Product Focus

WOMEN’S IMAGING

Hologic’s 3Dimensions system is designed to provide higher quality 3D images for radiologists, a more comfortable mammography experience for patients with the SmartCurve breast stabilization system1, and enhanced workflow for technologists. The system offers the unrivaled performance of Hologic’s Genius 3D Mammography exam, which is more accurate than conventional 2D mammograms, detecting 20%-65% more invasive breast cancers.2 The 70-micron high resolution 3D data enables more natural looking Intelligent 2D synthesized images* and workflow advantages with 3DQuorum technology* – reducing interpretaHOLOGIC 3Dimensions Mammography System1 tion time, patient dose and time under compression.3-6

REFERENCES

*Optional licenses 1. Smith, A. Improving Patient Comfort in Mammography. Hologic WP-00119 Rev 003 (2017). 2. Results from Friedewald, SM, et al. “Breast cancer screening using tomosynthesis in combination with digital mammography.” JAMA 311.24 (2014): 2499-2507; a multi-site (13), non-randomized, historical control study of 454,000 screening mammograms investigating the initial impact the introduction of the Hologic Selenia® Dimensions® on screening outcomes. Individual results may vary. The study found an average 41% (95% CI: 20-65%) increase and that 1.2 (95% CI: 0.8-1.6) additional invasive breast cancers per 1000 screening exams were found in women receiving combined 2D FFDM and 3D™ mammograms acquired with the Hologic 3D Mammography™ System versus women receiving 2D FFDM mammograms only. 3. Tech File: TFL-00059 4. Report: CSR-00116 5. Physician Labeling: MAN-06153 6. FDA Submission: P080003/S008.

ASPIRE Cristalle 3D Mammography System

Fujifilm’s ASPIRE Cristalle is engineered with innovative high-sensitivity capture and advanced image processing technologies to produce exceptional image quality for all breast types at gentle dose. Patient experience enhancements such as its patented Comfort Paddles and new Comfort Comp feature are designed to make mammograms noticeably more comfortable. The Comfort Comp feature automatically minimizes compression prior to the exposure, and the Comfort Paddle’s soft edges and fourway pivot contours to the individual breast composition to more comfortably apply the right compression. Fujifilm recently received 510(k) clearance for its contrast enhanced digital mammography (CEDM), an emerging modality that combines digital mammography with the administration of intravenous contrast material.

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GE HEALTHCARE

Voluson Expert 22

GE Healthcare recently unveiled its most advanced ultrasound yet, the next-generation Voluson Expert 22. This latest addition to GE Healthcare’s award-winning women’s health portfolio utilizes graphic-based beam former technology, which produces higher quality images and offers greater flexibility in imaging functions. Cutting-edge tools powered by artificial intelligence (AI) ensure greater consistency in exams and decreased number of tasks. Customizable touch panels, color and lighting options provide for a revolutionary user experience. The Voluson Expert 22’s Lyric Architecture unlocks new imaging and processing power to achieve higher resolution, detailed images — and increased independence from body habitus and other difficult scanning conditions. The Lyric Architecture generates new levels of penetration, resolution, and frame rates to reveal fine anatomy in 2D/3D/4D with ease, and delivers uniformity throughout the image with increased spatial and contrast resolution.

The MAMMOVISTA B.smart reading platform from Siemens Healthineers accelerates the reading workflow for breast imaging. The intuitive user interface supports maximum reading performance across multiple imaging modalities and reduces the number of clicks required for specific tasks. It also increases the image loading speed by up to 75 percent.1 Artificial intelligence-supported2 workflows highlight breast tissue abnormalities during the reading phase and provide a confidence score. This score indicates the algorithm’s assessment of the probability of cancerous tissue.

SIEMENS HEALTHINEERS MAMMOVISTA B.Smart 4

1 Data on file 2 AI is an option and available with Transpara powered by FusionAI, ScreenPointMedical.

Imaging Jobs

NOW AVAILABLE

htmjobs.com

Companies like ours have such a difficult time finding qualified candidates for field service roles that it just made sense to publish our opening with HTMJobs. – K. White, HR/Compliance Manager ” LOOKING TO FILL A POSITION?

