imaging and assistant professor of radiology at Mount Sinai Medical Center, New York City. “We use it on every single mammogram. We look at the image without it first, and then turn it on in the digital environment and double-check any area that it has flagged as an area of possible concern.”

Margolies describes the system as “a wonderful double-check for anybody,” but emphasizes its usefulness in training and education of less experienced radiologists and radiology residents. “It’s been shown in several studies that younger radiologists will miss more than people who are more experienced or who do mammography full time,” she said. “And when you’re a radiology resident, you have to learn to read mammograms by looking at hundreds and hundreds of them. It’s great to make your own decision and then have iCAD show you where to double-check. It challenges you to make a decision about each and every mark the computer puts on, so you have to use all of your skills to determine whether it’s something that requires further inquiry.”

Though an experienced mammographer like Margolies rarely misses an area of concern, she notes that anyone can benefit from using a CAD system as a second set of eyes. “It keeps me on my toes and provides an extra measure of confidence,” she said. “And it really makes one not be complacent about looking at breast tissue.”

That added confidence makes iCAD worth the small amount of time it adds to the reading of each image. “It does slow down workflow slightly,” Margolies said. “But if it even catches one cancer a year, to me the extra time would be worth it.”

As far as how many cancers per year iCAD does catch, Margolies says it’s hard to estimate because the incidence of cancer varies so greatly among different patient populations. But she has no doubt about what the results of the American College of Radiology Imaging Network’s new study, which hopes to determine the software’s utility with digital mammography, will be.

“I think the software works even better in the digital environment,” she said. “It’s more reproducible, and it’s faster and easier to use. It’s right on the same screen as what you’re looking at—right on the actual viewing monitor, so you’re not going back and forth between a monitor and a film. It’s all on one workstation, and you can turn it on and off at will.”

In the future, Margolies hopes to see the system become more specific for calcifications and both more specific and more sensitive for masses. “It’s obviously not one hundred percent sensitive,” she said. “But it’s a great person sitting next to you.”

—Cat Vasko