Case Study | November 09, 2006

The All New Hoag Breast Care Center Is an Integral Part of the Sue and Bill Gross Women’s Pavilion.

Dr. Lynda Frye, breast radiologist, and Dr. Gary Levine, breast radiologist and medical director.

The new home for Hoag Breast Care Center in Newport Beach, CA, is the Sue and Bill Gross Women’s Pavilion. The Pavilion is a multimillion dollar medical facility dedicated to providing women with the highest quality healthcare services.
In keeping with this dedication, the Center decided to completely upgrade its mammography equipment. The older analog technology was eliminated and replaced with Selenia digital mammography systems from Hologic. “We already had two Selenia units at our previous site,” explained Gary Levine, M.D., breast radiologist and medical director. “We were very impressed with the technology and with Hologic as a company.” To date, four Selenia mammography systems have been installed in the new Center.
A Focus on Women’s Health
The decision to create a totally digital mammography center was a logical step in improving healthcare delivery for women. The decision to go with Hologic as their digital vendor was not as easy.
For many years Hoag had partnered with another manufacturer. They bought their systems exclusively from that company and were a committed and important show site. Despite the long history of working with the other company and the offer of very favorable pricing to go with the other company’s digital mammography acquisition systems and workstations, Hoag chose Hologic.
“One reason,” said Dr. Levine, “was the company itself, and its focus on women’s health issues. Hologic has a concentrated focus on women’s imaging and breast care. With other manufacturers, the mammography equipment was merely one item in a multifocused array of equipment.”
The increased contrast and much greater detail of digital images made the decision to move from analog to digital easier. “The images are simply superior,” said Dr. Levine. “The image quality is exceptional.”
Going Digital Saved Time
With the new Selenia technology, the time for interventional procedures, such as needle localizations and surgical biopsies, has been cut in half. Procedures that once took as long as 45 minutes can now be done in 20.
For some patients, shorter exam times can be very important. Dr. Levine points to several incidents of women having trouble being in compression for the time required on the old analog systems. “Remaining in compression for too long, motionless, in a warm room, some women get light headed, and even pass out. But the shorter procedure times with the Selenia system has completely eliminated this occurrence.”
According to Sandra Reynaga, CRT(R)(M), lead technologist at Hoag Breast Care Center, the Hologic FAST paddle technology ensures that the patients are more comfortable during mammography procedures. “The FAST paddles provide even compression across the breast. This is not possible with other equipment. Women are much more comfortable in the Selenia system. They are not complaining about the compression at all.”
Digital Improved Workflow
Since moving to the Hologic equipment, patient throughput has dramatically improved at Hoag. While exam times vary depending on the procedure, on one dedicated screening unit, the number of screenings performed in a day more than doubled, from 25 patients to 52. “That was our benchmark goal,” said Dr. Levine, “to see if we could double our throughput on a single system. And we reached it very easily.”
Reynaga points out that with digital there is no need for films and processing, so the women who come to Hoag are in and out much faster. “Our average screening time is down to six minutes,” she said, “and with digital our repeat rate is way down, because we know right away if an image is too dark or too light.”
Improvements in patient throughput have come without adverse affects elsewhere in the workflow.
“Some radiologists worried that digital mammography would dramatically increase the amount of time spent reading a mammogram,” Dr. Levine noted. “This simply is not true. There is more information to interpret with digital, but the improvement in quality outweighs the slight increase in image reading time.”
Dr. Levine adds that digital makes a big difference when incorporating computer-aided detection (CAD). "Digital technology makes the integration of CAD a seamless process. With digital the process is totally automated. The images are available immediately, and the CAD results are almost instantaneous."
Besides the improvements in patient throughput and image quality, the switch to Selenia has brought about another change for the better, one that has come as a pleasant and unexpected surprise to the technologists on staff.
With the old analog systems, repositioning the arm for different views required the technologist to physically lift the tube from one side to the other. The Selenia system is fully automated. Positioning and repositioning of the imaging tube no longer requires the physical effort needed in the past.
The Making of a Great Partnership
Since the switch to the Selenia systems, Hoag Breast Care Center has become a show site as well as a Hologic test site for evaluating the latest software and system upgrades.
“Upgrades are continuous,” said Dr. Levine, “and they are constantly improving the systems. Hologic has proven to be very open and receptive to ideas. Suggestions for improvements from doctors and technologists are quickly integrated into system upgrades.
“I can pick up the phone,” said Dr. Levine, “and call the president of the company, and actually get him on the phone. You can’t say that about many other companies. To me, that’s the sign of a great company. Hologic really listens, and they really care.”

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