Remote reading of mammography images a hot topic at infoRAD

A potential advance in remote reading of breast images diagnosis is one exhibit at the infoRAD demonstration hall at this week's annual meeting of the Radiological Society of North America (RSNA) in Chicago. The exhibit highlights groundbreaking work in long distance transmission of digital screening of mammograms which the researchers are putting forward as a potential solution to what they believe is a "mammography crisis" in this country.

This crisis is driven by a lack of highly skilled experts in the field of reading digital mammography images, said Alan R. Melton, MD, assistant clinical professor, Department of Radiology, Columbia University Medical Center who led a pilot research program. Melton collaborated with a number of colleagues at New York Presbyterian Hospital-Columbia University Medical Center including Peter D. Esser, PhD, and Suzanne J. Smith, MD, and Philip O. Anderson, MD.

With this idea in mind, Melton suggested to the Institute of Medicine that digital mammography images could be sent over a virtual private network (VPN) without compression and without any loss in image quality, to radiologists with special training to view the images remotely in batches. This solution could potentially give healthcare organizations access to the highly-skilled but much needed specialists they might lack at their own facilities. As a result, the Institute of Medicine challenged him to prove that it could be done.

The challenge was met with a test program that -- all told -- saw a total of approximately 1,300 studies with sets of images (in some cases 10 images totaling around 90 MBs) sent from a hospital over a secure high speed connection to a remote reading facility with no reduction in quality. Eighty studies could be transmitted on weekends though this did drop to as low as 30 on busier weekdays.

As a result of this study, Melton believes that the combination of digital mammography plus the use of highly skilled experts doing the reading could significantly reduce breast cancer mortality rates. To expand this model nationally, a network of "Center of Excellence" could be established which would house specialists who would receive and review digital mammography images remotely, Melton said.

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