Justin Smith, Product Marketing Manager, Intelerad

Driven by customer demand and designed in consultation with leading radiologists who specialize in mammography, the IntelePACS Breast Imaging module from medical imaging solutions provider Intelerad Medical Systems will soon offer support for tomosynthesis.

The Intelerad Tomosynthesis Support module is said to provide new modality capabilities seamlessly without requiring additional capital investment for new workstations.

“Intelerad believes strongly in eliminating dedicated workstations, which have less relevance in radiology practices that are increasingly agile and distributed,” said Helene Gey, Intelerad vice president of marketing. “The Intelerad Tomosynthesis Support module integrates the modality right into existing mammography workflows, reducing the capital expenditure for new workstations.”

According to Gey, Intelerad has made it a point to respond to radiologists’ concerns about being forced to leave their reading rooms for modality workstations. “By integrating into existing workflows, radiologists aren’t interrupted, maintaining their levels of efficiency while adapting to this new modality.”

The Intelerad Breast Imaging module’s universal worklist enables access to multimodality images regardless of the radiologists’ location, and it offers the option to integrate with a Breast Imaging Reporting and Data System (BIRADS).

As explained by Justin Smith, Intelerad product marketing manager, tomosynthesis and its 3D reconstruction provide higher quality reads, compared to traditional mammography. “Radiologists can better identify masses and distortions, mitigating the confounding effects of superimposed tissue,” said Smith, adding that as a result, the technique drives earlier detection and reduces patient recall. “Tomosynthesis also facilitates more precise lesion localization in breast volume and better contrast between dense and less dense components.”

Citing a study presented at the American Roentgen Ray Society (ARRS) meeting this year, Smith said that through tomosynthesis, radiologists were able to more accurately distinguish between cancerous and benign lesions, improving early detection by 5% to 12% while reducing recall rates by 40% when compared to traditional mammography, at Yale-New Haven Hospital in New Haven, Conn. “Recalls are a big source of anxiety for many patients, so tomosynthesis not only improves the effectiveness of radiologists, but also improves the patient experience and provides more meaningful health care service delivery,” Smith said.

According to Smith, the most attractive feature of the Intelerad module for tomosynthesis is its ease of integration into radiologists’ current workflow structures. “Radiology practices can easily and flexibly expand their service offerings by using Intelerad, as we can very easily integrate new or premium modalities into the existing diagnostic environment,” he said.

Still, the modality does face an uncertain future, in terms of the level of adoption that will take place. As Smith admits, “It appears that the jury is still out on tomosynthesis as ‘the next big tool’ for mammography. The key reason for the uncertainty is the unclear use case. There is no consensus or common understanding on when to use tomosynthesis versus traditional mammography, in either a screening or diagnostic scenario. For now, tomosynthesis is typically being managed as a ‘premium’ study, due to the increased time and storage requirements for these higher fidelity studies.”

Although the radiology community has yet to determine how and when it will leverage the new technique, Intelerad plans to make sure it is poised to provide a seamless and flexible solution.

“All editors and industry analysts I have talked to agreed that radiologists have great pressure on their shoulders to deliver quality care in highly productive conditions and that it will not make sense not to include new modality images such as tomosynthesis in the radiologist worklist,” Gey said. “Many customers are using Unified worklists such as the IntelePACS or InteleOne radiology worklist and wish to keep using a single platform for their reading and reporting needs.”

The Intelerad Tomosynthesis Support module, which started its research and development phase last fall, will likely continue to undergo further development until its release in the third quarter of 2013.