Visit htmjobs.com/start-posting/ to post a job.

Companies that post with us:

MXR Imaging, OSF Healthcare, First Call Parts, Associated Imaging Services, Medical Imaging Solutions, Renovo Solutions, TRIMEDX, Canon Medical Systems, Cal-Ray, Banner Health, Agiliti and many more!

ICE2022

IMAGING CONFERENCE & EXPO

FEBRUARY 20-22, 2022 • NAPA, CA

Contact us at htmjobs@mdpublishing.com to learn more about our various posting options!

Imaging Engineer II

If you are wondering what makes TRIMEDX different, it’s that all of our associates share a common purpose of serving clients, patients, communities, and each other with equal measures of care and performance. Everyone is focused on serving the customer and we do that by collaborating and supporting each other. Every associate matters and makes a difference.

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Imaging Service Engineer

An Imaging Service Engineer (ISE) performs and documents planned maintenance and repair of medical diagnostic imaging equipment and associated systems with under the supervision from service management to perform the required duties. The ISE must demonstrate a working knowledgeof and ability to use the required test equipment and have the electronic and mechanical knowledge and skills.

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Field Service Engineer

We specialize in an objective, total solution medical imaging technology program that delivers world-class quality of products and services, resulting in greater efficiency and lower cost to our healthcare provider partners, with a strong focus on clinical staff satisfaction and improving patient outcomes.

VIEW FULL DETAILS www.htmjobs.com Field Service Engineer - Nuclear Medicine

Associated Imaging Services has been offering nuclear medicine and ultrasound solutions to our customers since 1990. We specialize in the sales and service of new and refurbished nuclear medicine cameras and ultrasound systems throughout Kansas, Oklahoma, Texas, and the surrounding areas.

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Imaging Field Service Engineer

Agiliti is a nationwide company of passionate medical equipment management experts who believe every interaction has the power to change a life. Our industry-leading commitment to quality and team of expert technicians helps ensure clinicians have access to patient-ready equipment needed for patient care. Make an impact in healthcare and grow your career with Team Agiliti!

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Customer Support Engineer II/III (X-RAY)

MIS provides asset management solutions for hospitals and imaging institutions nationwide. We combine 20 years of service experience with the industry’s most advanced asset-management software, raising the bar in the industry to manage the increasing demands placed on diagnostic operations.With our contract management program, we make everything imaging as simple as possible for you.,

VIEW FULL DETAILS www.htmjobs.com Zone Support Specialist (CT)

Provide modality-specific technical service support within a prescribed zone to Customer Engineers (CE) for resolution of complex customer situations. Recommendations and actions should be focused to drive the Zone to technical self reliance. CMSU is an Equal Opportunity Employer and reasonable accommodations will be considered.

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Imaging Field Service Engineer III

Field service on medical equipment, installation of x-ray equipment, Diagnostic Imaging field service engineer servicing multi-vendor/multi-modality equipment in hospital and other environments. Focusing on c-arms, Digital R/F, Digital Mobiles, x-ray systems and digital capture both DR and CR modalities. Growth opportunities to include CT, MRI, Ultrasound, and others.

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X-Ray Service Engineer

First Call Parts has been providing customers with quality replacement imaging parts since 2009. We pride ourselves in developing a top-notch reputation in the imaging industry as delivering the best in diagnostic imaging replacement parts. We specialize in the sale of refurbished/tested and used, Philips, Siemens, and GE in the Cath/Angio, R/F, and RAD modalities.

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NO MAKING UP FOR LOST TIME

Impacts of the Pandemic Lapse in Breast Cancer Screening

By Matt Skoufalos

At the best of times, bringing at-risk and underserved patients in for routine breast cancer screening can be a complex proposition. But during the novel coronavirus (COVID-19) pandemic, when elective imaging procedures were shelved as all of the health care world shifted to battling the virus, a new wrinkle emerged.

