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MammographyRAD·BOOK 201266 IT-SOLUTIONS50 RAD·BOOK 2012 Tomosynthesis has been available in Eu- rope and other countries recognizing the CE mark since 2008. In February 2011, Hologic’s Selenia® Dimensions® breast tomosynthesis system was the first com- mercial system approved by the U.S. Food and Drug Administration. With the Hologic tomosynthesis system, an ex- amination takes only seconds longer than a conventional two dimensional digital mammogram. The system was approved for use in the same clinical indications as 2D mammography including breast cancer screening and diagnosis. Prior to introducing tomosynthe- sis into a clinical practice, there are a number of practical considerations that Since the approval of the first commer- cial systems in 2000, digital mammog- raphy has become an accepted stand- ard of care in breast cancer screening and diagnosis worldwide and has paved the way for the newest groundbreaking technology in this arena - breast tomo- synthesis. Breast tomosynthesis is a screening and diagnostic modality that acquires images of a breast at multiple angles during a short scan. The individual images are then reconstructed into a series of thin, high-resolution slices typically 1 mm thick, which can be dis- played individually or in a dynamic ciné mode. Andrew Smith, Ph.D., Vice President - Imaging Science, Hologic PracticalConsiderationsinImplementing BreastTomosynthesisinaClinicalSetting should be evaluated. Most breast imaging centers have multiple digital mammography systems, and it may not be economically feasible to immediately replace every 2D system with a Tomo-capable units. It is likely that many facilities will implement to- mosynthesis in phases, beginning with one or two systems initially, similar to the pattern seen in the transition from analog to digital mammography. During this implementation phase, facilities will need to develop criteria for determining which patients will receive Tomo ex- ams and processes to ensure efficient patient management in a mixed 2D and tomosynthesis environment. In addi- A tomosynthesis data set virtually eliminates detection challenges associ- ated with overlapping structures in the breast, which is the primary drawback of conventional 2D analog and digital mammography. In addition, breast tomosynthesis offers other potential benefits including increased lesion and margin visibility, help in localizing struc- tures in the breast, a reduction in recall rates, and increased cancer detection.