ICE Magazine - October 2018

ADVANCING THE IMAGING PROFESSIONAL

OCTOBER 2018 VOL.2 NO.10

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Introducing

Centers of Excellence for Imaging Devices

In healthcare, Centers of Excellence advancing best practices, efficiencies, and outcomes are nothing new. Providers and consumers alike embrace breakthroughs from trusted institutions focused on advancing clinical treatments for various areas of human healthcare. While many Centers set new standards for entire industries to follow, they are only as good as the information they have, and a key source of this information is imaging devices. It all starts with an ultrasound, MRI or radiography device, all of which require regular maintenance and frequent repairs to assure clarity for clinicians making critical diagnoses.

Yet Centers of Excellence focusing on advancing technology, processes, and efficiencies for maintaining and repairing imaging devices have not existed.

and service standards. All Center of Excellence Quality Systems are ISO-13485:2016 certified.

Across all modalities and locations in the U.S. and Europe, Innovatus’ approximately 175 employees bring decades of knowledge and experience to healthcare providers, helping them achieve financial and performance goals in addition to confidence in imaging quality.

“By establishing and operating Centers of Excellence, we can increase our value to both providers and patients,” says Dennis Wulf, CEO of Innovatus Imaging. “Our focus is to give providers of all sizes the diagnostic quality needed to enhance lives while moving the industry forward. Imaging devices are not just tools of a trade, they are the foundation of life-saving diagnoses and treatment, and we take that very seriously.”

Until now.

The leaders of Innovatus Imaging, formed in 2017 as a result of the merger of Bayer Multi Vendor Service, Wetsco, and MD MedTech, recognized the need for Centers of Excellence to help advance the medical device repair industry toward a higher standard of repair processes and outcomes, and help lower ownership and operating costs for providers. In July 2018, they reorganized global operations into Centers of Excellence for ultrasound probe repair, MRI coil repair, radiography, and manufacturing with high concentrations of expertise, research, and development focused on improving efficiencies, performance, and advancing design

One way Innovatus continues to challenge the status quo and engineer greater efficiencies and technologies is by answering this simple question, “What if we could turn back time on imaging devices?”

According to Bill Kollitz, President and COO, “Our approach is to question everything. We start by asking ‘How could we generate substantial savings for imaging departments if we could extend the life of each device by 1 year, 3 years or more? This is what keeps our entire team motivated and excited about the impact we can have on healthcare and patients.”

Ultrasound Transducer Repair Center of Excellence Innovatus Imaging Center of Excellence for Ultrasound Probe Repair is founded on a 40-year heritage of leading the industry in quality processes, service and research, leveraging the expertise and vision of Dennis Wulf, CEO of Innovatus. The Center provides best-in-class repair services for all major probes and transducers while continuously researching and developing new ways to enable healthcare providers to diagnose faster and better.

Innovatus’ proprietary processes enable technicians to repair even “totaled” probes, helping providers avoid costly exchanges and replacements.

Currently, Innovatus offers a 100% guaranteed solution on 140 probe models through its TotalRepair program, which includes a 6-month warranty. To date, Innovatus has provided solutions for more than 1,100 probe models across all major OEM’s including Sonosite, GE Voluson E9 and Philips X series. Matt Tomory, VP of Ultrasound, a respected authority on ultrasound probe repair, is leading the customer experience and program development.

99% first-time fix rate with mobile inventory. Solutions engineered for best-in-class outcomes include end of life support, disaster recovery and backup, full interface support, CR cassette repair and plate replacement, on-site de-install and reinstall and networking/connectivity support.

The MVi-DR upgrade solution, a software and cassette-sized detector, seamlessly integrates and converts conventional x-ray room or portable units into digital systems, while enhancing efficiencies and versatility. Tracy Schrecengost, VP of Radiography and Europe Operations, leads the customer experience and program development for the Radiography Center of Excellence.

MRI Repair Center of Excellence Leveraging more than 25 years of manufacturing and repair expertise, the MRI Center of Excellence maintains a coveted 99% repair rate for all MRI coil makes, models, designs and field strengths. All activities are based on Innovatus’ reverseengineering repair process, assuring all coils are returned to customers at performance levels equal to OEM equipment.

Veteran technicians and engineers have improved processes to generate 40 – 60% savings over OEM exchange pricing.

Innovatus’ MRI coil repair program, which covers approximately 700 documented repair processes, extended warranties, an unmatched loaner inventory and exchange options is led by Joseph Habovick, VP of MRI.

Radiography Center of Excellence The Center of Excellence for Radiography Solutions provides imaging departments with support for all radiography needs, including film printers, computed radiography, consulting services and a retrofit system for the transition to digital radiography.

All products are backed by an industry-leading field service team, proficient on Fuji, Agfa, Carestream systems, and maintains a

Engineering, Testing, Regulatory Compliance and Manufacturing Center of Excellence In Denver, CO, Innovatus operates an FDA-registered engineering, testing, regulatory compliance and manufacturing site. Design, development and testing of specialty products and ultrasound arrays take place in this facility, in addition to Quality and Regulatory activities. Each year, millions of dollars are invested in research and testing to advance quality assurance, new product development, and regulatory compliance across Innovatus’ modalities of ultrasound, MRI and radiography.

Beyond product repair, engineers are engaged in various R&D projects and partner with multiple OEM’s, as well as top tier academic research institutions across the country.

“Our research and development work demands deep knowledge of the engineering, physics, and regulatory processes associated with new medical imaging devices. Applying this know-how and disciplined methodology to the repair industry ensures repaired products that meet OEM design intentions, which ultimately provides safe and effective products that physicians and patients deserve,” says Mike LaBree, CTO for Innovatus and co-founder of the former MD MedTech.

Innovatus Imaging also offers strategic advice and free audits of current inventory and savings potential from managing the life-cycle of ultrasound, MRI and radiography devices. For a free “What If…” analysis, email info@innovatusimaging.com or call our customer care team at 844.687.5100.

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contents

ICE FEATURES

October 2018

“When a woman walks into a room that’s semi-darkened and sees this nice lighting, it takes the edge off, and allows the technologist to better position her more easily, and this is key to image quality.“ –Pam Cumming

Professional The World of Breast Cancer 24 Spotlight 36 Screening Despite conflicting recommendations around mammograms, their utilization rates, and the subsequent, myriad implications for breast cancer screenings overall, medical device manufacturers have pressed on with technological solutions for improving the accuracy of imaging studies.

Leaving the big city of Memphis, Tennessee, and moving to a small town environment was just what the doctor ordered for Heidi Hordyk, MBA, MSHA, RT(R), CNMT, CRA. Hordyk is the director of radiology at Murray-Calloway County

Department Spotlight

The JPS Health Network clinical engineering department has four of it 25 employees dedicated to imaging. The imaging team services general and portable X-ray, fluoro, dental, ultrasound and nuclear medicine. The imaging service professionals are well trained through hands-on experience with their own equipment and training negotiated at the time of capital purchases.

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Hospital in Murray, Kentucky.

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contents

ICE DEPARTMENTS

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people

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10 Imaging News

24 Professional Spotlight

41 Career Advice

18 Webinar Wednesday

26 Department Spotlight

29 Mammography Product Spotlight

20 People on the Move

30 Mammography Gallery 34 Tools of the Trade

43 Imaging Matters 44 Imaging Service 101 46 Daniel Bobinski 50 Index

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ICE Magazine (Vol. 2, Issue #10) October 2018 is published by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to ICE Magazine at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.imagingigloo.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

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ADVANCING THE IMAGING PROFESSIONAL

Making our customers heroes™

Lowering Healthcare Facilities’ Total Cost of Ownership

ISO 13485:2003 Certified

Quality Management System

P: 866-586-3744 E: info@mysummitimaging.com W: mysummitimaging.com YouTube.com/SummitImaging

news

IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

Richardson Healthcare Announces ISO 13485:2016 Certification Richardson Healthcare, a Division of Richardson Electronics Ltd., has been awarded ISO 13485:2016 certification. This certification is an international standard that outlines the requirements for a quality management system specific to the medical devices industry.

This certification validates the consistent design, development, production and delivery of medical devices that are safe for their intended purpose. To be certified, Richardson demonstrated the ability to provide medical devices and related services that consistently meet customer and regulatory requirements.

“Quality is at the core of Richardson’s long history, and this ISO certification represents our continued commitment to that tradition,” said Pat Fitzgerald, executive vice president and general manager of Richardson Healthcare.

As part of the ISO certification process, Richardson participated in a thorough audit of its quality system processes, as well as

product quality requirements. The company follows these standards throughout all departments such as customer service, design, manufacturing, assembly and distribution.

“We have invested heavily in our health care manufacturing facility and are proud of the team’s accomplishment. We are able to incorporate many of the ISO 13485 best practices throughout the rest of our manufacturing operations making Richardson Electronics that much stronger in both the CT and power grid tube industry,” added Edward J. Richardson, chairman, chief executive officer, and president.

With this certification, customers can be confident that Richardson Healthcare is dedicated to maintaining the highest level of quality, efficiency and responsiveness required by the medical community. • For more information, visit www.rell.com.

ISS Announces New Facility Injector Support & Service (ISS) serves customers by providing professional and timely support and service for medical contrast injectors from a new facility in Winter Garden, Florida.

The facility was completed last year and allows business owners, Ryan and Jennifer Clarke, to bring their team together under one roof. The ISS team is known in the medical equipment industry for its biomedical technical support, preventative maintenance with calibration verifications, parts identification and sales, depot service and loaner injectors.

“ISS is dedicated to providing only the very best in contrast injector support and service,” according to a news release. • For more information, visit injectorsupport.com.

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ADVANCING THE IMAGING PROFESSIONAL

news

HealthMed360 Announces Launch Support Services Company HealthMed360 LLC has announced the launch of its new national company, specializing in system sales, services, parts and mobile rentals of CT, MRI, PET/CT and ultrasound.

HealthMed360 LLC has been formed by Robert Dakessian, the founder and former president/CEO of Genesis Medical Imaging.

In July, HealthMed360 moved into their 40,000-square-foot technical facility that includes system staging bays, a paint booth for cosmetic refurbishment, fully functional CT/

MRIs for training and parts testing and several electronics labs for coil, board, RF, computer and many other in-house repair capabilities.

“Our approach in starting Healthmed360 is to be the one-stop solution to all your imaging needs. We know how important lowering the cost of ownership has become, so we came up with solutions to provide a well-rounded program to support you in doing so,” says Dakessian.

HealthMed360’s focus is equipment sales, installation/deinstallation, system upgrades

and refurbishment, replacement parts and in-house parts repair, cold head replacements and the company has a mobile fleet for interim mobile rentals. HealthMed360 works with hospitals, imaging centers, clinics, asset management companies and independent service organizations. • For more information, visit www.HealthMed360.com

Technical Prospects Expands Product Offerings Technical Prospects, a leader in the medical imaging industry specializing in Siemens equipment, is proud to announce the addition of Siemens MRI and ultrasound modalities to its suite of imaging parts. The organization also continues to develop and expand its staff and offers a full support team for all Siemens models currently in stock, including the new additions.