A pre- and post-COVID (March 2019 through May 2021) analysis of the U.S. National Mammography Database published in the Journal of the American College of Radiology (ACR) in August 2022 identified the impact of these shutdown. Screening mammograms were down 37 percent, diagnostic mammograms down 58 percent, breast biopsies down 47 percent, and cancer diagnoses down 49 percent, all as compared with pre-pandemic levels.

“Although diagnostic mammogram levels returned to near pre-pandemic levels … screening mammograms, breast biopsies and, most importantly, cancer diagnoses continue to lag,” wrote Dr. Lars Grimm of the ACR National Mammography Database (NMD) Committee in a summary.

“These findings are likely to have a major impact on future breast cancer outcomes,” Grimm wrote. “The cancer diagnosis deficit that started in the acute phase of the pandemic continues to grow in parallel with lower screening mammography utilization rates. Failure to diagnose smaller, screen-detected cancers will lead to more late-stage cancers in the future. Initial cancer registry data demonstrates a stage shift to later-stage breast cancers, and multiple modeling studies predict a corresponding increase in patient mor-

bidity and mortality.”

As the nation recovers from the myriad impacts of the pandemic, there are specific concerns as to how breast imaging practitioners are handling the specific needs of their patient populations, particularly those who face barriers to accessing routine screenings.

Henry Izawa is vice president of modality solutions and in-vitro diagnostics at FUJIFILM Medical Systems U.S.A. Inc., and executive vice president of business integration at FUJIFILM Healthcare Americas Corporation. Izawa said that its clinical partners reported that some of their biggest post-pandemic breast imaging challenges have as much to do with roadblocks in staffing as with generating return visits from hard-to-reach, at-risk patients.

“There’s a lot of people who are not coming back to work among our clinician partners, especially the technicians,” Izawa said. “It’s a very big problem. I talk to a lot of rural and critical access hospitals, and the CEOs say, ‘My biggest fear is not money; it’s the fact that I can’t get staff.’ A lot of federally qualified health center (FQHC) facilities want to provide a line of service [like cancer screening], but they worry about staffing, so they don’t bother. Our fear is that if they stop providing services, the [screening] rate is going to go down more and more.”

The FUJIFILM response to shortstaffed practice environments has been to focus on technological solutions that drive volume through efficiency and a consistency in image quality, with the intention of delivering reproducible results independent of staffing changes. By studying patient callback ratios and monitoring physician practices, the company found that its clinical partners could improve their study outcomes by re-training them to best position patients for their mammograms. Making those technical adjustments to how practitioners compress and position the breast helped improve efficiency while also helping patients feel more comfortable during the process.

“I think some of the work we’ve done has provided our customers with confidence that, regardless of personnel, they’ll be able to provide that efficiency, or spend more time with patients as they come back in order to build their relationship,” Izawa said.

FUJIFILM is also working in partnership with its potential customers to develop community health events that can drive awareness of the importance of annual breast cancer screenings while emphasizing technological solutions that promote patient comfort and confidence during the

exams. DNA methylation-based liquid biopsy technology allows physicians to screen patients for cancer with a blood draw rather than a tissue sample, as in traditional biopsies. Technological advancements in digital breast tomosynthesis provide dense-breasted patients with additional insight into their cancer risk. Genetic profiling can help women with a family history of breast cancer to identify their risk levels on an individual level. FUJIFILM is also exploring dual-energy, contrast-enhanced, digital subtraction mammography technology, which offer a greater degree of accuracy in breast imaging. Discovering which patient groups are the best fit for which specific technological solutions helps improve their outcomes as well.

“There’s a lot of awareness of known technology that’s being used to provide personalized care for dense-breast patients, or higher-risk patients,” Izawa said. “There’s also a lot of newer technologies that are being introduced into the market. People are transitioning into how we use these technologies to drive more of a personalized care approach to screening.”

All these high-end technologies are leveraged in service of early cancer detection, but they can’t be put to use if patients aren’t able to access them. To that end, Izawa also spoke about the need for mammography vendors to support clinical outreach programs that help connect women who should be screened for breast cancer with the health systems that can facilitate those studies.

“We’re partnering with our potential customers and holding events to create more awareness of how important annual screening is,” he said. “The most important thing is driving early detection.”

