From the July 2015 issue of HealthCare Business News magazine


She believes that the lack of reimbursement from private insurers is one of the reasons why tomosynthesis has not been widely adopted yet. “There needs to be universal reimbursement so people can afford to buy the equipment,” she adds. It’s mostly the large academic hospitals that are offering the service, but Siemens has noticed interest from some community hospitals.

“It obviously takes community hospitals a little bit longer to get the funding and the budget for [tomosynthesis] but we are seeing a trend toward a very competitive market,” says Okken. Three vendors are currently dominating the tomosynthesis market and all of their systems acquire both 2-D and 3-D mammograms.


Hologic was the first to the market with the introduction of its Selenia Dimensions mammography system in 2011. GE was next, after it received FDA approval of its SenoClaire 3D Breast Tomosynthesis system in September 2014. Then Siemens received approval in April for its tomosynthesis add-on to its MAMMOMAT Inspiration digital mammography system.

To date, Hologic has sold 1,800 systems in the U.S., with at least one in every state, and it’s available in over 50 countries, spanning five continents. Several of Siemens’ tomosynthesis add-ons have already been installed and several more are scheduled for installation within the next few weeks. The systems acquire images in different ways. The Siemens system has a 50-degree angulation and takes 25 projections every 2 degrees. The Hologic system has a 15-degree angulation and acquires 15 projections every degree, and the GE system has a 25-degree angulation and about every 3 degrees acquires about 9 projections. Siemens’ Okken says that’s a big problem.

“The challenge is that the technologies on the market are so different and the detection rate is proving to be different based on the technical differences of the equipment,” she adds. The FDA requires each patient to undergo separate screening programs for each device because the FDA had to approve them as three separate technologies.

Okken believes that the technology needs to be standardized, and to do that the vendors need to adjust their angulations to match. She believes that as more studies are published, the larger angulation is going to be shown to correlate with a higher detection rate.

Where’s the proof?
Many institutions, including the University of Pittsburgh, Yale University Cancer Center, and University of Pennsylvania, have been investigating the technology. Over the past few years, a plethora of studies have been published comparing tomosynthesis and 2-D mammography.

July 2015 Magazine

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