Technical Prospects’ decision to introduce both MRI and ultrasound parts comes as a direct response to current customer needs and the growing medical imaging market. With the addition of these modalities, the

organization continues its dedication to quality-tested parts and support, holding more than a 99 percent on-time delivery rate and DOA rate of only 1.3 percent.

“No matter which Siemens part you order, customers can expect the quality, care and expertise Technical Prospects has provided for more than 20 years,” Jeremy Probst, president and CEO for Technical Prospects, said. “We are dedicated to providing our current and future customers with the best parts and support possible, and the addition of Siemens MRI and ultrasound modalities further enables us to do so.”

Technical Prospects’ quality-tested parts and support are available now for both MRI and ultrasound modalities. In addition, Technical Prospects can support a variety of parts’ needs and support requests for Siemens Definition AS, YSIO, Luminos Agile, Artis Zee and Multix Fusion models, and they offer more than 42,000 Siemens parts currently in stock. • For more information, visit TechnicalProspects.com.

TOMTEC’s Educational Platform Connects Professional Peers TOMTEC Imaging Systems GmbH optimized its educational platform and enhanced it with valuable content to assist clinicians with their day-to-day practices.

“With the makeover of TOMTEC ACADEMY (TTY) we want to create an educational platform that offers an added value for our customers,” states Gregor Malischnig, CMO at TOMTEC. “We are proud to have so many key opinion leaders as speakers for our webinars, eager to share their insights and knowledge with others. In the future we would also like

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to use the Academy as a tool for interaction.

Connecting peers, offering a place for knowledge exchange – these are the next steps for innovative communication and knowledge acquisition in a clinical environment, and TOMTEC will contribute to that.”

The webinars address basic to advanced clinical content, trends in imaging and diagnosis, and insights in efficient workflows; all of which are supported by real-life case studies. Further, there are open discussion rounds providing opportunities to exchange

questions and experiences with professional peers.

To assist with some day-to-day challenges, TOMTEC developed 1-minute video tutorials that support users on their mobile phone or web-browser on how-to navigate the software applications.

As support for trainings, video tutorials and webinars, users can download Quick Guides for all TOMTEC software applications.

In addition, publication lists with clinical validations are also available for users. •

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news Fujifilm, Indiana University Enter AI Research Agreement FUJIFILM Corporation entered a joint research agreement with Indiana University School of Medicine to develop the application of artificial intelligence (AI) in medical imaging diagnostic support systems, starting immediately.

Recent advances in diagnostic imaging system capabilities, such as multi-slice CT, has led to significant increases in the number of images that need to be interpreted.

Hence, a solution to efficiently read and interpret a large number of images is required. The application of AI technology to support physicians by detecting suspicious lesions in images, comparing results with prior studies and the implementation of semi-automated reporting is expected to increase significantly the efficiency of diagnostic medical imaging in patient care.

Fujifilm is developing image diagnosis support systems using AI technology to support the overall diagnostic workflow of physicians. In parallel with multiple inhouse development projects, Fujifilm is also proactively partnering with leading AI technology vendors to increase the disease coverage of its systems. The Indiana University School of Medicine is affiliated with Indiana University Health (IU Health), a medical health care system with 17 hospitals and approximately 33,000 employees in the United States.

The aim of this collaboration is to combine Fujifilm’s image processing and AI technology with the rich diagnostic and clinical expertise of the Indiana University School of Medicine to develop medical AI technology, while searching for a system optimized to support diagnosis workflow.

The initial scope of the research will include utilizing Fujifilm AI technology to segment and quantify muscle atrophy (sarcopenia) in body images as well as the detection and quantification of brain lesions in neuroradiology imaging exams.

Fujifilm is developing AI technology to support diagnostic imaging, medical workflow, equipment warranty and service by expanding the AI technology under the “REiLI” brand; providing solutions designed to meet market demands. Going forward, as clinical information is increasingly viewed in the context of big data, AI technology will be applied to develop products that meet the different and challenging needs of the health care industry.

Fujifilm aims to contribute to patient wellbeing through further improvements in healthcare efficiency and quality. •

MUSC, Siemens Healthineers form Strategic Partnership The Medical University of South Carolina (MUSC) and Siemens Healthineers have formed a first-of-its-kind strategic partnership with the mutual goal of advancing the quality of health care in South Carolina. The partnership will capitalize on the coupling of MUSC’s clinical care, research and education expertise with Siemens Healthineers’ engineering innovations and workflow-improvement capabilities.

“We are leveraging a longstanding relationship to reshape what we can both deliver in health care,” said David J. Cole, M.D., MUSC president. “Our nation is demanding that we address our fractured, costly and inefficient health care delivery systems. As the leading academic health sciences center in this state, MUSC’s purpose must be to drive the highest quality care for our patients at the lowest cost through commitment and partnerships.

In discussions with the Siemens Healthineers team, we discovered a high degree of alignment with these concepts, and we are very excited to have them move forward with us.

Our mutual goal is to not merely provide the best care possible for just our patients; we will define the new gold standard for others to follow.”

Specifically, this new agreement will fo12

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cus on driving performance excellence at MUSC and generating significant clinical and value-driven innovations in focused target areas including pediatrics, cardiovascular care, radiology and neurosciences.

“Ultimately, our goal is to enable health care providers to get better outcomes at lower cost. We will achieve that by empowering MUSC clinicians on this journey through four specific areas of focus – expanding precision medicine, transforming care delivery, improving the patient experience and digitalizing health care,” said Dave Pacitti, president of North America for Siemens Healthineers.

“These four core values of Siemens Healthineers are representative of the goals of our strategic relationship with MUSC, and we hope that the spirit of this flagship partnership will initiate a trend in value based care within the industry.”

For example, MUSC and Siemens team members plan to drastically reduce the time it takes for severe stroke patients to receive treatment. The national standard for stroke care sets the goal at less than a 90-minute average from entry to the hospital to the start of the surgery to open a blocked blood vessel.

While MUSC currently provides care for severe stroke patients well below that marker,

this partnership creates an opportunity to do even more, with the aim of setting new industry-wide standards and increasing the number and variety of good outcomes for patients post-stroke.

Another example of enhanced collaboration related to the new strategic partnership is the enhanced application of “digital twin technology.” A kind of artificial intelligence, a digital twin is a digital replica of a physical asset, process or system. A digital twin has been deployed to optimize the patient and family experience and maximize efficiency at the MUSC Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion, a new facility currently under construction on the Charleston peninsula. This digital replica enables planning teams to quickly determine the impact of changes that would be costly, if not impossible, to test in the real world, and helps them forecast how well possible workflow solutions or health innovations may actually work in that new facility.

Lisa Saladin, Ph.D., MUSC executive vice president for academic affairs and provost, sees the strategic partnership as capable of removing some systematic barriers to learning about and implementing health care innovations. • ADVANCING THE IMAGING PROFESSIONAL

news

EchoNous Unveils AI Station for Emerging Nursing Tools EchoNous has released the AI Station, a new docking system especially designed for emerging nursing tools, aimed at raising convenience for nurses and lowering costs for health systems. With the goal of reinventing what has historically been an afterthought medical device element, EchoNous commissioned an industrial designer and listened to clinicians and biomedical leaders at one of the nation’s top health systems.

“Everything from colors, to selection of materials, to the most minute of daily functions were reconsidered from a blank sheet of paper and through a fresh set of eyes,” said Niko Pagoulatos, COO of EchoNous. “Quite importantly we have integrated a ‘flexible electronic hub’ into the AI Station, aimed at both current and newly emerging AI functionality tasks.”

The AI station is a uniquely expandable platform that integrates EchoNous’ current intelligent tools, the Uscan bladder scanner and recently released EchoNous Vein, as well as devices currently in development. Together, this family of tools will powerfully utilize emerging artificial intelligence methods along with the company’s extremely miniaturized ultrasound platform to conquer everyday problems in health care.

Designed from the ground up, EchoNous reimagined every com-

ponent of the nursing dock, based on first-hand direct input from nurses and biomedical engineers in the creation of this new AI Station.

Key design elements include a more narrow lateral design for better maneuvering in tight spaces, a lower base height to fit underneath a hospital bed – enabling the entire cart to be closer to the patient, probe cords docked in an “inner channel” to prevent snagging and tripping, and importantly, the use of the best materials available in consideration of aggressive infection control techniques used in hospitals. •

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news

Renovo Solutions Ranks on Inc. 5000, Again Renovo Solutions announced that Inc. magazine ranked Renovo as No. 4,136 on its annual Inc. 5000 list, a ranking of the nation’s fastest-growing private companies. The list represents a unique look at the successful companies within the American economy’s independent small business segment. This is the third con-

secutive year that Renovo Solutions has appeared on the Inc. 5000 list.

The entire 2018 Inc. 5000 list is available now online at www.Inc.com “RENOVO’S strategy to deliver innovative and cost-effective service solutions to the health care and life science market has positioned us for continued expo-

nential growth. It’s a very exciting time for Renovo at this point in our company’s history. This incredible achievement would not be possible without the hard work and dedication of our employees, as well as through great relationships with our clients,” says Sandy Morford, CEO of Renovo Solutions. •

Parrish Healthcare Installs First Canon Medical Systems’ MR Theater in U.S. Patients at the Parrish Healthcare Center in Titusville, Florida, are the first to have access to enhanced comfort during Magnetic Resonance (MR) exams thanks to the installation of the nation’s first Vantage Titan/Zen Edition 1.5T MR Theater from Canon Medical Systems USA Inc. The new MR theater projects peaceful, virtual reality images onto a dome-shaped screen inside the bore and the Vantage Titan/Zen Edition 1.5T features exclusive Pianissimo quiet scan technology, which helps reduce acoustic noise during acquisition. The audio features of the MR system and visual

features of the MR Theater provide a truly engaging experience to help patients relax, enabling clinicians to complete MR exams quickly and capture the high-quality images they need for accurate diagnosis and treatment.

“We are proud to be the first in the U.S. to make this advanced imaging technology available to the people and communities we serve on Florida’s Space Coast,” said George Mikitarian, president/CEO, Parrish Medical Center, Parrish Healthcare. “The new MR Theater serves as another example of our commitment to

fulfilling our mission to provide healing experiences for everyone all the time.” •

Intermountain Healthcare Clinic Installs Digital X-ray Imaging Systems Alta View Clinic in Sandy, Utah installed three Carestream DRX-Ascend Systems to capture urgent care, orthopaedic, pediatric and other radiology exams.

The outpatient clinic is affiliated with Alta View Hospital and both facilities are members of Intermountain Healthcare.

