Most facilities simply can't afford direct digital mammography since systems run anywhere from $350,000 up to $600,000. Traditional analog units go for $60,000 to $100,000. Used film equipment can be available for as low as $35,000.

As Denholtz suggested, many radiologists prefer film to digital studies.

"Film screen-the old stuff-is still better than digital and it probably will be that way for another eight to ten years. You will not hear that from the vendors because they want to sell you a half-million dollar unit rather than another $100,000 unit," said Richard Cooper, MD, a radiologist in private practice as well as President and CEO of Imaging Centers of America, Inc., based in Valdosta, Georgia. Cooper acknowledged research showing that digital mammography is better for younger patients with denser breasts. However, these women represent a tiny fraction of patients and cancers. "There is a call for digital mammography," Dr. Cooper noted. "But by far the best thing we have right now is film screen mammography."




Mammography systems widely entrenched in the field include GE, Hologic/Lorad, Siemens, Instrumentarium, Fischer, Planmed and others. In terms of the new digital systems, the most coveted is Hologic's Selenia full-field digital mammography system.

"Digital is the future and that's where everybody is going whenever the pricing is better and the availability is there," predicted Courtney Lane of Innovative X-Ray Services, Friendswood, Texas. "We are going to see a phenomenal spurt in digital but there is still a big need for the analog systems."

Acknowledging the image quality and functionality of digital mammography, Leon Gugel, President, Metropolis International, Long Island City, N.Y., said it all comes down to simple economics. "If you're a doctor, look at it this way, if you are not going to go fast around a race track why buy a Ferrari? The station wagon will do the job."




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