AAMI: Digital mammo redefines biomed role

SAN ANTONIO—The emergence of digital mammography applications has greatly benefited the early detection of breast cancer while bringing with it an increased responsibility to the clinical engineer, according to Steve Madere of Unisyn Medical Technologies, who presented his company's findings on June 26, during the 2011 Association for the Advancement of Medical Instrumentation (AAMI) conference & expo.

Madere traced the history of breast cancer detection from the screen-film mammography systems used in the 1960s to the silicon-wafer technology that developed almost 20 years later. “Image capture technology was born with silicon-wafer technology,” said Madere, technical support manager for mammography for the Golden, Colo.-based developer of software service platforms for the diagnostic imaging industry.

The field has continued to evolve with the more recent move from film to digital technology, producing improvements in spatial resolution, contract resolution, signal-to-noise ratio, dose efficiency and field of view, according to Madere.

Madere expanded on the benefits of using digital over film by acknowledging the former’s reduced warm-up time, an increase in data processing time, advances in automatic exposure techniques, reduction in cost and overall growth potential. In describing the digital format's superior display capabilities, he cited the use of fiber optic cable, image manipulation and marking, and the abilities to store, archive and retrieve data.

With the move towards digital mammography applications, Madere made clear the increased role of the clinical engineer, highlighting the basics: “Read your operator’s manual and know your DICOM conformance statement,” said Madere. “Know your system.”

He recommended that clinical engineers develop a checklist when using digital mammography systems. He acknowledged the importance of paying careful attention to the details, most notably in regards to image quality, x-ray tube life, patient comfort (making sure compression paddles are in good working order, for example) and image detection performance (insisting on fiber optic cable care).

He also had strong words for today's software users. "It's important in preventive maintenance that you know your software," said Madere. "Make sure you know your passwords. Usually when something fails it's electrical or mechanical. I hardly ever see any software problems. When there is a problem with software it's usually because something has changed--a server, or a password, for example."

Madere also pushed clinical engineers to continue their education. “Know radiation safety practices, be sure to follow HIPAA practices and make sure you know your physicist’s test procedure,” he said. "Learn as much as you can."

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