“Our new outpatient clinic provides high-quality imaging studies for a variety of specialists and general practitioners who have offices near our campus. We capture X-rays of the chest, abdomen, joints, head, spine and extremities as well as long-length imaging studies to detect scoliosis,” said Travis Hartvigsen, the clinic’s imaging coordinator.

These systems capture more than 2,500 imaging exams a month and each DRX-Ascend system is equipped with a Carestream DRX Plus 3543 cesium iodide

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detector designed for high-resolution imaging.

DRX-Ascend systems are configured with an optional elevating float-top table that has a weight capacity of up to 650 pounds and accommodates patient types ranging from pediatrics to adults and patients who use wheelchairs.

Radiographers can capture images using the wall stand, table or tabletop.

“Our health care group evaluated DR systems from major suppliers and selected Carestream as our sole imaging provider for all DR rooms and portables

within our network of 22 hospitals and almost 80 clinics and imaging facilities,” according to James Jeppson, imaging quality and operations manager for Intermountain Medical Group. •

ADVANCING THE IMAGING PROFESSIONAL

news

AI in Medical Imaging to Top $2 Billion by 2023 The world market for machine learning in medical imaging, comprising software for automated detection, quantification, decision support and diagnosis, is set for a period of robust growth and is forecast to top $2 billion by 2023, according to a new report from Signify Research, an independent supplier of market intelligence and consultancy to the global healthcare technology industry.

Despite some of the earlier market hype, it is becoming increasingly clear that AI will transform the diagnostic imaging industry, both in terms of enhanced productivity, increased diagnostic accuracy, more personalized treatment planning, and ultimately, improved clinical outcomes. AI will play a key role in enabling radiology departments to cope with the ever-increasing volume of diagnostic imaging procedures, despite the chronic shortage

of radiologists in many countries.

Following the introduction of deep learning and affordable cloud compute (GPU) and storage, the pace of product development for AI-based medical image analysis tools is faster than ever before. Not only is this leading to increased product availability from a wider selection of vendors, but AI-based tools are gradually becoming more accurate and sophisticated with added functionalities.

According to the report’s author, Signify Research analyst Simon Harris, “The interest and enthusiasm for AI in the radiologist community has notably increased over the last 12 to 18 months and the discussion has moved on from AI as a threat, to how AI will augment radiologists. At the same time, there are emerging clinical applications where the use of AI has been shown to both improve clinical outcomes and deliver a return on investment

for health care providers. Examples include software to detect and diagnose stroke and analysis tools to measure blood flow in non-invasive coronary exams.”

“Up to now, the market has mainly been driven by the many start-ups and specialist companies who are applying machine learning to medical imaging, but the major medical imaging vendors are now ramping-up their AI activities. In the last year or so, we’ve also seen several of the world’s technology giants apply their AI expertise to medical imaging, most notably China’s Tencent and Alibaba. Over the coming years, the combined R&D firepower of the expanding ecosystem will knock down the remaining barriers and radiologists will have a rapidly expanding array of AI-powered workflow and diagnostic tools at their disposal,” Harris concluded. •

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news EOS imaging Achieves 100th Installation in U.S. EOS imaging, a pioneer of 2D/3D imaging and data solutions for orthopedics, has announced that the Methodist Dallas Medical Center installed an EOS system for low-dose, 2D/3D imaging of adult and pediatric patients. The installation marks the 100th system installed in the United States and the 10th system in Texas.

Methodist Dallas Medical Center is part of the Methodist Health System that operates 10 hospitals in Texas and more than two dozen Methodist Family Health Centers and Medical Groups. The Methodist Dallas Medical Center has developed a comprehensive neurological and spine program with surgical staff specializing in back pain, tumors, stroke conditions, spinal disorders and injuries as well as other neurological conditions.

“Achieving the 100th EOS installation in the U.S. and 10th in the state of Texas represents great milestones for our company that reflect the adoption of the EOS technology as a standard of care in all orthopedic points of care, including the large and high-growth community hospitals and private practices market,” said Marie Meynadier, CEO. “Addressing the needs of these care providers in the U.S. has been an important part of our commercial strategy in the last year, and we are happy to see that our investments are prompting an acceleration of the EOS adoption. Our dynamics in the U.S., our largest and fastest growing market, have reached an excellent pace and together with our momentum in all markets provide confidence in our growth.” •

FUJIFILM Sonosite Unveils Full Suite of iViz Point-of-Care Transducers FUJIFILM SonoSite Inc. has announced the launch of two new transducers for the SonoSiteiViz point-of-care ultrasound, now connecting a total of four to its hand-held diagnostic tool. Built-from-the-ground-up, iViz is a lightweight, miniaturized ultrasound system that fits right into your pocket. It can be taken anywhere, from a patient’s bedside to first response at a car accident. Now with the addition of the L25v and C60v transducers to its portfolio, the iViz enables clinicians the ability to view superficial applications such as ophthalmic, arterial, venous, lung and nerve as well as deeper applications such as abdominal and obstetrics.

“FUJIFILM SonoSite designs, manufactures and tests transducers in-house with real-world customer needs in mind,” said Diku Mandavia from FUJIFILM SonoSite Inc. “Our transducers exceed stringent military specifications for drop-testing so you can use them with confidence in the most demanding of environments. “ The all-new SonoSite L25v transducer is available for superficial applications such as ophthalmic, arterial, venous, lung and nerve.

The pocket-sized device offers superior 2D image quality with new exam presets.

The SonoSite C60v transducer is available for deeper applications such as abdominal, lung and obstetrics. The pocket-sized, one-hand operated device offers superior 2D image quality with new exam presets,

calculations and measurements suitable for acute care, internal medicine, obstetrics and veterinary. The C60v also features DirectClear Technology which elevates transducer performance by improving penetration and contrast resolution. •

Arkansas Children’s to Use TRIUX neo MEGIN (formerly Elekta Oy), a provider of magnetoencephalography (MEG) technology, announced that Arkansas Children’s Hospital has signed an agreement to acquire a TRIUX neo for functional brain imaging.

MEG is a completely non-invasive diagnostic device and directly measures magnetic activity generated by neurons in the brain. TRIUX neo is being used in the diagnosis and assessment of complex neurological disruptions and is able to detect and localize neural events with millimeter accuracy and with millisecond resolution. This detection capability is impactful when diagnosing patients across a wide spectrum including 16

ICEMAGAZINE | OCTOBER 2018

epilepsy, brain tumors, traumatic brain injury, post-traumatic stress disorder and autism.

“MEG is a state-of-the-art device that can precisely localize the source of seizures within the brain to help provide a life-changing cure for select children with uncontrolled epilepsy,” said Gregory Sharp, MD, chief of neurology at Arkansas Children’s, the state’s only pediatric health system. “This asset will lead to new understandings of neurologic disorders through research.”

TRIUX neo is scheduled to be installed by the end of 2018. • ADVANCING THE IMAGING PROFESSIONAL

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news

A special thank you to the companies that sponsored this month’s webinars.

WEBINAR WEDNESDAY

Because Quality Matters.

More Than 5,000 Register for Free Sessions

T

he 2018 Webinar Wednesday series is a huge success with more than 5,000 registrations logged and an average of 235 attendees per webinar. The webinars have covered a wide range of topics with many offering ACI-approved continuing education credit. The three webinars presented in August received high marks and met the high expectations of participants.

Product Procurement Study The PartsSource-sponsored presentation “The Time it Takes: A Study of Medical Equipment Product Procurement” delivered valuable content to 174 Webinar Wednesday participants.

The 60-minute webinar featured Ted Courtemanche, principal, Courtemanche Health Advisors, and Dan Brenner, PMP, director of strategic programs for PartsSource.

The webinar delivered the results of time motion studies from top hospitals and how to conduct a time motion study to understand your team’s true costs of parts sourcing. Attendees also learned the impact integration of systems can have to lower the overall cost of procurement.

Attendees shared positive comments in a post-webinar survey.

“This webinar was educational. With this I can assist my procurement team on how we can be more efficient,” Biomed S. Chand said.

“Excellent review of the company and the services they provide. Insightful infor18

ICEMAGAZINE | OCTOBER 2018

mation about the different types of purchase orders,” Clinical Engineering Manager P. Brown said.

“This webinar was extremely relevant to the parts procurement that many facilities are dealing with” said E. Willocks, BMET. Cost-saving Tips The Conquest Imaging-sponsored webinar “Why Do Ultrasound Probes Cost So Much?” was well attended and received positive reviews.

Bob Broschart, senior director of technical operations at Conquest Imaging, educated attendees regarding the high cost of ultrasound probes and how they can protect themselves and their organizations from these costs. The webinar attracted 196 attendees and earned a 3.9 rating.

“I enjoy most webinars that TechNation hosts but this session was particularly informative and relevant to my work. I appreciate the fact that the questions I sometimes muse over can finally be answered, especially the all-to-obvious query of ‘Why does it cost so much for ultrasound probe repair?’ that seems to always blindside us at the most inconvenient of times. Now I know,” Biomed D. Mishchuk said.

“This Webinar Wednesday was a great in-depth look into how the transducers we work with everyday are designed, constructed and why it costs so much to make/repair them. As usual, the present-

er was very knowledgeable on the subject with background experience on several different sides of healthcare technology management. We can’t wait for another great Webinar Wednesday,” said Image Specialist R. Marek.

“The webinar provided valuable information which I can apply in my current role. Thank you so much,” said Biomedical Service & Support Manager G. Myers.

“Very convenient to receive in-depth training at my jobsite. I hope that I can pass on this information to nursing staff,” Biomed Engineer M. Brunemeier said.

The Webinar Wednesday series continues to receive high marks from attendees.

“Webinar Wednesday is a great way to bring your department together after lunch to gain knowledge and wind down,” Corporate Director of Clinical Engineering B. Gould said.

“The topics discussed in the Webinar Wednesday sessions are always well done, informative and useful,” Imaging Manager D. Parker said.

“I am grateful for the training facilitated by the TechNation team, you guys provide us with a great source for keeping current with changes in technology,” said Equipment Specialist L. Mezquia.

“This is the best way to stay on top of the industry’s ever-changing pieces. If you want to stay in the loop get on the webinars,” said Senior Biomed Engineer G. Haungs.

“This is the best source for CE credits I ADVANCING THE IMAGING PROFESSIONAL

have found! Webinar Wednesday helps keep me current and provides new knowledge,” said K. Walker, Advanced Imaging Service Engineer.

“The Webinar Wednesday series is a great resource for biomed techs that have a difficult time attending vendor schools. This provides an avenue for staying up on the resources out there,” Biomed M. Glover said.

“Webinar Wednesday is the ‘glue’ for HTM professionals that holds together the academic thirst for information and the ability to apply the knowledge to enhance the patient experience,” Senior Director C. Nowak said.

“Webinar Wednesdays help me keep up to date with what’s happening in the HTM field. I recommend these webinars to all my co-workers and biomed students,” said C. Villafane, Webmaster.

