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Computer-Assisted Second Readings

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April 3, 2000 (Chantilly, Va.) -- Considered by some to be the stealth technology of women's health care, the computer-aided second reading is now regarded as a reliable way for doctors to look for breast abnormalities that the naked eye may have missed.

The process converts a mammographic image into a digital signal that is analyzed by a high-speed computer. The computer then displays the image on a video screen, with markers pointing to areas the radiologist should check closely.

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"The computer can be programmed to look at data and pick up possible lesions,'' said Phan Huynh, M.D., a breast imaging specialist at the University of Texas Health Science Center in Houston. "It looks at the size and shape of masses. It is really for detection, not diagnosis. But a computer is not perfect either. It may pick up some stuff that may not be a concern.''

The U.S. Food and Drug Administration (FDA) has approved one such device for use in reviewing mammograms, the M1000 ImageChecker, manufactured by R2 Technology, Inc., of Los Altos, Calif.

The FDA said its studies of the ImageChecker showed use of the device would improve a radiologist's detection rate from approximately 80 out of 100 cancers to almost 88 out of 100. The FDA's approval, announced in June 1998, was based on data from clinical studies in which more than 40,000 mammograms were reviewed.

The technology is a precursor to digital mammography, which uses a computer to capture x-ray images of the breast. The FDA, in late January approved GE Medical Inc.'s Senographe 2000D digital mammography system, but cautioned that it is no more effective than current mammography techniques.

The computerized images do have some potential advantages over the film mammograms: They can be stored electronically so films aren't lost, adjusted for under- or overexposure without the need for a repeat X-ray, and sent electronically to specialists worldwide for consultation.

"Because the pictures are in a computer, the radiologist can manipulate the image,'' said Luz Venta, M.D., Director of Breast Imaging at the Lynn Sage Comprehensive Breast Center at Northwestern Memorial Hospital in Chicago. "In the past, when we had an area we wanted to look at more closely, the woman would have to come back and take another X-ray. We now hope that fewer women will have to come back for additional views. It will save some anxiety.''

Michael D. Towle writes regularly for WebMD on health and legal issues.

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