The Promises and Implications of Digital Breast Tomosynthesis


Digital Breast TomosynthesisDigital Breast Tomosynthesis will make it easier to see breast cancers in dense tissue and is becoming widely adopted. Compared to standard 2D mammograms, DBT offers a number of important advantages. The Oslo Study is the first large-scale study comparing the combination of DBT and 2D imaging with 2D imaging alone.

The study reported a 27 percent increase in cancer detection, a 40 percent increase in the detection of invasive cancers, and a 15 percent decrease in false positive recalls. The reduction in false positives not may help reduce duplicate studies, and may also have a major impact on reducing patient anxiety.

According to the American Society of Breast Disease, DBT may allow reductions in tissue overlap, potentially leading to increases in the sensitivity and specificity of breast cancer detection. It may also improve the characterizations of different lesion types. Early clinical studies suggest that DBT helps reduce screening recall rates and improve screening sensitivity and diagnostic accuracy.”

However, healthcare providers are carefully considering their IT environment in order to fully understand the impact of DBT prior to implementation.

DBT does have its own set of challenges.

  1. The size of the images. According to McKesson customer data, a conventional 2D breast image is about 16 megabytes. A DBT image is about 380 megabytes, or roughly 15 times the size. The larger image size of DBT requires a huge increase in storage capacity, especially since it is common practice to store three copies of mammography images (working, backup and off-site archive).
  2. Demands for network bandwidth to accommodate the new technology also increases.
  3. The larger images also take longer to read, sometimes twice as long, and radiologists’ workstations may have to be upgraded to handle the DBT images. Radiologists need to smoothly scroll through images at a rapid rate without skipping. Radiologists also need to annotate each frame separately and provide a guide, within the image file, to frame containing abnormalities.
  4. Finally, the process for reimbursement is still being worked out. DBT is more expensive than 2D imaging, so insurers and the Centers for Medicare and Medicaid Services (CMS) are still settling on how to compensate for that. This year, CMS established separate billing codes for DBT, making it easier for providers to be reimbursed for DBT studies done in conjunction with 2D mammograms.

The McKesson Radiology Mammography Plus™ solution helps users efficiently load, navigate and manipulate large DBT datasets. Additionally, other solutions such as Conserus™ Image Repository Retention Management application help define image retention policy rules than can help sites save money on storage and make room for new larger data sets. For more information about our mammography solution, please visit our web site .

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