“Webinar Wednesday – an hour-long presentation on various topics that provide information to various hospital staff giving new information, tools and ideas for the improvement of various facility mission goals,” explained Biomed Department Manager K. Ongchango. ICE For more information about future webinars and recordings of previous webinars, visit WebinarWednesday.live.

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ICEMAGAZINE

19

PEOPLE ON THE MOVE

By Matt Skoufalos

1

Varian of Palo Alto, California has seen its president and CEO, Dow R. Wilson, added to the board of directors of the U.S.-India Strategic Partnership Forum (USISPF). The forum promotes bilateral trade, and is headquartered in Washington, D.C. with offices in New York, Silicon Valley, Mumbai and New Delhi.

2

Metro Health has promoted its chief medical officer, Peter Hahn, to president and CEO, succeeding the retiring Michael Faas. A pulmonologist and former Mayo Clinic physician, Hahn served in various health care leadership roles in Oregon.

3

OncoTracker Inc. has named James Kuo, MD, MBA, its CEO. Kuo is a biotech executive with more than 20 years of experience in corporate development, finance and licensing.

He was formerly managing director at Athena Bioventures, has been chairman and CEO at Synthetic Biologics and BioMicro Systems, and was managing director at HealthCare Ventures and associate director of corporate licensing and development at Pfizer. Kuo currently chairs the boards of ImmunoPrecise Antibodies and Monarch Labs.

4

BD (Becton, Dickinson and Company) has added Jeffrey W. Henderson to its board of directors. Henderson is the non-executive chairman of the board of Qualcomm Inc., serves on the boards of directors at FibroGen Inc. and Halozyme Therapeutics Inc., and is an advisory director to Berkshire Partners LLC. He was CFO of Cardinal Health for a decade, and spent seven years at Eli Lilly & Co. as a vice president, corporate controller and president and general manager of its Canada operations. Henderson also spent a decade at General Motors Corp.

5

ROX Medical has named Mike MacKinnon as its CEO. MacKinnon joins ROX from Philips North America, where he was head of sales for image-guided technologies. MacKinnon joined Philips through the acquisition of Volcano, where he was president and CEO. Prior to AtheroMed, MacKinnon held leadership positions with Hansen Medical, Access Closure and FoxHollow Technologies.

20

ICEMAGAZINE | OCTOBER 2018

02

6

FUJIFILM SonoSite Inc. has named Takaaki Ueda its CEO and chair of FUJIFILM SonoSite Inc. Ueda is also president and CEO of FUJIFILM Medical Systems U.S.A. Inc. and FUJIFILM New Development U.S.A. Inc. Rich Fabian has been promoted to president COO of FUJIFILM SonoSite Inc. subsequent to the reassignment of Masayuki Higuchi to Tokyo as deputy general manager of global finance and accounting at FUJIFILM Corporation. Ueda was previously general manager of the Fujifilm global endoscopy systems division; Fabian joined the company in January 2017 from Philips Healthcare.

7

TRIMEDX has named Ramy Boghdadi executive vice president of strategic client value and relationships. Boghdadi has 20 years of experience in leadership roles at Siemens Healthcare IT, GE Healthcare, IMS Health, Berlex Laboratories and Accenture.

8

McKesson Corporation promoted Brian S. Tyler, chair of the McKesson Europe management board, to president and COO of McKesson. Tyler has been president of McKesson North American Pharmaceutical Distribution and Services, McKesson U.S. Pharmaceutical, McKesson Medical-Surgical and McKesson Specialty Health, as well as executive vice president of corporate strategy and business development. He holds doctorate and master degrees from the University of Chicago.

Additionally, Nick Loporcaro, president of McKesson U.S. pharmaceutical and specialty solutions, has departed the company.

9

The InterMed Group of Alachua, Florida has added Kevin Ferm to its business development team. With 16 years of experience in the medical devices industry, Ferm started in 2002 with University Hospital Services (UHS) where he was an account manager and sales executive, and later worked for RF Technologies, GE and SPBS.

10

Bayer has named Patrick Lockwood-Taylor its regional president of consumer health, North America. Most recently, he was CEO of the Oneida Group. Lockwood-Taylor succeeds Natalie Bartner, and will become a member of the Bayer consumer health executive committee.

ADVANCING THE IMAGING PROFESSIONAL

09

10

11

Johnson & Johnson has promoted its CFO of the North America Hospital medical devices business, Chris DelOrefice, to vice president of investor relations. DelOrefice has held various leadership positions across all three segments of Johnson & Johnson. He holds a Villanova MBA.

12

Imaging Endpoints of Scottsdale, Arizona promoted senior vice president of compliance and regulatory affairs Manual Ramirez to chief compliance and regulatory affairs officer.

13

Hologic Inc. has promoted Chief Accounting Officer Karleen Oberton to CFO. Oberton joined Hologic from Immunogen in 2006 as corporate controller; previously, she had been a senior audit manager in the Ernst & Young life science practice, and in Arthur Andersen’s high technology practice. An active CPA, Oberton holds a bachelor’s degree in business administration from Merrimack College, where she is a member of the leadership council.

14

ViewRay Inc. has named Scott Drake its president, CEO, and a member of its board of directors, succeeding the outgoing Chris A. Raanes, with Shar Matin succeeding outgoing COO Doug Keare. Joining Drake on the board is Keith Grossman, past president and CEO of Thoratec Corporation and of Conceptus Inc. Drake is the former president and CEO of Spectranetics, which was acquired by Royal Philips in 2017, and currently chairs the board of AtriCure Inc. and of JustRight Surgical. Matin is a former COO of Spectranetics, who has also worked for Guidant (now Boston Scientific).

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The Mariottsville, Maryland-based Bon Secours Health System and Cincinnati, Ohio-based Mercy Health will merge this fall under the leadership of President-CEO John M. Starcher Jr.

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ICEMAGAZINE

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ADVANCING THE IMAGING PROFESSIONAL

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people

By K. Richard Douglas

PROFESSIONAL SPOTLIGHT Making a Difference; One Patient at a Time Heidi Hordyk, MBA, MSHA, RT(R), CNMT, CRA

L

eaving the big city and moving to a small town environment was just what the doctor ordered for Heidi Hordyk, MBA, MSHA, RT(R), CNMT, CRA. Hordyk is the director of radiology at Murray-Calloway County Hospital in Murray, Kentucky. Hordyk grew up, and lived most of her life, in Memphis, Tennessee.

“I first became interested in health care as a teenager. I became involved with the Red Cross as a ‘Volunteen’ and worked for four summers in a hospital OB unit during high school,” she remembers.

“I thoroughly enjoyed the health care environment and helping patients in many different ways. I spent the next several years in college taking generic pre-med science curriculum courses trying to decide what aspect of health care I wanted to pursue as a career. I considered nursing, physical therapy and many other possibilities before my father had some imaging tests done and told me to check out nuclear medicine,” Hordyk says.

She says that after investigating the profession and visiting the local college, she found that imaging and nuclear medicine were the perfect match for her aptitude for science and mathematics and desire to work in health care. That was the first step in her imaging career.

She enrolled at Baptist College of Health Sciences (BCHS) in Memphis, Tennessee, in its inaugural baccalaureate program, 24

ICEMAGAZINE | OCTOBER 2018

to focus on nuclear medicine.

“The third year at BCHS focused on radiologic technology and the fourth year on nuclear medicine leading to dual certification upon graduation. After graduating and beginning work at Baptist Memorial Hospital (BMH), I took advantage of a cohort program with Central Michigan University to obtain a Masters in Health Administration at BCHS,” Hordyk says.

“As a ‘professional student,’ when health care began to undergo major changes, I decided to go back to school again and got my MBA from Murray State University in 2013,” she adds.

Hordyk’s career in imaging began at Baptist Hospital in Memphis as a technologist in nuclear medicine; then in nuclear cardiology.

“After living all my life in Memphis, I decided that I wanted to try life in ‘small town USA.’ I accepted a position in Murray, Kentucky, at Murray-Calloway County Hospital as a nuclear medicine technologist in 2001,” she says.

She says that at MCCH, she found a facility that was an integral part of the community and where she could take on additional responsibilities.

“In 2005, I was given the task of implementing the first PACS at MCCH and became the PACS administrator. When the director retired in 2013, I became the director of radiology. I have enjoyed the opportunity to make a difference in a community hospital,” Hordyk adds.

Hordyk says that she has always been very comfortable with project management and caring for patients – all areas that her education prepared her for.

“I thoroughly enjoyed the health care environment and helping patients in many different ways. ” -HEIDI HORDYK

“However, moving into the director role has been a challenge in leadership and people management that I have found to be a continual learning experience,” she says.

“One project that I am proud of is the success my team has had in improving our department’s patient satisfaction scores,” Hordyk says.

“We have always prided ourselves on patient care, and the personal touch we can provide to our community, but for years our scores stayed around the 60th percentile. Two years ago, we made a concerted effort to improve the scores with a goal of maintaining scores above the 80th percentile. I’m proud of the team’s efforts – 9 months into the 2017-18 year, the entire radiology department’s scores are at the 93rd percentile,” she says enthusiastically.

ADVANCING THE IMAGING PROFESSIONAL

people

Favorite part of being an imaging professional?

Making an impact on a patient’s life, helping them through a difficult time.

Heidi Hordyk and her team are on a mission to improve patient satisfaction.

GET TO KNOW THE PRO Favorite book Medical related: “Gesundheit!” By Patch Adams MD Heidi Hordyk and Tamara Burchett have earned CRA certification.

Away from work, Heidi Hordyk enjoys traveling.

She has won her hospital’s MVP award for having a positive impact on its safety culture and was the MCCH Employee of the Month in January 2016.

She is an alumni board member for the Baptist College of Health Sciences and was elected vice-president last year. She is also a Murray Calloway County United Way board member and was nominated as secretary this year.

Travel and Leisure Not everything for Hordyk is work related. She has enjoyed some adventures that have taken her far from her Kentucky home.

“I enjoy reading, traveling and learning about other areas of the U.S. and world. The most recent memorable trip was last year when we took a cruise

WWW.IMAGINGIGLOO.COM

from L.A. through the Panama Canal to Miami. Visiting Mexico, the engineering marvel of the Panama Canal, Nicaragua, Guatemala and Columbia was very educational,” she says.

On the job, she has always enjoyed interaction with patients, which has become less common these days.

“Health care, specifically imaging, continues to be a rewarding career and I thoroughly enjoy making a difference, one patient at a time. The most difficult part of becoming a director has been a reduction in hands-on patient care, but I look forward to the continuing challenges of leadership,” she says.

Those patients can rest-assured that Hordyk’s work still has a positive impact on them, whether in person or not. ICE

Personal: “The Hero Effect” by Kevin Brown Favorite food Pechuga Frita ( Mexican dish at local restaurant) Hidden talent Played clarinet in the marching band through college at the University of Memphis – Go Tigers! Not so great a player anymore though.

