Women's Imaging 2013
Measuring The Options

Key Findings

• No Bad Options for 2D Digital Mammography—Hologic is the top performer in 2D mammography, but the top three vendors all turn out solid performances. Hologic delivers leading technology, and providers tout their Hologic partnership in women’s imaging. Siemens has improved over their past mammography offering the NovationDR with the new Inspiration, which offers some good automation. GE’s strength comes from a solid product and network of field support engineers.
• Ultrasound Is Women’s Imaging’s Little Sweetheart—Providers report ultrasound has not replaced mammography but works in conjunction with it for advanced breast imaging and those patients with dense breasts. There can be inherent challenges with reproducibility and image acquisition time. Automated breast ultrasound units, such as GE’s somo•v INSIGHT, Siemens’ ACUSON ABVS, and SonoCiné’s ABS, are positioned to solve that problem and promise consistent images.
• MRS Increases Performance Gap—Overall, women’s imaging providers prefer using a dedicated MIS over a RIS for mammography. MRS is the strongest performer with v.7 adding new functionality. PenRad and MagView providers feel development has not kept up with their wants and needs.
• Demand for Tomosynthesis Increasing——When asked what they would choose if they could start over, providers overwhelmingly said tomosynthesis. This includes GE and Siemens customers who are waiting for the vendors’ tomosynthesis offerings to be approved.

Bottom Line On Vendors

• DIGITAL MAMMOGRAPHY–RANKED:

  FUJIFILM—ClearView-CSm great for budget-conscious providers. Competitive with field service and reliability. However, many customers desire more recent platform of digital mammography and tomosynthesis and a partnership with Hologic. Only 19% would start with Fuji if they could start again. Early adopters of AspireHD pleased so far–overall performance far ahead of that of ClearView-CSm with eight-point gap

  GE Healthcare—Excellent field engineers and support coverage. Customers feel GE is slow on delivering tomosynthesis—losing some market share to Hologic. Lack of parts availability causing extended downtime. The somo•v INSIGHT whole breast ultrasound recently added, rounding out GE’s breast imaging portfolio. The somo•v INSIGHT has great image quality and patient comfort. Lack of adequate reimbursement for screening breast ultrasound is barrier for use.

  Hologic—Top performer in 2D digital mammography. Dedicated to women’s imaging and development of new technology; providers feel Hologic is a partner. Implementations and training top notch. Some customers live more than three years report reliability issues.

  Siemens—Inspiration big improvement over prior system NovationDR. Better image quality and functionality. Automated compression feature, Opcomp, and paddle options improve workflow and patient comfort. Competes with Hologic on 2D mammography, but customers still want tomosynthesis, which is live for Siemens customers in Europe. Implementations have room to improve. Automated whole breast ultrasound, AVBS, leverages the general use of the ACUSON S2000 and S3000.

• SPECIALTY–UNRANKED:

  Aurora—Field service and phone support have improved over past two years and are now meeting customer expectations. Providers report updates happen more often and are pleased with enhancements. Simple design; easy to use. Providers need high volumes for a dedicated MRI to achieve ROI.

  Dilon—Strong functionality and reliability. Concerns over dose and reimbursement problems have reduced use. Only 71% would buy again. Service team has improved over the past year.

• MAMMOGRAPHY INFORMATION SYSTEMS (MIS):

  MagView—Great functionality for internal, regulatory reports, and meaningful use. Mixed reviews on support. Training could be more comprehensive. Providers frustrated by slow development but optimistic about future.

  MRS—Leader of the MIS market with solid performance. Reporting is touted as fantastic, including MQSA, critical results, and clinical reports. Flexible, robust functionality for mammography-specific functions and regulatory requirements. Tracking patients for follow-up procedures and yearly screenings is easy with MRS.

  PenRad—Good value, but service dropping off. Considered more effective for mammography than RIS, though has lowest-rated effectiveness among MIS vendors. Providers feel development is stagnant and some report physician workflow is difficult.

Are You Dense?

Breast density is a controversial issue that has recently come into the national spotlight. While it is a positive movement, it has implications for the women’s imaging market. Providers agree patients need to be notified and educated, but there is a delicate balance between enough information and resources. Historically, education has been one of the biggest obstacles related to women’s imaging, and breast density adds another layer of complexity for patients and providers.

One director said “I feel like the community in general needs to be more informed. . . . One example is the upcoming laws in our state for dense breasts. Patients are already confused, and this is adding to their confusion. We aren’t sure what processes to put in place to get this important information to our patients without bogging down what we already have to do. And because of reimbursements being so low, we are already really tight in our budget. We are spread very thin in women’s imaging, too. So the new laws are another bottleneck, although we agree they need to happen.”

There is some momentum toward a consistent, standard reimbursement for breast ultrasound, and some vendors are poised to take advantage of it. For instance, GE purchased the somo•v INSIGHT, and providers note that while the technology is excellent, the service from GE so far is subpar. The Siemens AVBS is not well adopted yet, but it allows providers flexibility by allowing them to use their Siemens general ultrasound unit. The SonoCiné ABS also offers automated breast ultrasound in tandem with the ultrasound unit already in place. Hologic has a partnership to sell Aixplorer, a general ultrasound with breastspecific applications.