Due to the higher metabolic activity of cancerous cells, those cells absorb a greater amount of the tracing agent and are revealed as "hot spots." BSGI captures the cellular functioning of the breast tissue, and is particularly useful for patients with dense breasts.

CAD - the radiologist shortage is giving it a boost

Over the past two decades, computeraided detection and diagnosis (CAD) has been developed to help radiologists detect suspicious changes on mammograms, and this has really taken off with the growth of digital mammography.
"CAD is a hot topic," says Hall. "It's the one reimbursable by most insurance
companies. With a shortage of radiologists and most sites wanting two readings, if you don't have enough doctors, the computer can help you look."

Computers can help doctors identify abnormal areas on a mammogram by acting as a second set of "eyes." For traditional mammograms, the film is fed into a machine, which converts the image into a digital signal that is then analyzed by the computer. Alternatively, the technology can be applied to an image captured with digital mammography. The computer then displays the image on a video screen, with markers pointing to areas that the radiologist should check closely.

A recent study, published in the April 2008 American Journal of Roentgenology, confirms that CAD is useful in screening mammography. The study compares a single reading with CAD to double readings of screening mammography studies.
After considering more than 200,000 mammograms, researchers concluded that CAD, compared to double readings, results in lower recall rates, which was the point of contention. CAD enhances the performance of a single reader with only a small
increase in recall rate. A previous New England Journal of Medicine study suggested that increased CAD false positives were evidence of inaccuracy, leading some insurers to consider dropping CAD reimbursement at least temporarily.

The study finds that, compared with a double reading, single-read CAD resulted in a slight increase in sensitivity at a lower recall rate. Double reading increased sensitivity as well as recall rate when compared to a single reading. (The North Carolina radiology group that conducted the study had switched from double reading to a single reading with CAD.)

The larger volume of film-based CAD studies in the newer research may suggest it supersedes the NEJM study. To read more about the AJR study as originally reported in DOTmed Online News, visit dotmed.com/dm5468.

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