What’s on my bench?

• “Don’t worry, be Hoppy” frog mug holding my pens •

Holiday cards with pictures of my staff and their families

•

“I Love Memphis” Baptist College of Health Sciences thermos

•

An expensive paperweight – a blown quench valve from when our MRI spontaneously quenched last year

•

“Stress Away” essential oil for the days when I need it!

ICEMAGAZINE

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people

DEPARTMENT SPOTLIGHT JPS Health Network Imaging Team

J

ust west of Dallas, in north central Texas, sits the city of Fort Worth. It was once a trading post for cowboys. Today, it is much different. From the Kimbell Art Museum to the Fort Worth Zoo, the city offers things to do for Tarrant County residents and visitors.

For more than 100 years, the JPS Health Network has provided medical services to the residents of Tarrant County. The level 1 trauma center also offers comprehensive stroke and cancer care.

With more than 40 primary and specialty health centers (578 beds) and 370 emergency visits a day, the JPS Health Network is the eighth largest employer in Fort Worth.

JPS currently has two MRIs (one more will be installed pending construction completion), 16 portable X-rays, 16 rad rooms, four trauma bays with a rad system in each, three nuclear medicine cameras, six CTs, one EP lab, one cath lab, one hybrid OR (pending installation), five C-arms, five mini C-arms, over 50 ultrasound units and multiple dental X-ray units.

To keep the diagnostic process of treatment working for all patients, the health network’s clinical engineering department has 26

ICEMAGAZINE | OCTOBER 2018

four of it 25 employees dedicated to imaging.

The imaging team services general and portable X-ray, fluoro, dental, ultrasound and nuclear medicine.

The imaging service professionals are well trained through hands-on experience with their own equipment and training negotiated at the time of capital purchases.

“We set aside annual budget dollars to help cover the cost of training. Additionally, we work with our vendors to come up with creative ideas on how to get training,” says Joshua Virnoche, MBA, CBET, manager of clinical engineering.

“Recently, purchasing/negotiating training in with the capital purchase of equipment has worked really well. We’ve also had on-site training in our facility using our own equipment, which allows us to train multiple technicians for around the same cost as sending one,” he says.

Virnoche says that the team does not currently service MRI/CT/invasive labs in-house.

“JPS is a level I trauma center in Dallas-Fort Worth. We are also a comprehensive stroke center and have the AMI and Sepsis Gold Seal of approval. In critical situations, our vendors can have parts to the hospital within a few hours, where it would take quite a bit longer if we had

By K. Richard Douglas

to purchase parts ourselves,” Virnoche says.

“Additionally, with just four staff members, they would be stretched incredibly thin to cover these items, and the training is cost-prohibitive when we’re considering stewardship of our taxpayer’s money,” he adds.

The team takes an active role in the purchase and planning for new equipment.

“We are involved in the capital procurement process in terms of life cycle planning. Over the last few years, we have worked really hard to gain a level of confidence and trust from our internal customers who now consult us for nearly everything,” Virnoche says.

He says that the team has a standing meeting with the design and construction department to keep abreast of all the upcoming projects.

“Additionally, we often review blueprints of installations before final approval. The clinical engineering department owns all service level agreements in the organization, and we work closely with the equipment owners to leverage service and capital costs to ensure we get the best cost for our organization,” he says.

Virnoche says that on anything that is not covered by a service level agreement, they ADVANCING THE IMAGING PROFESSIONAL

people

The JPS Health Network Imaging Team includes (left to right) Hunter Harren, Ray Pierce, Jai Joshi and Raul Rosado.

“We are involved in the capital procurement process in terms of life cycle planning. Over the last few years, we have worked really hard to gain a level of confidence and trust from our internal customers who now consult us for nearly everything,” —JOSHUA VIRNOCHE, MBA, CBET source parts and perform most repairs themselves.

“Our team is fully trained on all of our ultrasound devices, general rad rooms, nuclear medicine, contrast media injectors, portable X-rays, dental X-rays, C-arms, as well as a few other lower acuity items. Over the next few years, our service model will develop into a completely first call/first look agreement, where we lean on our internal team to address and assess all issues, with critical WWW.IMAGINGIGLOO.COM

backup labor supported by the vendors. Currently, we just provide vendor management on all MRI/CT/IR modalities,” Virnoche says.

Ultra Stable Ultrasound The group has learned that taking on a new project can be a learning experience.

“We work on the de-installation and decommissioning of old equipment, as new capital is purchased,” Virnoche says.

“Recently, our team was able to work with one of our vendors on the installation of a new nuclear medicine camera. This particular camera was tucked away on the thirdfloor of our main campus, so the old equipment had to be navigated through many small corridors and elevators, and around patient care areas to get the equipment out,” he says.

He says that the installation equipment had to go the same route and that the total installation took nearly three weeks.

Raul Rosado, the imaging team lead, says the thing that stuck out most about the project was, “you get to learn about the function of the equipment, and how it all goes together, before it’s ever even turned on. During installs you get to see places in the hospital

you’ve never seen before, and learn about the structure of the buildings before you drill into it.”

“Additionally, we have worked over the last few years with the upgrade from HDD to SSD for our ultrasound equipment,” Virnoche says.

“We had run into issues where the HDD were failing constantly causing equipment failure, slow boot speeds and lost data. We went from HDD issues 1-2 times per month, to 1-2 times per year. The upgrade to SSD has made the ultrasound much more stable, with much quicker boot speeds, improving the quality of life for end-users,” Virnoche adds.

He says that the imaging team also took on a project to upgrade all of the ultrasounds to wireless rather than wired. The project took nearly a year, but allows the end-user to download images wherever they are, rather than having to return to “homebase” to plug in and download.

“Another huge quality of life upgrade for our users,” Virnoche says.

And, that is what the imaging team at JPS Health Network does; they contribute to a better quality of life for patients and clinicians. ICE ICEMAGAZINE

27

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products

PRODUCT SPOTLIGHT Global Mammography Market Continues Upward Trend

S

everal research groups predict continued growth for the global mammography market.

The global mammography systems market will exceed $2 billion by 2023, according to Zion Market Research.

According to Zion Market Research, the global mammography systems market was valued at approximately $1.68 billion in 2017 and is expected to generate revenue of around $2.69 billion by the end of 2023, growing at a CAGR of around 8.1 percent between 2017 and 2023.

A report from MarketsandMarkets predicts that the breast imaging market is expected to reach $4.14 billion by 2021.

Transparency Market Research reports that the global mammography systems market was valued at approximately $1.5 billion in 2016 and is anticipated to expand at a CAGR of over 8 percent from 2017 to 2025 to reach $3.1 billion by 2025.

Mammography systems involve the use of low-energy ionizing radiations, such as X-ray, to detect unsuspected cancer. Health care organizations have undertaken numerous screening programs over the years to decrease cancer-related mortality rates, worldwide. Health care organizations, such as American Medical Association, the National Cancer Institute and the National Compre-

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hensive Cancer Network recommend the use of routine screening mammograms for women above the age of 40 years to improve cancer screening participation to avoid the risk of developing breast cancer.

The rising health care expenditure, booming health care industry and growing demand for regular monitoring are some of the pivotal factors expected to propel the demand for mammography systems. Also, growing government initiatives to improve clinical interpretation and increase access to mammary gland cancer screening systems is one of the crucial factors expected to drive the demand for mammography systems over the forecast period. However, radiation exposure risks and generation of false positive or negative results are expected to impede market growth.

Based on the type, the market for mammography systems is segmented into analog mammography systems, digital mammography systems and breast tomosynthesis systems. The digital mammography systems segment is further sub-segmented into computed radiography systems and digital radiography systems. The digital mammography systems segment is expected to dominate the global mammography systems market during in the forecast period. The growing demand for technologically advanced breast cancer screening and diagnostic equipment is one of

the crucial factors expected to drive the market in the coming years. The presence of favorable reimbursement policies and growing government support in improving screening results are also some of the key attributes that account for the largest revenue share of the global mammography market.

Based on technology, the market is segmented into 2D mammography, 3D mammography and combined 2D and 3D mammography. The 2D mammography segment is expected to dominate the global mammography systems market. The 3D mammography system market is the fastest growing product segment. The presence of the Medical Imaging Modernization Act, 2015, is one of the pivotal factors up surging the demand for 3D systems in the coming years. The rising demand for highly specific screening equipment to reduce call-back visits, false alarm and missed cancer diagnosis is also one of the main factors contributing to the increasing demand.

North America is expected to dominate the global mammography systems market.

This is due to the increase in the prevalence of breast cancer among women in U.S. region.

An increase in a number of mammography units in hospitals and diagnostic centers along with the number of units per million women in North America has led to the growth of mammography systems market. ICE

ICEMAGAZINE

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products

FUJIFILM Medical Systems U.S.A. Inc. ASPIRE Cristalle FUJIFILM Medical Systems U.S.A. Inc. presents its latest advancement in digital mammography, the ASPIRE Cristalle, now with digital breast tomosynthesis (DBT) option and state-of-the-art dose-saving Hexagonal Close Pattern (HCP) image capture technology for exceptional image quality for all breast types. The newest solution also features innovations to optimize dose and contrast based on individual breast composition, along with intelligent image processing and fast acquisition time. The ASPIRE Cristalle is engineered with a focus on every detail of the patient experience helping ensure patients receive personalized imaging and noticeably improved comfort with Fujifilm’s patented Comfort Paddle. • For more information, visit www.fujimed.com.

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ADVANCING THE IMAGING PROFESSIONAL

products

GE Healthcare Senographe Pristina + Pristina Dueta Senographe Pristina was designed to revolutionize the patient experience to make mammograms more comfortable for women. Its new features, including rounded corners instead of sharp edges that used to poke patients’ ribs and armpits, a thinner image detector and comfortable armrests for women to lean on instead of conventional handgrips to help women relax their pectoral muscles during the exam, help to reduce pain associated with the exam. Senographe Pristina also offers women the opportunity to use Pristina Dueta, the industry’s first patient-assisted compression remote control device that allows patients to control their breast compression during a mammogram under the guidance of a technologist. Senographe Pristina’s DBT delivers superior diagnostic accuracy at the same low dose as a 2D mammography exam, the lowest patient dose of all FDA approved 3D mammography systems. •

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products

HOLOGIC 3Dimensions Hologic’s newest innovation in breast cancer screening, the 3Dimensions mammography system, reinvents breast tomosynthesis, delivering the fastest, highest resolution 3D images,1 a mammogram clinically proven to be more comfortable2 and enhanced workflow. Armed with Clarity HD high-resolution 3D imaging, the system offers the same 70-micron pixel size as FFDM, you can detect more invasive cancers with confidence.3 When paired with Intelligent 2D imaging technology, the system delivers a comprehensive, natural-looking synthesized 2D image, allowing you to enjoy unprecedented clarity, contrast and detail at a lower dose. With the addition of the SmartCurve breast stabilization system, the 3Dimensions system also increases patient comfort2 without compromising on speed, dose or accuracy. • 1. Data on file and from public sources, 2017 2. Smith, A. Improving Patient Comfort in Mammography. Hologic WP-00119 Rev 003 (2017).

