TierneyHow do you feel when someone reads over your shoulder? How would you feel if you had the “eyes of a thousand radiologists looking over your shoulder?”

That’s how one person described computer assisted diagnosis — also known as CAD. It is technology designed to assist radiologists and minimize false negative readings during mammogram screenings. You can read more about it in “CAD: Radiology’s Spell-checker Looks to the Mainstream” on page WH-44. Now in clinical use for about two years, CAD has been compared to the spell checker in word-processing software, but it’s a lot smarter and its able to learn.

In a study of 12,860 women, radiologists found 20.5 percent more cancers in screening mammography studies with CAD than they were able to find without it. More important, the study showed that CAD assists in finding cancer earlier — detecting early stage malignancies at 78 percent, instead of 73 percent without CAD. That’s important — the five-year survival rate for breast cancer patients is 97 percent when the disease is detected in its early stages. It’s a team effort, of the 49 cancers detected, 32 were detected both by the radiologist and CAD, 9 were only caught by the radiologist and 8 owe their initial detection to CAD.

Of course large hospitals were early adopters of CAD, yet hospitals of 50 to 100 beds are now realizing the benefits. One small hospital in the Northeast saw a 70 percent increase in mammography patients since it installed CAD. It’s competitor? It’s mammo procedure volume declined 40 percent over the same period.

CAD is a differentiator. The truth is, women talk. When one woman hears about technology that could potentially help detect breast cancer earlier, she tells a friend, and so on, and so on. Men should spread the word about CAD. For every 100 women diagnosed with breast cancer, one man is diagnosed with breast cancer, too.

The dollars are cooperating. CAD gained Medicare reimbursement on April 1st — an additional $15 on top of the reimbursement for a conventional mammogram. Typically, the facility gets $10 more and the physician an extra $5. The CAD industry is coaxing insurers to follow Medicare’s lead, and a few on the West Coast already have. The annual cost of breast cancer to the U.S. healthcare system is about $4 billion. Approximately 120 million mammograms read each year, with an annual growth rate of 9 percent. If CAD can ease the financial and physician burden, the extra fees are money well invested.

CAD isn’t just for mammography. On the horizon are CAD applications for lung and chest work, CT, MRI, ultrasound, CR and DR. (See “CAD on the Cusp: Lung Cancer Screening” on page WH-48.) We’ll have to wait a few years for the clinical evaluations, but its in these other modalities that CAD’s real workflow enhancements will shine.

So, how do you feel about the eyes of a thousand radiologists looking over your shoulder? I, for one, feel just great about it.

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Mary C. Tierney, Editor
[email protected]