As critical as public outreach is to bringing women in for breast imaging studies, Tricia Trammell, imaging operations manager at the UT Southwestern Medical Center of Dallas, Texas, believes that getting them to come back year after year means employing staff who can manage patient anxiety with sensitivity to the emotional intensity of their experiences. This is particularly significant given the lapse in studies conducted during the pandemic: patients either had to reckon with the fear of skipping a routine screening, and thus, potentially missing a chance for early detection of an abnormality, or else weighing the risk of contracting COVID-19 for a non-urgent health visit.

“After the height of the pandemic was over, when imaging services really ramped up again, many patients had a perceived sense of, ‘I didn’t have any testing done for this year and a half, and everything was fine,’ ” Trammell said. “ ‘Nothing happened to me while I didn’t have imaging, so what’s going to happen now? Will they find something because I didn’t stick to my

annual screening schedule?’ ”

“Conversely, patients wondered if they were risking getting COVID from coming to the hospital or outpatient centers and being around other people, or should they delay longer and not be on their annual schedule and see what happens,” she continued. “Either way, you’re playing with fire, so that adds to the whole emotional factor that’s already underlying when you’re caring for and communicating with patients who are getting a mammogram.” Trammell believes that the physical discomfort that

patients experience during a mammogram is secondary to the psychological discomfort they may be more intensely feeling during the lead-up to the study and during the study. As important as the results of the test are, the heightened emotionality of the experience around the cancer screening process puts an even higher premium on patient interactions.

“Often when a patient states that she doesn’t want a mammogram because it hurts, or when she delays in scheduling the exam, what she’s really uncomfortable about it is the unknown,” Trammell said. “Until they receive a benign or no-findings result, they’re emotionally uncomfortable. The story hasn’t changed in the 22 years that I’ve been doing mammography: it’s about early detection, access to care, technology and great compassion for people.”

“I did breast ultrasound imaging this morning, and two of my patients were crying and shaking with fear,” she said. “I held their hands and hugged them and had an opportunity to remember why I am in this field; why I am in this industry. It’s to care for people and to help them through very scary situations.”

In addition to her imaging leadership role, Trammell is a certified patient navigator, a process that she believes plays a critical role in removing the barriers to care that keep patients from accessing the imaging technologies that can save their lives through cancer screening.

“If a patient doesn’t know or have access to that technology because nobody navigated them to that technology, the technology doesn’t mean anything,” Trammell said. “An imaging navigator is going to call when there’s an irregular mammogram, schedule a biopsy, hold their hand through that biopsy, call the patient with biopsy results and coordinate follow up care. It’s a game-changer as it relates to time between screening and diagnostic mammography, time between diagnostic and biopsy, and time between biopsy and surgical referral.” Trammell points out that access to care has been a historic problem for some segments of the imaging patient population, and likely will continue to be so. For those reasons, she values community outreach programs that help either bring patients to imaging centers, or take the modalities into the community. But many mobile mammography programs were shut down or limited during the pandemic, which underscores the deficit that communities lacking access to imaging technologies continue to face. “Most programs are now fully back up and running, and going full speed, but there’s no way to recover that year and a half that was lost,” Trammell said. “There’s no way to get it back. Now the focus is getting people back on their annual schedules, and finding any interval cancers that may have developed throughout that pandemic.” Dr. Linda White Nunes is the

University of Pennsylvania vice chair for inclusion, diversity and equity in the department of radiology as well as the division chief of abdominal imaging, Pennsylvania Hospital. She described the impact of “dual pandemics” — one that has chronically kept patients away from hospitals, and another that acutely limited the lines of service that hospitals were equipped to offer amid virus surges — on community health initiatives aimed at improving breast cancer screening for people who struggle to access imaging services.

Siemens Healthineers North America employees attending the inaugural Penn Medicine/Siemens Healthineers mobile mammography screening outreach event, held Oct. 18-29, 2021, in North Philadelphia, include Abigail Weldon, Senior Director of Women’s Health; Lara Barghout, Senior Vice President of Advanced Therapies; Nina Marino, Project Support Analyst; and Francis “Franny” Gentile, Project Assistant.

