Prof. M. Bazzocchi

Professor of Radiology at the University of Udine - Italy

 

I’m Massimo Bazzocchi, a professor of radiology at the University of Udine and I direct the radiology department of the city hospital.

One of my main fields of study is the Breast Care. For this reason we tried to acquire a unit featuring tomosynthesis.

Today tomosynthesis represents a recent, but already strongly consolidated reality. Tomosynthesis consists in a device which scans a breast volume and enables it to be reconstructed in thin layers; this serves to eliminate overlaps of tissue which could mask masses or calcifications in the area of the mammary gland.

The units marketed up to now have quite different features with respect to the type of scan, scan angle, number of exposures, etc.

It is still a technology that is definitely evolving but it has already borne excellent fruits. In fact, the expectations from this technology, tomosynthesis, are focused above all on increasing the sensitivity, that is the detection of breast tumours, as well as on the possibility of reducing the recall rate in screening; therefore, of increasing the specificity, or reducing the number of false positives, providing greater safety and increasing confidence in the interpretation of the radiologist/breast specialist.

A paper was recently published by a multi-centre group, coordinated by the head of the radiology department of the university of Oslo, concerning a prospective study on over 45,000 women (hence a very important study), which clearly demonstrated that tomosynthesis increases the sensitivity of mammography to a considerable degree, as it identifies 14% more breast tumours. We can thus safely say that tomosynthesis today represents an absolutely necessary tool in the realm of breast screening.

The hospital acquired a unit, made in Italy, by IMS, which we had already been working with for a number of years, that is, since IMS produced a digital unit.

Working together with IMS has always been fruitful, since we have had the possibility of collaborating directly with the manufacturer, with the technical staff, thus in some way exerting an influence on technology and technological upgrades from a clinical viewpoint.

At the same time we have had an opportunity to carry out studies and thereby increase our competences/know-how in this realm, and this has led to quite good results in terms of scientific production.

Today we still have a series of studies underway which also involve tomosynthesis and began before the European Union’s recognition of the CE marking of the device, usable on surgical material, anatomical parts and then, precisely, in clinical research, in particular for in-depth diagnosis and for ultimately demonstrating, as regards specificity, the reduction in the recall rate.

We are considering the possibility of starting a prospective study to assess the detection capability both in screening and clinical mammography.

I am therefore satisfied about having begun a relationship of collaboration with IMS that by now dates back many years; and I hope to be able to continue it.

Moreover, it should be said that when some thought that digital mammography represented the point of arrival for mammography they were certainly mistaken, because in actual fact it is not the point of arrival but the starting point. Today, therefore, digital mammography, which is expressing itself with this evolution, tomosynthesis precisely, sees before it other goals to be reached, with the possibility of using “dual energy” and tomosynthesis, therefore a “CONTRAST ENHANCEMENT”. In the field of mammography, the possibility of using CAD tailored for tomosynthesis, biopsy in tomosynthesis, etc. etc.……

Thus the future has absolutely just begum and we are very happy to be able to continue working together.