Comparison of SonoCiné AWBUS and Handheld Ultrasound
| Handheld Ultrasound |
SonoCiné | |
|---|---|---|
| SCREENING EQUIPMENT | • Uses the doctor’s / facility's ultrasound machine | • AWBUS is an automated add-on to
the doctor’s / facility’s ultrasound
machine - not a replacement • AWBUS assists the operator performing the procedure in systematically scanning and recording all breast tissue |
| PROBE SIZE | • 5cm - Standard | • 5cm - Standard |
| PAIN CAUSED BY THE PROCEDURE | • The 5cm probe causes no pain during the exam | • The 5cm probe causes no pain during the exam |
| BREAST COVERAGE DURING SCANNING | • Gathering & viewing are done
simultaneously and, therefore, at
the same speed • When gathered quickly, does not provide sufficient images for recognition of small lesion • When gathered slowly does not allow for recognition of an aberrant disruption • Very few permanent images gathered | • AWBUS program prevents skipped
areas on the surface and deepest
parts of the breast • Concentration is focused solely on doing the best possible scan |
| HOW IMAGES ARE GATHERED | • Gathering & viewing are done
simultaneously and, therefore, at
the same speed • When gathered quickly, does not provide sufficient images for recognition of small lesion • When gathered slowly does not allow for recognition of an aberrant disruption • Very few permanent images gathered | • Gathering and reviewing are
separated and therefore optimized • Gathering is done slowly to collect sufficient images for quality interpretation • Depending on breast size, 4,000-8,000 permanent images are gathered |
| HOW IMAGES ARE VIEWED | • Large screen format while scanning in a distracting environment, not optimized for viewing | • Small screen format in a nondistracting environment • Images are viewed as a ciné loop at an optimized speed (quickly) and size, enabling recognition by the maculae of aberrant disruptions • Disruptions are detected as motion, for which the human eye isvery sensitive |
| AVERAGE DIAMETER OF CANCERS FOUND | Hand Scanning (Astound Study): • 8% 5-10mm • 33% 11-14mm • 58% 15mm or larger | AWBUS: • About 75% less than 10mm • About 15% 10-13mm • About 10% 13mm or larger • The mean for 3 major AWBUS sites is 8mm |
| INTERPRETATION | On-line in exam room, patient can demand biopsy for any lesion found, even when a radiologist believes it to be benign | Off-line reading, a radiologist can call more lesions benign, and reduce false positive rates |
| MULTITASKING | • Scanning and detection are done simultaneously, preventing full needed attention to each task | • Scanning and detection are done separately, allowing full attention needed for each task |
| RECOGNITION OF PATHOLOGY | May be missed by: • Distracted viewing • Improperly large image • Shorter persistence of the image due to fewer recorded images • Imaging display factors set by the technologist | Optimized by: • Non-distracted viewing • Proper sizing of the image • Increased persistence of the image due to decreased distance between images • Complete control of display factors of the images by the reading radiologist |
| PERMANENT RECORD | No permanent recording of entire
scan: • If abnormality not seen during scanning, it goes undetected • Prevents off-site reading • Only a verbal description and a few single images of a recognized abnormality can be archived | Permanent recording of entire scan: • Recordable to a CD or USB drive • Easily reviewed by other physicians at a distance or even years later • Allows off-site reading for radiologists, FPs, OBGYNs and breast surgeons • All images transfer to PACS or other image archiving system • The radiologist’s report is based on review of all possible findings in the breasts |
| FINANCIAL IMPLICATIONS | • Possible loss of revenue from competing sites adopting AWBUS | • Will increase business and result in a net positive bottom line. |
| TRAINING | • Training to scan consistently the
entirety of both the breast at a
steady rate & steady pressure is
challenging • Training someone to simultaneously scan well, recognize malignancy & know if any tissue has been missed is very difficult | • AWBUS uses the radiologist’s
standard ultrasound machine and
format, and requires no additional
training • AWBUS relieves the operator of determining probe speed & position, and recognition of malignancy all at the same time • Training is almost entirely about capturing quality images by manipulating the pressure and incidence of the probe to the skin |
| WORK FLOW | • The radiologist either sees fewer cases a day due to both acquiring and reading images, or relies on the skill and judgement of a nonphysician operator | • Allows the radiologist to see more cases a day if he/she only reads the images & doesn’t spend time acquiring them |
| JOB FLEXIBILITY | • Inflexible: radiologists need to be present during patient exams | • Flexible: radiologists needn’t be present during exams, which can be read at their convenience (evenings, weekends, etc.) |
| PROPERTIES OF A GOOD SCREEN | • Not reproducible • Every screen is variable, regardless of place, time or operator | • Reproducible • Every screen is the same, regardless of place, time or operator |