“Sometimes it’s hard for us to separate the effects of the two pandemics,” Nunes said. “There’s a well-described delay in care associated with COVID. Even after that acute six to 12 months, people were fearful of coming back for things that weren’t urgent for fear of contracting COVID. We feel that we are just now making up for that time, and catching cancers that may have developed during that period.”

Nunes cited CDC reports of approximately 41 percent of American adults avoiding medical care, and 32 percent avoiding routing care during the pandemic; an in-house survey of patients presenting to a University of Pennsylvania breast imaging center found that 26 percent reported delaying care during the pandemic. Those affected were younger people who often had household responsibilities, or had contracted COVID themselves, she noted. In addition to the impact of the pandemic, Nunes also described the weight of the social unrest following the murder of George Floyd in police custody, which led to broader, louder discussions about health disparities and social determinants of health.

“People were not presenting at hospitals to get the screenings they should,” she said. “We chose to try to combine a community partner, a corporate partner, and ourselves, to see if we could get beyond the social determinants of health.”

Those partnerships proved fruitful. Siemens Healthineers North America provided the mobile imaging suite, delivered on a semi-trailer affectionately nicknamed “Mammo Mandy.” The Murrell Dobbins Career & Technical Education High School in the West Lehigh neighborhood of Philadelphia hosted one event, and the Community of Compassion CDC, a 5,000-member congregation in West Philadelphia, hosted another.

The first event was dedicated specifically to breast imaging, while the second provided breast, colon, and prostate cancer screenings, followed by another two weeks of onsite breast cancer screenings with the mobile unit. At Community of Compassion, the larger health fair also included opportunities for residents to undergo lung cancer risk assessments, familial or genetic risk assessments, and education about clinical trials and research.

“We wanted to both educate and screen on that day,” Nunes said. “Their leadership is really in touch and in tune with their community, and their community really trusts them.”

The events were both successful not only for their locations, which were well-known within the community, but also because of the connections their community partners had built within the neighborhoods. Nunes described the reach that the Community of Compassion has within the community as extensive and meaningful. In addition to the guests in the sanctuary, the church also livestreams its services to congregants, which brought in women from throughout the city.

“One of the people at the mammography van that day said she was home watching the livestream of the service,” Nunes said. “Between the pastor and the physicians saying how important it was, she said, ‘I’ve got to get out of this house, and get down there and get screened.’ Other people said a friend said the same thing to them.

“Having friends, community leaders and people you trust telling you, ‘You’ve got to do this and I’ll walk down there with you,’ that’s important,” she said.

Abigail Weldon, senior director of women’s health at Siemens Healthineers North America, said the partnerships proved fruitful for everyone involved.

“Penn Medicine is one of our most valued partners, especially in the Philadelphia area,” Weldon said. “We located the space, and provided the equipment and the project management – and 241 women got their mammograms in a two-week span with very little marketing.”

“That solidified for both Penn Med and Siemens that there is a need that I don’t think we’ve even quantified yet for us to be in inner cities,” she said. “Mobile mammography is not just for rural areas that don’t have access.”

When it comes time to measure the success of community initiatives like these, there are quantitative and qualitative takeaways, Nunes said. She pointed to the higher-than-expected number of cancers among patients post-pandemic as evidence that the programs are reaching people who do not ordinarily come in for routine screenings. Penn Medicine is working to create a program using a smaller mobile unit – one capable of rotating through the city on a regular schedule – to expand upon their successes.

“There are health centers that are not doing breast imaging, and you could roll up to their parking lot,” she said. “So we definitely see a lot of potential, and hopefully we’ll be able to give that type of program a try soon.”

Weldon also believes that any efforts that can be made to address health care disparities in general aree significant, and specifically those that have been exacerbated by the pandemic.

“We won’t know the true effect of the pandemic for years to come,” she said. “We are seeing health care providers also pivot to make up for the lost screening. I think that’s where we can have a sense of hope. There’s a lot of movement around getting these screening services to the non-traditional space.

“We were on a good path when it came to screening, and seeing less deadly effects of breast cancer,” Weldon said. “We need to be in more spaces when it comes to screening.” •