Mammography firms push digital edge at RSNA

Anyone who doubted the future of digital mammography must be thinkingtwice after this year's Radiological Society of North Americameeting. Digital systems were featured prominently on the exhibitfloor. Fischer Imaging and Lorad displayed works-in-progress systemsfor full-breast digital mammography, while other vendors playedcatch-up by showing digital spot mammography devices.

Fischer and Lorad have been competing neck-and-neck in therace to commercialize a full-view digital system. Both companiesare marketing spot mammography products with a 50 x 50-mm field-of-viewfor guiding stereotactic breast biopsy procedures.

Fischer and Lorad announced before the RSNA meeting their plansfor full-breast digital (SCAN 10/20/93 and 9/8/93). Lorad wasaided in its cause with an infusion of digital technology fromparent ThermoTrex, while Fischer inked a deal with the Departmentof Energy's Lawrence Livermore National Laboratory in Livermore,CA, for its help in designing a system.

Fischer played another card at the RSNA meeting. The Denver,CO-based vendor announced that it has signed an agreement witha Texas high-technology company to develop flat-panel displaysfor a full-breast digital system. The displays could overcomethe last technological barrier standing in the way of a digitalmammography screening unit, according to Morgan W. Nields, Fischerchairman and CEO.

The company, SI Diamond of Houston, has developed amorphousdiamond film technology that will be used to create display monitorswith the resolution and brightness required for screening mammography.Fischer hopes to build monitors with technical specificationscomparable to the 5000 x 5000-pixel display matrixes and 500-foot-lambertbrightness levels inherent in screen-film mammography.

"Our current monitor product is shown with a 2500 x 2000-linedisplay," Nields said at a news conference at the RSNA meeting."The brightness is significantly less than we would likeit, but that's the best there is today. This technology that we'veannounced with SI Diamond will provide a very interesting solutionto the problem."

Fischer displayed a mock-up of a full-breast digital unit inits booth. The company hopes to have units in clinical trialsin the second half of 1994, with production units available in1995.

Competitor Lorad also featured a full-breast mammography mock-upin its booth. In addition, the Danbury, CT, company announceda joint product development agreement with Philips that couldhave implications for digital mammography.

At present, the agreement covers only a conventional screen-filmmammography unit, the MD 3000, and a mobile x-ray system, PMS2000. The systems will be manufactured by Lorad using Lorad andPhilips technology and will be marketed by Philips.

Lorad and Philips will continue to collaborate in mammographyproduct development, according to John Brenna, director of marketingfor Philips. One area of possible cooperation would be in developinga mammography version of Philips' selenium-based computed radiographysystem, Brenna said.

Philips unveiled the system, called ThoraVision, at the EuropeanCongress of Radiology meeting in September (SCAN 9/16/93). Thesystem is the first non-phosphor CR system offered by a majormultimodality vendor. Philips claims the system has a higher signal-to-noiseratio and delivers less radiation dosage than film.

The selenium detector technology could eventually be incorporatedinto the MD 3000, Brenna said.

"The relationship that we plan allows both companies tobring their best digital acquisition methods together, ours beingthe selenium and CCD (charge-coupled device) technology,"Brenna said. "This will give both organizations a leadershipposition in fighting breast cancer."

Both Fischer and Lorad claim that their digital spot unitshave been major clinical and marketing successes. These claimswere borne out by the number of other vendors that displayed works-in-progressdigital spot devices. Bennett X-Ray, GE and Elscint all showedsmall-field-of-view units at the RSNA conference.

Bennett's unit will be attached to the Copiague, NY, firm'sContour mammography system. The device uses a CCD camera and fiberoptics to digitize mammography signals, according to Bennett CEOCalvin Kleinman. The system has a 55 x 50-mm field-of-view and1242 x 1152-pixel image acquisition.

Bennett is developing the system in collaboration with LockheedAerospace and Johns Hopkins University. The company hopes to haveFood and Drug Administration 510(k) marketing clearance by early1994. Bennett is also working on a full-breast digital system,Kleinman said.

Elscint's spot mammography device is designed to be used withthe Israeli vendor's MAM-CH22S system, shown as a works-in-progress.MAM-CH22S features a bucky grid mounted on ball bearings, whichenables the grid to be easily removed for installation of a stereotacticbiopsy device or digital spot unit.

The biopsy device, called MammoGuide, was also shown as a works-in-progress.The digital unit is farther back in the product development pipeline,according to the company. The unit uses a CCD camera and optics,with a 60 x 50-mm field-of-view. The product should be on themarket some time next year.

Finally, mammography leader GE used display panels in its boothto showcase its work in digital mammography. GE's digital spotmammography offering would be attached to Senographe DMR. Thedevice, dubbed Stereotix, uses a phosphor screen detector anda CCD camera with a fiber-optics reducer. The unit features a60 x 60-mm field-of-view and a 1024 x 1024 image acquisition matrix.

Stereotix is being developed at Centre Republique in Clermont-Ferrand,France, and at the University of Massachusetts Hospital in Worcester.GE expects to have the product on the market by September or October1994.

The number of new products on display is ample evidence thatdigital spot mammography has arrived. Full-breast digital willbe a tougher nut to crack, however. The technological barriersto developing an affordable full-view system are high, but thepayoff could be even higher.

Going digital would allow mammography to be integrated intoteleradiology and picture archiving and communications systems.Digital mammography would also make possible the use of computer-aideddiagnosis systems to provide second-reader back-up for mammographers(SCAN 10/20/93).

"If you look around the show, you'll see all of radiologyis becoming digital," said Lorad president Hal Kirshner."If you talk to some of the leading doctors, they will tellyou that the last hurdle is mammography. We feel we've crossedthat last hurdle."