3. Results from Friedewald, SM, et al. “Breast cancer screening using tomosynthesis in combination with digital mammography.”

JAMA 311.24 (2014): 2499-2507; a multi-site (13), non-randomized, historical control study of 454,000 screening mammograms investigating the initial impact the introduction of the Hologic Selenia® Dimensions® on screening outcomes. Individual results may vary. The study found an average 41% (95% CI: 20-65%) increase and that 1.2 (95% CI: 0.8-1.6) additional invasive breast cancers per 1000 screening exams were found in women receiving combined 2D FFDM and 3D™ mammograms acquired with the Hologic 3D Mammography™ System versus women receiving 2D FFDM mammograms only.

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ADVANCING THE IMAGING PROFESSIONAL

products

SIEMENS HEALTHINEERS MAMMOMAT Revelation The MAMMOMAT Revelation mammography platform from Siemens Healthineers has new features that expand precision medicine and improve patient outcomes. Wide-angle tomosynthesis provides the industry’s highest depth resolution for better tissue separation, increased cancer detection and reduced call-backs. Automated breast density measurement at the point of care offers immediate risk stratification.

HDTomo Biopsy enables one-click targeting of suspicious areas with a +/-1mm accuracy and the InSpect integrated specimen imaging tool provides imaging plus real-time review of samples at the workstation, improving workflow, shortening compression time and reducing patient discomfort. TICEM (titanium contrast-enhanced mammography) serves as a cost-effective alternative to MRI. •

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products

TOOLS OF THE TRADE RADCAL Patient Dose Calibrator PDC

T

he Joint Commission: Accreditation, Health Care, Certification (JCAHO) recently released new requirements regarding accuracy of Dose Area Product (DAP) or (KAP) meters as applied to fluoroscopy applications. While this is a new requirement, Radcal has provided a solution to independently measure DAP and KAP for over 10 years. This solution is the Radcal PDC (Patient Dose Calibrator). The PDC is a reference class instrument for “field calibration” of patient dose measurement and control systems. The PDC is simple to use, displaying DAP (KAP) and dose rate during an exposure then automatically switching to display accumulated DAP (KAP) and dose on exposure completion. ICE For more information, visit radcal.com/dapcheck-pdc/.

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ADVANCING THE IMAGING PROFESSIONAL

the medical product support network “An excellent resource.

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ADVANCING THE IMAGING PROFESSIONAL

Breast The World of

CANCER

SCREENING B Y M A T T S K O U FA L O S

M

ammography is the oldest and most widely available imaging modality for breast cancer detection. Developed by French engineers Jean Bens and Emile Gabbay, it emerged in the 1960s as the “senographe,” a lowdose X-ray technology for the imaging of breast tissue. Mammography is particularly effective for patients aged 50 to 69, according to the National Cancer Institute (NCI), but it’s also historically been difficult to overcome the knocks against it.

For a start, the examination, while valuable to physicians for identifying tissue abnormalities, is physically uncomfortable. Mammograms are administered via paddle comWWW.IMAGINGIGLOO.COM

pression of the breast, which more uniformly distributes its tissue for study. But patients frequently report discomfort with the procedure for a variety of reasons, from its interaction with their personal physiology to psychological anxiety around the entire experience of being scanned.

Furthermore, at least 10 percent of women tested will receive a false-positive exam result; that figure climbs to 50 percent of all women among those who complete annual screenings for a decade. A smaller subset (seven to 17 percent) will even undergo tissue biopsies unnecessarily. Additionally, mammography can fail to detect invasive breast cancer in six to 46 percent of exams, particularly “rapidly growing interval tumors,” which can emerge between regular mammograms, and in women with dense

breast tissue, according to the NCI. As such, although early cancer detection can save lives, mammograms are on the decline in the United States. In 2007, the journal Cancer noted that, by the year 2000, some 70 percent of American women had reported having undergone a mammogram within two years of being surveyed. By 2005, that number was falling, and in 2009, the U.S. Preventative Services Task Force (USPSTF) modified its screening guidance to stipulate that mammograms are most useful for women aged 50 to 74, and then only every other year. That contradicted the historical position of the American College of Radiology (ACR) that annual mammograms should be routine for women aged 40 and older; in 2015, the American Cancer Society seemingly split the difference, recommendICEMAGAZINE

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Tracy Accardi,

Global vice president of research and development, breast and skeletal health solutions for Hologic

Pam Cumming,

Director of product marketing for Women’s Health at Siemens Healthineers North America

Agnes Berzsenyi,

President and CEO of GE Healthcare Women’s Health

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ICEMAGAZINE | OCTOBER 2018

ing annual screenings for women aged 45 to 54, and biennial mammograms thereafter.

Despite the conflicting recommendations around mammograms, their utilization rates, and the subsequent, myriad implications for breast cancer screenings overall, medical device manufacturers have pressed on with technological solutions for improving the accuracy of imaging studies. One of them is the Senographe Pristina, a mammography system introduced by GE Healthcare in 2017.

The company touts its women-led design team as having driven critical ergonomic improvements to the traditional mammography system that increase patient comfort, thereby improving the quality of studies conducted, and possibly mitigating the number of false positives and examinations deferred.

“While there are multiple factors impacting a woman’s choice to get screened regularly, improving the patient experience is one factor where we can make a difference,” said Agnes Berzsenyi, president and CEO of GE Healthcare Women’s Health.

Senographe Pristina features a number of structural improvements over legacy mammography systems. These include a bucky (breast platform) with rounded corners, as sharp-edged trays on earlier devices could uncomfortably poke patients’ ribs and armpits; and a thinner image detector “that requires less hard, cold material touching the patient,” Berzsenyi said. Its biggest ergonomic innovation may be the replacement of traditional handgrips with arm and headrests. As studies are conducted with women facing the machine, the arm and head rests allow them to relax their muscles during the exam, which Berzsenyi said helps improve image quality as well as patient comfort.

GE Healthcare also developed the Pristina Dueta wireless remote, which enables “patient-assisted compression” during a mammogram. In short, the patient is allowed to dial in the intensity of breast compression with the help of a technologist. Berzsenyi said this feature helps to mitigate patient discomfort, as does installing the device within a sensory suite designed to reduce patient anxiety with targeted “scent, sight and sound” stimuli.

She cites a 315-patient satisfaction survey in which a majority of women scanned with the Senographe Pristina at two European imaging sites said they had a better, more comfortable experience with the device as compared with traditional mammography systems. More than half the women scanned were offered use of the Dueta remote, and

80 percent of those said they found it made the scan more comfortable.

“By improving the patient experience, we hope to help health care providers get more patients screened regularly,” Berzsenyi said.

“Comfort is key to patients, and therefore clinicians see features like Pristina Dueta as an important offering to improve their patients’ experience and increase their patients’ adherence to regular screenings.”

In addition to improving patient comfort and experience during a breast imaging study, Pam Cumming, director of product marketing for Women’s Health at Siemens Healthineers North America, said advances in digital breast tomosynthesis could eventually push that technology toward becoming the standard of care.

“The purpose of mammography is to perceive subtle change that could be a sign of cancer,” Cumming said. “Tomosynthesis really allows radiologists to move through the breast in a 3D way. Regardless of skill level or experience, every single radiologist improves with the addition of 3D.” Siemens Healthineers MAMMOMAT Revelation digital breast tomosynthesis system works to capture the breast in “a wider sweep” during imaging, which Cumming said offers physicians up to three times better depth of resolution, which helps to eliminate overlapping tissue, making small cancers easier to find. And like GE Healthcare, Siemens Healthineers is working to improve scanning rates by increasing the patient comfort of its technologies, including adding mood lighting on the gantry and housing the device in a room with lower lighting to create an atmosphere of calm.

“When a woman walks into a room that’s semi-darkened and sees this nice lighting, it takes the edge off, and allows the technologist to better position her more easily, and this is key to image quality,” Cumming said.

Just as the GE Pristina Dueta offers patients the chance to help set the compression level of their studies, the MAMMOMAT Revelation has similar, comfort-focused features like OpComp, which helps determine how much breast compression is required. That pre-pulse also contributes to the radiation dose calculation, which allows for more precise tuning of the device, which means that each woman receives the correct dose for her anatomy.

“Anatomy is not always perfectly balanced, and a dose is calculated on the pre-pulse instead of on a standardized table,” Cumming said. “It adapts to her anatomy.”

Clinical investigations into the effectiveADVANCING THE IMAGING PROFESSIONAL

“

”

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The World of Breast Cancer Screening

ness of different breast imaging modalities educating women about critical mammogra- breast density and that there are other techare also shedding new light on prior ap- phy screening services not just during breast nologies out there,” Berzsenyi said. “But it’s proaches to mammography. Cumming cited cancer awareness month, but throughout the also important that secondary screening the results of a two-year, Siemens-sponsored, year, so they can become their own health ad- technologies such as ultrasound and MR are digital breast tomosynthesis (DBT) screening vocates and make informed decisions about covered.” trial involving 7,500 women in Malmö, Swe- their breast health.”

“Just because they are in the community den. Completed as the first half of a planned, Accardi traces “strong headway” with doesn’t mean that all women have access,” 15,000-patient study, it compared one-view private and government insurance payers to she said.

DBT and two-view digital mammography driving greater access to DBT via modalities When access is a priority, Cumming said (DM) via double-blind reading and arbitration like Hologic’s Genius 3D Mammography exam, that vendors can work with their customers to see if DBT could function as well as DM as which she said is the only mammogram to be to help improve screening rates. She pointed a standalone modality for the detection of FDA-approved as superior for routine breast to a case study that Siemens Healthineers did breast cancer. The study concluded that DBT cancer screening of dense-breasted women. with McCurtin Memorial Hospital in Idabel, was faster, more reliable, and more comfort- But she also touts the value of machine-learn- Oklahoma, a remote area of the state that has able than DM in a head-to-head comparison. ing-powered software and high-tech algo- one of the highest breast cancer death rates in “On top of the cancer detection rate, rithms in detecting abnormalities in imaging the country. In partnership with the Susan G. they found out they could do 50 percent less studies.

