Digital mammography arrives to rural Washington

The pressure was on to make an important purchase decision, and fast. Willapa Harbor Hospital, a 15-bed critical-access facility in the tiny Pacific coastal town of South Bend, Washington, had just seen its aging mammography machine reach the point of no repair. Several women had already been asked to postpone their annual screening.

The time had come to bite the fiscal bullet, replace the old workhorse system and reschedule those patients ASAP.  

Fortunately, the selection process wasn’t going to be a hard slog. The outgoing system was a Fujifilm computed radiography (CR) unit—and all internal stakeholders agreed that an economical upgrade from within the familiar and trusted Fujifilm product family made the best sense.

So it was that, on July 26, Willapa Harbor Hospital went live with Fujifilm’s ASPIRE Cristalle digital mammography system.

Known in the industry for its hexagonal detector design, which allows it to deliver detailed images with high efficiency and low radiation dose, the ASPIRE Cristalle won over the technology-acquisition team all but uncontested.

“The idea of the Fujifilm Comfort Paddle was also intriguing,” recalls diagnostic imaging manager Marshall Wirkkala, referring to the system’s patented patient-comfort feature that provides breast compression gently and evenly.

Wirkkala reports that, as of the last week of October, the new system has completed 225 mammograms. So far, fortunately, none have turned up cancers—but that day will come, and the team feels confident they’ll be able to do all they can to help.

“We are a small hospital with a small population catchment compared to many hospitals around the country,” says compliance officer Terry Stone. “At the same time, we’re sure all of those people appreciate that they can get this level of technology so close to home in such a rural area.”

Speaking on behalf of the radiologist at Willapa Harbor Hospital, Wirkkala says Stanislaw Pniewski, MD, is pleased with the quality of the images acquired with ASPIRE Cristalle.

“I recently asked him if he had any comments,” Wirkkala says. “He said the images obtained from patients with breast implants were much better than what he previously had experienced. And everything else was good too.”

Mammography technologist Cheryl Barton adds that Dr. Pniewski “doesn’t say a whole lot, but he is very pleased.”

Crisp images and reduced radiation

Fujifilm product specs indicate that the system’s image-quality features include 50-micron image display and a homogenous signal produced by the hexagonal design, which produces small pixels that “distribute the electrical field more efficiently than traditional square pixels.”

The result is a reduction of acquisition times to just 15 seconds, with image quality boosted by unique algorithms that optimize contrast and dose based on breast density, according to the materials.

Speaking of technical considerations, “the public is more educated on what’s out there,” Wirkkala says. “People had been calling to ask if we had digital mammography. The upgrade has given us a chance to say, ‘Yes, we have a state-of-the-art piece of technology’” for breast imaging.

Barton says patients have also been voicing their appreciation for the reduction in radiation exposure, reflecting heightened awareness of that concern among the general public.

“The ASPIRE Cristalle reduces radiation to the patient by approximately 30 percent,” Barton says. “I can also tell you that many of the women notice a difference in the comfort level with the flexible paddles. This system is much more comfortable than the system it replaced.”

Onsite applications guidance

Asked to look back on the installation process last June, Wirkkala and Barton recall a time of high expectations and, despite the pressure to work fast, days that went quite smoothly.

“The installation mostly went off without a hitch,” Wirkkala says. “The Fuji people worked really well with the technologists and the radiologist to tweak the images to meet the radiologist’s preferences.”

“Our application person from Fujifilm was great,” Barton says. “She spent three days onsite with us and went through everything, then came back for two days a month later for a follow-up visit.”

Now, with those memories further back and fading with every passing day, mammography services are humming along and the team is looking forward to the future.

Committed to the community

While Willapa Harbor Hospital has a relatively low profile online—it has a website, but no social media presence—it has tapped into the ASPIRE Cristalle’s appeal to do some community outreach. The institution ran an advertisement in the local newspaper announcing the system’s arrival, for example, and placed posters in areas of high foot traffic. In addition, they recently ran a woman’s wellness event for mammography through the Breast and Cervical Health Program (BCHP), which is funded by the government in collaboration with the Susan G. Komen organization.

“We provided mammograms to women who were uninsured or underinsured,” Barton explains. “There are certain criteria that they have to meet, and if they qualify, we gave them a free mammogram.”

(The BCHP program reimbursed the hospital for the technical costs and the radiologist for the interpretation.)
 
Wirkkala points out that, apart from Willapa Harbor Hospital, the closest facility offering mammography services is quite some distance away.

“For lot of our older patients, or for people who just have a hard time traveling, 40 minutes is a long drive for a medical appointment,” he says. “We hope that word of the ASPIRE Cristalle will spread so that patients will feel encouraged to stay local for their breast imaging needs.”

As a member of hospital leadership, Stone looks to the future with a sense of community service grounded in the reality of the hospital’s geographic setting.

“Our population here is fairly stagnant. Many residents are retirees,” Stone says. “But our mammography unit is state of the art. We feel that both our imaging services and our lab services are really good services, and the people who utilize our facility and our physicians agree with that.”

“Because of our small size, I’m not sure that we are going to always keep up with state-of-the-art types of technologies,” he adds, “but we certainly want to be providing optimum service for our patients whenever we can.”