Mammography image integration profile
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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

Mammography Image Integration Profile

Carolyn Reynolds

Connectivity Manager/Hologic, Inc.


Mammography image

Mammography Image

  • What’s so different about Mammography

  • Use cases & clinical examples

  • Profile requirement highlights

  • Industry Demonstration

  • Questions


Mammography image the problem assumptions

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


Mammography image not just another modality

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)


Mammography image use case

Mammography ImageUse Case

Modality

Workstation

Archive

CAD

“For Presentation” Image Data

Printer

“For Processing” Image Data

Mammo CAD Structured Rpt


Hanging protocol differences example preferred layout

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


Generic image display layouts applied to mammo images

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


Variances in ffdm vendor data detector size example

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


Workstation tool enhancements tissue vs air detection example

Workstation Tool EnhancementsTissue vs. Air Detection Example

Window/Center Adjustments


Printing considerations true size

Printing ConsiderationsTrue Size

10in x12in

Film size

8inx10in

Film size

Precision of <2% error

Film size vs. Detector Size


Printing considerations positioning minimal borders at chestwall

Printing ConsiderationsPositioning-minimal borders at chestwall

Centered images can

create large borders

at chestwall

Image offset with chestwall side having minimal borders


Mammography image integration value proposition

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


Mammography image integration value proposition1

Mammography Image IntegrationValue proposition

  • Ensures systems support required data objects for interoperability

  • Defines image display and printing operations required for effective and efficient diagnoses


Mammography image integration scope

Mammography Image IntegrationScope

  • Based upon existing actors and transactions

  • Expanded requirements within each transaction


Mammography image integration scope1

Mammography Image IntegrationScope


Mammography image expanded requirements

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


Mammography image expanded requirements1

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


Mammography image expanded requirements2

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)


Mammography image expanded requirements3

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


Mammography image expanded requirements4

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


Mammography image expanded requirements5

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


Mammography image industry demonstration

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


Mammography image1

Mammography Image

Questions???


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