Komen Foundation, the 99-bed, rural hospital [breast] compression” and not compromise “I think we’ll continue to see a much purchased a Siemens MAMMOMAT system, cancer detection, Cumming said. “Less dis- greater focus being placed on breast density and has begun seeing increases in patient volcomfort could increase compliance.” assessments, as each woman’s breast tissue umes such that it can now provide access to “In a screening population, most women is unique, and breast density impacts how dif- advanced breast imaging services. will not have cancer,” she said. “So we need ficult it is for radiologists to detect suspicious “Access is a huge passion of mine,” Cumto make sure the basis of the technology is lesions on certain screening technology,” Ac- ming said. “We know that there are definitely sound and strong. When it was 2D in the days cardi said. “It’s not just about bringing breast areas that are underserved. Where can we of film, you exposed the tissue and got a piece screening solutions to market, but more im- bring care? Perspective is critical and helps us of film. Now, you gather digital to create the portantly, ensuring women across the globe guide and formulate our passion for what we 3D volume and that information can be ma- are able to benefit from our technologies and believe: the best medicine for the right patient nipulated and enhanced, so we can see more lead healthier lives.” at the right time.” detail and hopefully not lose any of those tiny Berzsenyi said that GE Healthcare supFinally, Siemens Healthineers Technical subtleties that might be cancer.” ports state breast-density notification laws, Support Engineer Michael Figg points out that In addition to technological advances, and would support a federal notification law breast cancer awareness month often leads to everyone in health care follows the impact as well; however, those kinds of laws should an uptick in patient volumes, making proactive of policymaking on the future of the imag- be paired with coverage for additional imag- equipment assessments even more critical ing business. Whether it’s laws that notify ing services to make sure that they are most than usual. Figg suggests that service technidense-breasted patients that a mammogram effective in achieving their aims. cians connect with users to address any known may not necessarily detect cancer in their tis“It’s important for women to know their issues ahead of time. Leaning on established sue (34 states have such laws in place, with interdepartmental relationships can allow bills in the works in five others) or regulations clear, open feedback about clinical needs or that help improve patient access to examequipment concerns, and can smooth any inations, equipment manufacturers have potential problems that may arise.

When a their fingers on the pulse of legislative In addition to routine checks, Figg work and advocacy that shapes the recommends that engineers specifwoman walks into a marketplace. ically “examine breast paddles for “We realize that ensurany scratches or cracks, check sysroom that’s semi-darkened ing all women have access to tem motion for smooth and prethose solutions is critical,” said cise movement, and make sure and sees this nice lighting, it Tracy Accardi, global vice presthe acquisition systems have ident of research and develplenty of storage space.” takes the edge off, and allows the opment, breast and skeletal “From a service perspectechnologist to better position her health solutions for Hologic. tive, the most important part “Insurance coverage is a of being prepared is to be aware more easily, and this is key to key factor influencing patients’ of any issues and resolve them access to breast cancer screenquickly,” he said. “Minimizing deimage quality. ings, which is why Hologic is dedlays and possible equipment failicated to opening access,” Accardi ures is critical at this time, and being – Pam Cumming said. “We also believe that patient aware and prepared will ensure that education plays a huge role in breast breast imaging facilities provide the highhealth, which is why we’re committed to est level of patient care.” ICE

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insight

CAREER ADVICE 10 Interview Rules to Follow

A

n in-person interview is a professional business transaction where you are the salesperson and the product! No successful sales professional ever “closed the deal” without preparation! Here are some tips to help you seal the deal.

Rule #1: Take a deep breath and relax • Your resume, reference sheet and portfolio are complete and organized.

• You look sharp, polished and professional in your business suit.

• You have researched the company/hospital and are abreast of the industry and its technology.

• You feel confident and in control of the situation.

Note: Do not forget to turn off cellphones, tablets, etc.

Rule #2: Take the initiative • When entering a room for an interview, make the first move to introduce yourself with your hand outstretched for a firm handshake. (Your handshake should be firm whether with a male or female.)

• This body language demonstrates you are enthusiastic about being there and interested in the company and the position.

• It also demonstrates confidence and integrity.

Rule #3: Maintain direct eye contact • Eye contact should be maintained throughout the interview; however, looking away to gather a thought is normal.

• Eye contact demonstrates confidence, honesty, interest and enthusiasm.

Rule #4: Adapt your style to the interview type • When interviewing with HR, your technical responses can be stated in general terms. However, when interviewing with a technical manager be as technically detailed as possible.

• HR normally looks for personality behavioral traits to see if you would fit in the organization. Although that is also a concern for technical managers as well, they tend to focus on whether or not you can handle the position technically.

Rule #5: Keep responses related • Always keep answers related to the topic, not to what you might feel is important in your background. Job candidates can sometimes go off on tangents that have nothing to do with the position.

Rule #6: Back up your response with an example • About 90 percent of the candidates respond to a question without backing up their statements. Examples add credibility and help the interviewer visualize your capabilities. Your WWW.IMAGINGIGLOO.COM

Written by Jenifer Brown Health Tech Talent Management

examples should be directly related to the position for which you are applying.

Rule #7: Keep it positive • If you are asked why you left a company, always explain your departure in a positive manner. Negativity makes interviewers uncomfortable and concerned that you might be the same with them.

Rule #8: Never bring up money/benefits • Discussions about money or benefits should not take place until a verbal offer has been made. They may feel you are more concerned about the money or benefits than the opportunity or that you could be too easily enticed to change companies if a better offer came along.

• Interviewers who bring up money and benefits during the interview (especially the first) are probably screening you to see if your expectations are in line with the budget allocated for the position or if you are realistic about your experience or background.

• Never give a dollar figure; doing so at this early stage rarely helps you and could actually take you out of the running altogether. Most candidates say too high or lower than what the offer will be.

Rule #9: When it’s your turn, speak up • At the end of an interview, they will usually ask if you have any questions. On a psychological level, the interviewer has put the ball in your court and given you an opportunity to ask specific questions. This is your chance to mention your related achievements or experience that might not have come up.

Rule #10: Assume they want you • Show your portfolio (proof of training, education, etc.)

• Provide reference sheet or letters • Ask about the next step in the hiring process • Thank the interviewer for his or her time, express interest and follow up with a written thank you. It is so rare today for an employer to receive a written one so this really makes you stand out! ICE

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ADVANCING THE IMAGING PROFESSIONAL

insight

IMAGING MATTERS Lost Art

I

t is well-known that for the service and repair of medical imaging equipment, there is a continuing shortage of Field Service Engineers (FSE). Many of the individuals that are brought into the area of medical imaging equipment repair are drawn from the BMET community. Yet so many skills that were assumed to exist within that community are sadly fading away. One that will have the largest long-term impact is the basic understanding of electronics. Being able to read schematics, understanding how a basic power supply works, knowing the standard way AC is converted to DC, the various types of switching, and electron flow are just some examples. Knowing how to measure current or how to use an oscilloscope to measure ripple on a DC power supply are other examples of fading skills.

Individuals who are specialized in medical imaging repair are most often referred to as FSEs. Traditionally, the people who filled those positions were very much engineers.

They used schematics and knowledge of electronics to repair to component level when it made sense to do so. Some still do.

However, many individuals who have entered the field are not soundly rooted in electronics. Basic troubleshooting skills are often not taught. The idea of half-splitting or linear troubleshooting a circuit is a foreign concept.

There are a number of reasons for this development. The manufacturers have a service model that has become board swap to repair instead of troubleshooting down to component level. To further this end, they often use “functional schematics” instead of actual schematic drawings of the circuit.

This often makes it difficult to troubleshoot WWW.IMAGINGIGLOO.COM

as actual components are not shown. The location of inputs and outputs for a circuit board may or may not be listed. In the manufacturer model, this information is not necessary for the FSE to do their job. A side effect is that it is more difficult to troubleshoot a failure that is not a circuit board or other major part. This makes the in-house job more difficult.

For many companies when there is a service call they follow a model that is different than what would be ideal for the in-house team. Using the functional diagrams an issue is narrowed to a specific area and limits the failure to two to four different Field Replaceable Units (FRU), also called parts.

They ship all possible failing parts out to the FSE to replace in order of highest to lowest failure rate. The parts not used are shipped back to the warehouse location. If this requires more than the functional diagrams, the manufacturer has specialists who have access to additional information including schematics, failure rates of specific FSUs, and all field service notes. For most manufacturers, this has been deemed the most cost-effective way of providing corrective service to customers. It allows for reduced training and a broad range of skill levels to be able to service equipment. The down side is that it requires a larger inventory of parts. This is what drives the manufacturer’s rates for contracts and service. The upside for manufacturers is that they can provide a consistent level of service with relatively inexperienced FSEs all across the world. Yet the cost is relatively high, and that drives the amount a hospital or imaging center will have to pay for service.

Written by John Garrett Director of a Clinical Engineering Department in CHI

This is what allows an in-house system to be worth developing for most sites. However, as the years go by, there is less focus on electronics basics for the individuals who will be repairing medical equipment. It will take the hiring managers/companies working with colleges to ensure the level of electronic competence required for the medical imaging FSE is provided by those programs.

Bringing new talent on may require an investment in additional training. The additional training may be at a college or trade school, or even the development of an in-house training program. A local healthcare technology management association (HTMA) can also have an impact. By speaking as a group, they can help shape the college education and even create standalone electronics instruction and refresher courses. But, it will take the community to ensure these skills are brought back to the forefront of the industry. ICE John Garrett has 20 years experience in imaging service including general radiation, mammography, CT and nuclear medicine.

He has worked for third-party service companies, manufacturers, sales companies and in-house imaging teams.

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Mammography Heavily Regulated, Debated

U

nfortunately, many of us have had one or more family members or loved ones that have been affected by breast cancer. Female breast cancer is the most common cancer, with more than 1.5 million new cases worldwide each year. It is the second leading cause of all cancer deaths in the USA. It’s generally recognized that mammography screenings find breast cancer early and increase the odds of survival. U.S. law requires private insurers to cover biennial testing of women age 40 to 74 and U.S. guidelines require the use of digital mammography systems.

Those requirements, as well as favorable CMS reimbursement policies for digital mammography procedures and improvements in the designs of new scanners, have helped lead to the installation of many new full field digital and 3D mammography systems (and the de-installation of many analog systems). In the USA, there are almost 9,000 facilities with approximately 19,000 accredited mammography units. Market analysts say the OEMs with the largest market shares for new mammography systems are Hologic, the big 3 (GE, Philips and Siemens) and FUJIFILM. Each scanner requires maintenance and servicing as specified by the OEM. Mammography systems emit ionizing radiation and fall under Part 1020 of FDA law. In addition, because it is recognized that the quality of the images is critical to proper diagnosis, mammography facilities, personnel and scanners are also regulated by a federal law passed almost 20 years ago, the Mammography Quality Standards Act (21 CFR Part 900). Inspection and accreditation of facilities and scanners are required, and certification can be performed by any of four FDA-approved accreditation bodies; The American College of Radiology (ACR), and the states of Arkansas, Iowa and Texas. The FDA gives high priority to mammography, and the inspections are generally the toughest. Although 85 percent of inspections result in no violation, many result in findings that require corrective actions.

