“We introduced digital mammography in the Army a little later than the rest of the world,” he acknowledged, “because we wanted to make sure that the digital machines were ready for our patients. In the past, the older, traditional film screen had an infinite number of elements or pixels. By contrast, digital screens have a finite number. It’s a lot. But it’s also a lot less than the film screen. So, when the number of detector elements decreased, your image quality decreased. And we wanted to keep the mammogram as sharp as possible. But now that digital mammography is at the point where it is very, very clear, we have employed digital mammography for the past five years.”

“Spectroscopy is a type of imaging that not only shows you the shape of the object but also the material that it’s made of. For example, right now the CTs, by having dual energy, can determine if a deposit at your joint is calcium or uric acid. It uses the spectrum of shades of gray to determine the material. And I think pretty soon … we’re going to be able to distinguish between a lot of other materials as well …

He said that another advantage of the digital technology involved “tomography.”

“That allows for a 3-D image of a discovered tumor,” he offered. “In the past, the traditional mammogram machine took one or two pictures that the radiologist studied. But now, with tomosynthesis capability, the mammography machine takes as many as 20 pictures from different angles. So when the computer looks at these images, it can construct a 3-D image that gives the radiologist a better sense of the size and shape of the possible tumor.”

 

Supporting Technologies

Along with these representative technology efforts, USAMMA representatives are also involved in a range of supporting imagery projects.

As one example, several radiology PACS have been purchased and fielded over the past two years throughout the former Southern and Western Regional Health Commands. Fielding to the Northern region is currently in progress (estimated completion by January 2017). Each new system enhances radiologist performance, provides new advanced 3-D imaging capabilities, and helps to streamline workflow.

In another example, the joint Army/Navy Enterprise Clinical Imaging Archive (ECIA) has gone live in two Defense Health Agency data centers and represents the first federated long-term radiology imaging archive. The archive consolidates seven-plus antiquated archives into two primary locations, federates Army and Navy radiology images, and will tie into the forthcoming Cerner® Electronic Medical Record. Ultimately, this makes historical images more accessible to providers to help expedite diagnosis times.

Looking toward the future, Moaveni anticipates that imaging technologies will increasingly integrate spectroscopy technology.

“Spectroscopy is a type of imaging that not only shows you the shape of the object but also the material that it’s made of,” he said. “For example, right now the CTs, by having dual energy, can determine if a deposit at your joint is calcium or uric acid. It uses the spectrum of shades of gray to determine the material. And I think pretty soon … we’re going to be able to distinguish between a lot of other materials as well.

“So it’s going towards a comprehensive way of diagnosis,” he concluded. “And I suspect it will be different from what we look at in radiology today.”

This article was first published in the Veterans Affairs & Military Medicine Outlook magazine.