FFDM: Is Europe geared up to adopt it? -- MEDICA - World Forum for Medicine

The introduction of full field digital mammography (FFDM) has led to an excitement among the medical fraternity and the mammography manufacturers all over the world. There has been plenty of scientific evidence, which proves the advantages of digital mammography over the conventional analog screening mammography systems. Although the FFDM did face some initial apprehensions by the medical fraternity, today they consider it to be one of the best things to happen in women's care. There has been a state of excitement surrounding the full field digital mammography systems since the time it was launched in 1999 in Europe by GE Medical Systems (presently GE Healthcare). Now with as many as nine players in the market who have already launched their products or presently are in the process of launching their systems, the FFDM industry can look forward to a bright future.

Screening Program in Europe

It is a well-known fact now, with scientific evidence proving that screening programs are one of the best and most effective methods to detect and hence fight against cancer. Countries like Sweden realised it long time back in the late 1970s to start pilot studies for cancer screening. The first nationwide screening program started in 1986. Looking at the successes in Sweden many other European countries also started the trials for the screening program. The Netherlands also has a successful screening program at a national level. Other countries like Belgium and the United Kingdom have followed these two countries and have taken active measures to implement breast-screening programs. The United Kingdom has a mobile mammography screening system, which moves from one site to another to cover a larger area for screening. The Scandinavian countries already have a well-established screening program but are now looking to digitise their equipment. Since the penetration of Picture Archiving and Communication Systems (PACS) is very high in these Nordic countries, they are very receptive to the digital mammography systems

Why Digital???

The technology used for FFDM systems hold great capability to improve the cancer detection rates. In FFDM, the film screen cassette is replaced by a single detector or a panel of charged couple detectors (CCD). The contrast resolution provided by the FFDM is much superior in comparison to the analog screen film systems. The radiologist can manipulate the image according to his convenience. As the image is obtained in digital format, the technician is saved from the work of processing the films and saving the records. With the use of FFDM, there is better and improved technology efficiency, which improves the productivity of the department as a whole. The time for the study in analog screening is long as the radiologist after looking at the image encircles the abnormality and then asks the technician to take additional views. In a digital environment, this process does not take time but it becomes necessary to establish a proper link between the radiologist and the technician. The long waiting time for the mammography examination is reduced as the patient throughput increases. Also when we compare the price of the screen film mammography systems and the FFDM, although SFM are much cheaper than their digital counterpart, the cost of operation and the patient throughput prove that digital mammography systems are much more efficient and profitable for the healthcare providers and the hospitals. The transition to soft copy and its integration with the digital workflow is giving the impetus for the growth of FFDM.

So what's the problem???

Although digital mammography systems are considered to be superior to the analog screen film mammography systems, there are certain radiologists who still consider the analog screening systems to be the gold standard in screening mammography. One of the reasons for this approach is the fact that the medical community is often very cautious about the adoption of new technology. Another reason why digital mammography market is being hindered is the lack of proper training provided to the technicians and the radiologists. Many of the early adopters of digital mammography are reportedly facing some hitch with the amount of storage space required for the digital images. Due to poor management of storage and other workflow requirements, they have been disappointed with the system. This has led to poor references among their peers who would be the future customers. What becomes important in this case is proper training and education about how to manage data and improve the workflow while using the digital system. This is basically the responsibility of the vendors to educate and guide the customer to make systems usage more efficient and easy to manage. One digital mammographic image can be as large as 50 MB. What is more important is the number of such examinations done in a day, which require massive space to store data. Hence archiving this huge data becomes very essential for proper future management. The proper management of this digital data can be done by integration with PACS

What does the future beckon??

After considering all the pros and cons of the FFDM systems, there is evidence that the system is going to be adopted across Europe at a steady pace. However, there are countries like France, which still prohibits the use of digital mammography systems in public healthcare screening. The Euref (European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services) is taking active initiatives in drafting guidelines, implementing training courses and provides certification of breast services in the European union. Once these guidelines are properly implemented, it is likely that the digital mammography market would grow tremendously as many hospitals and imaging centers would be looking to replace their analog systems with the digital systems. Also the number of players in the European market have increased since the time GE Health care first introduced its Senographe 2000DS. At present there are almost 9 players who have or by the end of 2005 would launch their FFDM products. This would lead to increase in competition thus lowering the price of the system to some extent but giving the customer a wide range of systems to choose from. What is important for the growth of this market is the early implementation of the screening programs and also the introduction of quality standards and guidelines for its use for screening purpose.

For further information please contact:

Katja Feick
Corporate Communications
+44 (0) 207 915 7856