Confirma introduces next generation breast MRI CADstream system with advanced features

Kirkland 29 November 2004Confirma Inc., specialized in computer-aided-detection (CAD) for MRI, has launched the next generation of its successful CADstream product, the standard in CAD for breast MRI. The latest developments in CADstream contain advanced features that include a streamlined portfolio for more comprehensive patient treatment planning, incorporating the ACR BI-RADS Atlas for lesion classification, and a multimodality ready configuration, offering users the ability to access, view and reference patients' mammography and ultrasound studies while interpreting breast MRI with CADstream. Confirma has filed CADstream's new features with the FDA.


"CADstream has led to a profound improvement of our breast MRI programme at First Hill Diagnostic Imaging", stated Justin P. Smith, MD, First Hill Diagnostic Imaging, Seattle, Washington. "We have seen improvement in a variety of elements that affect our programme, including work flow, standardization, communication and study volumes. The new features in CADstream, I believe, will further improve our women's imaging programme. We now have even better, more informative tools to interpret and communicate the extent of disease."

"Fortunately, with recent advances in breast MRI, breast surgeons are now better able to understand and plan for a patient's breast surgery", stated Peter D. Beitsch, MD, FACS, Dallas Surgical Group, Dallas, Texas. "Since breast MRI is such a new and complex imaging method, radiology reports sometimes lack the standardization and detail a surgeon needs. The CADstream Portfolio now includes the ACR BI-RADS Atlas for lesion classification, the lesion location, quadrant and size information and relevant images. These are important elements for planning and better surgical outcomes."

CADstream enhances the efficiency and work flow of breast MRI studies by automating data analysis, improving image management and correcting for patient movement, which assists radiologists in the interpretation, standardization and reporting of these data-intensive studies. CADstream's core automated features include adaptive, high-order image registration (2D/3D), multiplanar reformatting, subtractions, angiogenesis maps, interactive real-time contrast curves, maximum intensity projections (MIPs) and volume summaries. CADstream is the market leader in breast MRI CAD and currently has an installed base of over 150 systems throughout the United States and Europe.

CADstream new, advanced features will include streamlined CADstream portfolio for treatment planning which automatically provides summaries with size, classification and location for tumour volume of interest and also incorporates ACR BI-RADS Atlas for lesion classification. The system is multimodality ready and offers the ability to access and view patients' mammography and ultrasound studies while interpreting breast MRI studies in CADstream, all on the same PC or workstation.

The system allows to perform interactive maximum intensity projections (MIPs) because it includes AngioMap overlays that are correlated for 3D navigation and mammography views. It has DICOM compatibility to provide query-retrieve and printing capabilities.

Current CADstream advanced features include DICOM to provide connectivity and archiving and an interventional guidance tool, SureLoc, for calculating needle position and insertion co-ordinates for interventional procedures. The tool supports angled needle access and medial, lateral, and cranial-caudal access approaches.

"The new, advanced features in CADstream have the ability to create even greater efficiencies in breast MRI and breast cancer detection", stated Dan Bickford, vice president of sales and marketing for Confirma. "Confirma's product development is based on customer feedback and MRI technology innovations; our 150-plus customers have contributed immensely to the advances in CADstream. Our customers asked for better, more detailed reporting tools, the ability to reference patients' mammography and ultrasound studies and to produce colour MIPs. We are pleased that with the latest developments in CADstream, we will further deliver on our customers' feedback and needs."

Clinical indications for breast MRI exams continue to expand as physicians increasingly recognize the value of this highly useful study. Since 1999, there has been a 40 percent per year increase in the number of breast MRI examinations in the United States, according to the MRI Census Market Summary Report, June 2002 by IMV Medical Information Division, Des Plaines, Illinois. Breast MRI is primarily used for determining extent of disease, called staging, monitoring response to therapy in breast cancer patients and screening high risk patients. Clinical research has reported that MRI demonstrates high sensitivity for detecting invasive breast cancer. (Tillman, Gayle F. Effect of Breast Magnetic Resonance Imaging on the Clinical Management of Women with Early-Stage Breast Carcinoma - J. Clin. Onc. 2002; 16:3413-3423.)

Scientific literature also shows the effectiveness of MRI in screening women at high risk for breast cancer. In May 2003, the American Cancer Society released updated guidelines for breast cancer screening indicating that breast MRI, when used with mammography, may enhance the effectiveness of screening and diagnosis. (Smith R.A., Saslow D., Sawyer K.A., et al. American Cancer Society Guidelines for Breast Cancer Screening: Update 2003 - Cancer J. Clin. 2003; 53:141-169.) Additionally, in July 2004, the New England Journal of Medicine published strong evidence to suggest that breast MRI studies can be effective in finding tumours in women at high risk for breast cancer. (Liberman, L., et al. Breast Cancer Screening with MRI - What are the data for patients at high risk? The New England Journal of Medicine 2004; 351:497-500.) Approximately 8,5 million women are at high risk for breast cancer in the United States.

As breast MRI gains acceptance as a highly effective diagnostic tool, imaging centres are requiring new tools for performing and interpreting these important studies. In addition to CADstream, Confirma plans to offer the Access Breast Coil, now available for investigational use only, as an advanced, more versatile alternative to the currently available breast coils. The Access Breast Coil has a dual purpose design, offering both high quality diagnostic imaging and flexibility in interventional access.

Confirma Inc. develops and markets computer-aided-detection (CAD) systems and accessories for medical imaging. The company's core product, CADstream, is the standard in CAD for magnetic resonance imaging (MRI). CADstream automates the processing of MRI studies, providing higher quality imaging studies, lower costs for radiology practices and improved communication tools for physicians and patients.

In its initial application, CADstream is being used to assist in the analysis and interpretation of breast MRI. Confirma plans to include medical imaging accessories, such as the Access Breast Coil. Access is designed to be a multi-channel coil for parallel imaging and improved interventional access. Confirma has partnered with over 150 imaging centres since 2003, helping develop more standardized, high performance breast MRI programmes that deliver premium patient care. More company news is available in the VMW August 2004 article Confirma debuts next version of CADstream introducing innovative interventional guidance tool.

Leslie Versweyveld

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