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Mammography Image Integration Profile

Mammography Image Integration Profile. Carolyn Reynolds Connectivity Manager/Hologic, Inc. Mammography Image. What’s so different about Mammography Use cases & clinical examples Profile requirement highlights Industry Demonstration Questions. What’s the big deal?

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Mammography Image Integration Profile

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  1. Mammography Image Integration Profile Carolyn Reynolds Connectivity Manager/Hologic, Inc.

  2. Mammography Image • What’s so different about Mammography • Use cases & clinical examples • Profile requirement highlights • Industry Demonstration • Questions

  3. What’s the big deal? Full Field Digital Mammography (FFDM) is just another modality to PACS Most existing PACS will handle FFDM fine once: the FDA approves the monitor hardware, and workstations have 510K approval for FFDM applications Mammography ImageThe Problem/Assumptions

  4. Mammography ImageNot just another modality! • What makes it different or challenging: • Two types of image data • Variances among vendors in image data and attributes • Common use of CAD (Computer Aided Detection) • Importance of prior study comparisons • Image size, orientation, & layout • Regional governance such as MQSA (Mammography Quality Standards Act – USA)

  5. Mammography ImageUse Case Modality Workstation Archive CAD “For Presentation” Image Data Printer “For Processing” Image Data Mammo CAD Structured Rpt

  6. Hanging Protocol DifferencesExample Preferred Layout R CC L CC R MLO L MLO • Hanging protocol determined by: • View Type (i.e. CC vs. MLO) • Specialty View Type (i.e. Spot, Mag) • Laterality • Patient Orientation

  7. Generic Image Display LayoutsApplied to Mammo Images R CC L CC L MLO R MLO • Hanging based upon series or study descriptions • Image order as acquired • Image orientation as acquired • Stacked series example

  8. Variances in FFDM Vendor DataDetector Size Example R L L R R L Typical “Fit to Viewport” effect L R Prior Exam from Vendor A’s system • Current Exam from • Vendor B’s system • Different resolution • Different pixel matrix

  9. Workstation Tool EnhancementsTissue vs. Air Detection Example Window/Center Adjustments

  10. Printing ConsiderationsTrue Size 10in x12in Film size 8inx10in Film size Precision of <2% error Film size vs. Detector Size

  11. Printing ConsiderationsPositioning-minimal borders at chestwall Centered images can create large borders at chestwall Image offset with chestwall side having minimal borders

  12. Mammography Image IntegrationValue proposition • Helps meet desire to have multiple FFDM vendors and use any vendor’s workstation for diagnosis • Ensures that FFDM modalities provide adequate information to facilitate downstream applications

  13. Mammography Image IntegrationValue proposition • Ensures systems support required data objects for interoperability • Defines image display and printing operations required for effective and efficient diagnoses

  14. Mammography Image IntegrationScope • Based upon existing actors and transactions • Expanded requirements within each transaction

  15. Mammography Image IntegrationScope

  16. Mammography ImageExpanded Requirements • Acquisition Modality • Send both for processing and for presentation images with reference that ties them together • Additionally required DICOM attributes • Detection and indication of tissue vs. air gap • Partial View Option (breast is larger than detector) • Modified requirements for film digitizers

  17. Mammography ImageExpanded Requirements • Image Display • Hanging protocols based upon view, laterality, patient orientation, and specialty views • Maintain a black air gap during window/center operations and inverted pixel data • Sizing • Same relative size • True size • 1:1 detector pixels to display pixels

  18. Mammography ImageExpanded Requirements • Image Display cont’d • Measurement calculation requirements • Display calibration and grayscale rendering • Labeling requirements • Mammo CAD Structured Report rendering on “for presentation” images • Partial View Option (breast larger than detector)

  19. Mammography ImageExpanded Requirements • Image Manager • Storage and retrieval of For Presentation and For Processing SOP Classes for Digital Mammography X-Ray • Storage and retrieval of Mammography CAD Structured Report SOP Class

  20. Mammography ImageExpanded Requirements • Evidence Creator (CAD) • Support for Mammography CAD SR SOP Class and Storage Commitment • No specifics on how Evidence Creator obtains mammography images

  21. Mammography ImageExpanded Requirements • Print Composers/Print Servers • True Size printing (Requested Image Size) • Justify chestwall and print with 5mm borders or less • Render VOI LUTS if present • Specify/Support maximum density • Specify/Support Presentation LUT • Labeling requirements • Support for 12 bit pixel depth

  22. Mammography ImageIndustry Demonstration • What we did in Feb 2007 • Society of Breast Imaging Conference • Very successful education seminar • Small group demonstrations (well attended) • Attended by over 500 radiologists • Fees for varying levels of participation ($3K and $1.5K) • What is being planned for 2008 • Industry conference Feb – Mar 2008 • Similar to 2007 – education & demonstration • Budget approx. $4K • Stay tuned for details as they become available

  23. Mammography Image Questions???

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