A little less than 1 percent result in a “violation” which is posted almost immediately on the FDA website. If you browse some Adverse Event and Action Reports, you will find many that say 44

ICEMAGAZINE | OCTOBER 2018

“The facility is believed to be closed.” This is a big reason that a large percentage of facilities use the OEM for servicing their mammo systems. The OEMs tend to further capitalize on this “fear, uncertainty and doubt” advantage by providing advanced tools to their FSEs and trying to restrict access to assemble, install, adjust, test (AIAT) information.

The ongoing medical research regarding the effectiveness of various imaging modalities and recent technological developments are all factors that have helped drive the sales of other types of scanners. Laws that have been passed in almost every state over the past few years require that the patient be notified if they have dense breast tissue, which has led to an increased use of ultrasound for breast exams.

Elastography, the most recent ultrasound mode to be approved by the FDA, is virtually 100 percent accurate in determining benign versus malignant tumors. Lots of upgrades, probes and new systems are being sold with that feature, which is typically only available on

The FDA gives high priority to mammography, and the inspections are generally the toughest. Although 85 percent of inspections result in no violation, many result in findings that require corrective actions. higher-end models. Magnetic Resonance Electrography (MRE) research has been going on for many years and MRI may provide the best way to distinguish pre-malignant tissue. The combination of non-invasive ultrasound elastography (UE) and MRE promises to eliminate the need for most breast biopsies. Currently, those are often done using stereotactic biopsy systems that shoot a needle into the breast, a rather risky and grisly procedure.

Radiography of the breast, X-ray mammography, is still the primary screening tool ADVANCING THE IMAGING PROFESSIONAL

SAVE THE DATE!

ICE2019

Still think you can get some mileage out of your “end-of-life” Nuclear Medicine camera?

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for cancer. The most common systems being used in the USA are Full Field Digital Mammography (FFDM) systems. The latest FFDM systems have reduced radiation doses, advanced processing algorithms that produce highly detailed images, and computer-aided diagnosis using artificial intelligence (AI) that in some cases is more accurate than a radiologist. The latest premium systems produce 3D images using digital breast tomosynthesis (DBT). Many new scanners being sold are a combination of FFDM and DBT technologies.

The improved performance of these systems is helping to address an ongoing and huge debate about mammography, which has to do with the benefits of it versus the potential harm that could come from it.

Many studies regarding the safety and efficacy of mammography have been done over the years. Years ago, studies revealed that radiation from analog mammography units were actually causing more cancers than they found. More recently, over-diagnosis and overtreatment have been the main concerns. “Overdiagnosis” refers to finding very small tumors that may or may not turn cancerous. Overtreatment results from overdiagnosis, and can be everything from biopsies, to radiation and chemotherWWW.IMAGINGIGLOO.COM

apy, all the way to breast removal. The studies that conclude most of these are treating clinically insignificant tumors have led to controversial policy changes; raising the age when mammograms should start, and recommending the frequency be every two years instead of annually.

Those studies are based on years of retrospective data and older technology. The problem is figuring out whether the tumors seen in a specific exam are significant or not. Some patients will take severe preventive actions based on a slight indication of disease. Those are obviously difficult personal decisions. As imaging engineers, our responsibility is to make sure they have the best images possible to make that decision.

We need to use the manufacturer’s AIAT information to assure the system is working correctly and safely. That is especially true in the case of mammography systems; the imaging engineer has to sign a 2579 form and submit it to the FDA affirming that the manufacturer’s information was used during servicing. Contact the regulatory department of the OEM to get what is needed, and involve the FDA district compliance officer if necessary. Making sure the correct and best diagnosis can be made is literally a matter of life and death. ICE

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ICEMAGAZINE

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insight

HELPING UNCOOPERATIVE COWORKERS

S

everal key problems will always be detrimental to workplace success.

Lack of a shared vision is one, but that issue rests squarely on the shoulders of people in leadership. From my perspective, the problem that causes damage at all levels in an organization is people who refuse to cooperate. Such people think their way is the right way, and they won’t listen to anyone else. They don’t adapt nor look for ways to be team players. They just expect others to bend to their style with a mindset of, “This is who I am – deal with it.” Left unaddressed, even one person displaying such an attitude can cause a company to crumble from within.

Allow me to share an example. I’ll call this guy Bill (not his real name). Even though he has a reputation as an uncooperative know-it-all, he’s is a mover-shaker who sees the big picture rather easily.

Over the years, Bill has received several promotions, but those occurred in spite of his style, not because of it.

Bill’s problem is that he sees problems in everyone but not himself. He’s quick to say that the office manager needs to change how she does almost every aspect of her job, and the purchasing manager needs to take more initiative. In fact, when talking with Bill, you’ll hear him go on for several minutes about each of his peers, telling you what they need to change about themselves so they can be better. Yet when you ask Bill how he needs to improve, he hems and haws, then jokingly talks about how he needs to get more sleep because he’s working so hard.

Bill is blind to it, but the truth is that almost nobody likes working with him. His direct reports want to keep their jobs, so they don’t say much, but his peers and the people who work for his peers? To them, 46

ICEMAGAZINE | OCTOBER 2018

Bill is an annoying blend of arrogance and ignorance.

As one of his peers said, “Bill is the worst coworker I’ve ever had. Nobody likes being in the building when Bill is around.” Another coworker said, “We all put on our professionally polite face, but it’s nothing but a facade.”

How do I know these things? Because Bill’s boss asked me to work with him – to coach him. He wanted Bill to lose his rough edges and become more cooperative before other key people threw in the towel and quit.

As you may have heard before, employees usually don’t quit companies, they quit bad managers. Ironically, such managers can’t figure out why employees are leaving because they’re looking at everything else besides the mirror.

Trying to resolve this type of workplace problem can be a challenge by itself. Remember, ask these people where they can improve, and they usually insist that everything they do is just fine. If you have such people in your workplace, the solution should involve HR, but usually it comes down to an ultimatum. Something along the lines of, “You need to make some changes, or other changes will have to be made.” That’s what happened to Bill, and why he agreed to having a coach.

Of course, this can be a real problem when it’s the very top person in an organization who’s doing the offending, as there’s no one above him or her to do the confronting. But that’s the subject for an entirely different discussion.

Regardless, resolving these problems at any level is never easy. It’s not uncommon for the person’s self-defensive barriers to show themselves even more. Also, relationships can become strained as the

Written by Daniel Bobinski Workplace Consultant

offending party struggles to maintain positional dignity and power. The prevailing mindset is, “these methods got me here – why should I let them go now?” For these reasons and more, getting someone a coach or mentor is best done discretely.

By the way, sending someone to a training class may help some, but it’s rarely the cure. The same defensive tendencies tend to rear their ugly heads: “This touchy-feely stuff is for other people, not for me.”

The best solution for helping abrasive or uncooperative people is one-on-one mentoring or coaching. The reason? Such problematic behavior stems from insecurities, fears and an inability to connect interpersonal dots. Usually this is because nobody has ever taught them about the value of interpersonal skills. The concept of emotional intelligence is foreign to them.

In one-on-one mentoring or coaching, specific issues are addressed and specific behaviors – and their ripple effects – are evaluated. Accountability for improvement is a vital part of the process, and so is the goal of increasing the person’s capacity for empathy. Without focused accountability and a reason to change, old habits will remain, especially if the offending party is far up the chain of command.

Remember, they may firmly believe their style got them to where they are.

One of the main reasons that one-onADVANCING THE IMAGING PROFESSIONAL

one coaching works so well is that people can “save face” by dealing with their issues in private. That said, I am always clear to point out that having a coach is not the same as “seeing a shrink.”

If you have an uncooperative person (or persons) at your work, know that many certified management and executive coaches have experience resolving these problems. Multiple associations exist with certified coaches who can help your organization resolve issues of abrasive or uncooperative behavior.

For the record, my client Bill initially pushed back during his coaching sessions, but eventually he saw the value of adapting his style, and both his boss and his peers report that he’s much easier to be around now.

I’m a firm believer that workplace success is easier to achieve when people have a shared vision and employees are cooperative in working toward that vision. So, if you don’t have a shared vision, create one and share it. And if you have someone who’s uncooperative or abrasive, talk with HR about finding a coach to help that person out. Remember, the cause for their behavior is usually due to nobody ever teaching them what they needed to learn. ICE PROOF APPROVED CHANGES NEEDED

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Daniel Bobinski, M.Ed. : teaches teams and individuals how to use Emotional Intelligence, and his videos and blogs on that topic appear regularly at www.eqfactor.net.

He’sFOLLOWING also a best-selling PLEASE CONFIRM THAT THE ARE CORRECT author and a popular speaker at conferences and retreats. Reach sales@trisonics.com | 877.876.6427 | trisonics.com LOGO PHONE NUMBER WEBSITE ADDRESS SPELLING GRAMMAR him at daniel@eqfactor.net or 208-375-7606.

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To renew or start a FREE subscription, fax this form to 770.632.9090. ICE Magazine is available without charge to eligible individuals in the U.S. only. The publisher reserves the right to determine eligibility for free subscription.

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49

index

THE WORLD MOVES FAST. WE MOVE FASTER.™

626 Holdings p. 13

Health Tech Talent Management, Inc. p. 19

KEI Medical Imaging Services p. 22

Radon Medical LLC p. 19

Ray-Pac® Adel Lawrence Associates, Inc. p. 49

AUE

Injector Support & Service p. 42

ADVANCED ULTRASOUND ELECTRONICS

MedWrench p. 35

D E F I N I N G TH E S T AN D A R D

Advanced Ultrasound Electronics p. 44

Medical Imaging Technologies p. 45

p. 4, 5

Inrayparts.com p. 40

p. 6

Diagnostic Solutions

RSTI/ Radiological Service Training Institute p. 17

Innovatus Imaging

DIAGNOSTIC IMAGING & SURGICAL SOLUTIONS

Carolina Medical Parts

Ray-Pac p. 52

InterMed Group p. 42

Multi Diagnostic Imaging & Surgical Solutions p. 2

Stephens International Recruiting Inc p. 47

MW Imaging Corp. p. 28

p. 48

Sodexo CTM p. 21

Summit Imaging, Inc p. 9

Exclusive Medical Solutions, Inc. p. 40

International X-Ray Brokers p. 22

Oxford Instruments Healthcare p. 3

SOLUTIONS

Tri-Imaging Solutions p. 23

Trisonics, Inc. p. 47 Global Medical Imaging p. 15

KEI Med Parts p. 49

PM Imaging Management p. 49 Webinar Wednesday p. 22

50

ICEMAGAZINE | OCTOBER 2018

ADVANCING THE IMAGING PROFESSIONAL

SAVE THE DATE!

9 FEBRUARY 17-19, 2019 • TAMPA/CLEARWATER

FEBRUARY 17-19, 2019 WYNDHAM GRAND CLEARWATER BEACH

TA MPA /C LEARWATER

9

RY 17-19, 2019 • TAMPA/CLEARWATER

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