A multisite telemammography system for remote management of screening mammography: an assessment of technical, operational, and clinical issues.

OBJECTIVE: This paper describes a high-quality, multisite telemammography system to enable 'almost real-time' remote patient management while the patient remains in the clinic. One goal is to reduce the number of women who would physically need to return to the clinic for additional imaging procedur...

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Publicado en:Journal of Digital Imaging Vol. 19; no. 3; pp. 216 - 226
Autores principales: Leader JK, Hakim CM, Ganott MA, Chough DM, Wallace LP, Clearfield RJ, Perrin RL, Drescher JM, Maitz GS, Sumkin JH, Gur D
Formato: research Journal Article
Publicado: Springer Nature Sep2006
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2006
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      pub: Springer Nature
      place: New York, New York
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        atl: A multisite telemammography system for remote management of screening mammography: an assessment of technical, operational, and clinical issues.
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          Leader JK
          Hakim CM
          Ganott MA
          Chough DM
          Wallace LP
          Clearfield RJ
          Perrin RL
          Drescher JM
          Maitz GS
          Sumkin JH
          Gur D
        affil: Imaging Research Division, Department of Radiology, University of Pittsburgh, 300 Halket Street, Suite 4200, Pittsburgh, PA, 15213, USA. leaderjk@upmc.edu
      sug:
        subj:
          Breast Neoplasms Radiography
          Health Screening
          Mammography
          Teleradiology
          Ambulatory Care Facilities
          Breast Neoplasms Epidemiology
          Computer Communication Networks
          Computer Simulation
          Computers and Computerization
          Female
          Image Processing, Computer Assisted
          Management Information Systems
          Observer Bias
          Radiographic Image Interpretation, Computer-Assisted
          Radiology Information Systems
          Software
          Study Design
          Human
          Female
      ab: OBJECTIVE: This paper describes a high-quality, multisite telemammography system to enable 'almost real-time' remote patient management while the patient remains in the clinic. One goal is to reduce the number of women who would physically need to return to the clinic for additional imaging procedures (termed 'recall') to supplement 'routine' imaging of screening mammography. MATERIALS AND METHODS: Mammography films from current and prior (when available) examinations are digitized at three remote sites and transmitted along with other pertinent information across low-level communication systems to the central site. Images are automatically cropped, wavelet compressed, and encrypted prior to transmission to the central site. At the central site, radiologists review and rate examinations on a high-resolution workstation that displays the images, computer-assisted detection results, and the technologist's communication. Intersite communication is provided instantly via a messaging 'chat' window. RESULTS: The technologists recommended additional procedures at 2.7 times the actual clinical recall rate for the same cases. Using the telemammography system during a series of 'off-line' clinically simulated studies, radiologists recommended additional procedures at 1.3 times the actual clinical recall rate. Percent agreement and kappa between the study and actual clinical interpretations were 66.1% and 0.315, respectively. For every physical recall potentially avoided using the telemammography system, approximately one presumed 'unnecessary' imaging procedure was recommended. CONCLUSION: Remote patient management can reduce the number of women recalled by as much as 50% without performing an unreasonable number of presumed 'unnecessary' procedures.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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