2020 Global Breast Imaging Workstation New Product Innovation Award

Industry Challenges

According to the World Health Organization (WHO), breast cancer impacts 2.1 million people each year and causes the highest number of cancer-related deaths among women. In 2018, WHO estimated that 627,000 women died from breast cancer—approximately 15% of all cancer deaths among women.1 Early detection impacts the patient’s overall survival. The relative 5-year survival rate for localized breast cancer is 99%, steeply dropping as it progresses; 27% when metastatic.2 International campaigns, programs, and initiatives increased public awareness over the last several decades.3

Regular breast cancer screening is critical to early detection and timely intervention. Screening mammography is the most used method worldwide. Standard 2D mammography does not detect small tissue abnormalities, mainly hidden in patients with more dense breasts, which account for more than 50% of all women. Over the years, digital technology innovations increased diagnostic accuracy, sensitivity, and patient safety by reducing ionizing radiation exposure. Scanning modalities such as 3D ultrasound, ultrasound, automated  breast ultrasound, and 3D mammography (tomosynthesis) realized an increased market adoption. Nonetheless, as the industry shifts towards value-based care, radiologists still struggle to reach high-level radiology objectives—timely, precise diagnostics for definitive treatment.

With medical image review workstations confined to one or few imaging modalities, radiologists do not have access to holistic patient views.4 Furthermore, the astronomical data file sizes from advanced breast imaging modalities result in long and inefficient study transfers. A single breast examination can result in one to five gigabytes of data depending on the technology. Sending scans across PACS systems at peak business hours places an enormous strain on hospital networks, leading to long wait times for the data to reach the radiologist’s workstation. Also, radiologists must view previous breast scans to gain patientspecific context and determine if a particular tissue area is of concern. As a result, a single patient’s breast examination consult can result in up to 15 gigabytes of data transfer, the equivalence to 15 full-length movies per patient.

Furthermore, large imaging institutions have multiple satellite locations, giving patients scheduling, availability, and location options for greater convenience. However, satellite locations sometimes assign different medical record numbers to a patient. As radiologists use these numbers to access patient’s exams, this multiplicity can cause data confusion. Various patients within the enterprise can have the same medical record number. Conversely, a single patient may have several medical record numbers under their name. Additionally, if a woman changes her name after marriage, radiologists can also miss breast exams identified with her maiden name. Regardless of the scenario, radiologists may only have access to part of a patient’s medical history. New Product Attributes and Customer Impact Established in 2007, and headquartered in Newport Beach, California, Candelis, Inc. (Candelis) is a medical imaging informatics solution provider for hospitals, clinics, and imaging centers. Candelis’ information technology (IT) portfolio spans across breast imaging, radiation therapy, oncology, and radiology.

Tag Morphing: Patient-centric Care

The Advanced Breast Imaging Enterprise Viewer incorporates conditional tag morphing capabilities, ensuring identified exams match the patient. The technique manipulates DICOM header information associated with each image to identify all the scans connected to a single patient, providing radiologists with a full mammogram and tomosynthesis history. 

Multi-modal: Full Screening History

Breast imaging relies on a range of imaging scan types (including 2D mammography, 3D breast ultrasound, MRI, CT, and tomosynthesis) all of which may make up a single patient’s scanning history.

Powered by its best-in-class ImageGrid™ platform, Candelis’ Advanced Breast Imaging Enterprise Viewer enables the quick routing of data movement, integrating the viewer with an entire set of PACS tools to support multi-modal viewing and analysis. Thus, radiologists can view, annotate, and read any scan performed throughout the patient’s screening history on the Advanced Breast Imaging Enterprise Viewer.

Aligned with Value-based Breast Imaging Goals

Candelis’ Advanced Breast Imaging Enterprise Viewer automatically transports the data typically the day before the patient’s visit during off-business hours, lessening the strain on the hospital’s IT network during peak usage hours. The only data transmission occurring during business hours is the ongoing breast scan. Moreover, the viewer pre-renders images for viewing, preparing relevant images during off-hours. Thus, pre-fetching and prerendering entire image files during off-hours streamline the radiology workflow the following day; i.e., radiologists have access to all the information needed for comprehensive interpretation and diagnosis the moment they read the new scans.

Radiologists have access to the patient’s entire diagnostic picture immediately after completing the screening tests, allowing for precise interpretation of the rendered images while the patient is still in the clinic. If there is an area of concern requiring further examinations, radiologists can direct patients for an ultrasound or biopsy on that same visit. Providers optimize clinical resources and assets and avoid additional operational costs, e.g., calling back patients for a subsequent visit, while delivering quality care. For instance, the Riverside Medical Clinic in Riverside, California, reports realizing huge time optimizations and overall return on investment. The healthcare organization indicates doubling patient per-day breast imaging workloads with Candelis’ Advanced Breast Imaging Enterprise Viewer.

Likewise, streamlined, optimized workflows enhance the patient experience (e.g., scans and results on the same day) and convenience (i.e., both travel time savings and costs related to taking off additional time from work).

Conclusion

With the growing shift towards tomosynthesis and 3D mammography, hospital IT networks are under extreme data transmission strain due to the vast exam and image sizes. The massive data files, coupled with previous scans and multi-modality breast imaging, impact access to the patient’s full clinical history and data transmission times to the radiologist workstation for scan reading; thus, hinders value-based breast imaging. 

As a leader in data management and storage within PACS systems, Candelis’ Advanced Breast Imaging Enterprises Viewer overcomes mammography’s challenges. Its breast imaging workstation incorporates unique optimization techniques automatically streamlining clinical workflows, enabling patient-centric direct scan visualization and interpretation, and enhancing the patient experience with immediate results. Pre-fetching, tag morphing, and multi-modal capabilities provide for unmatched data movement and routing speeds, allowing radiologists access to all the information needed for a timely, accurate read.

For its strong overall performance, Candelis Inc. is recognized with Frost & Sullivan’s 2020 Global New Product Innovation Award in breast imaging workstations.

Customer Impact

Criterion 1: Price/Performance Value
Requirement: Products or services offer the best value for the price, compared to similar offerings in the market.

Criterion 2: Customer Purchase Experience
Requirement: Customers feel they are buying the most optimal solution that addresses both their unique needs and their unique constraints.

Criterion 3: Customer Ownership Experience
Requirement: Customers are proud to own the company’s product or service and have a positive experience throughout the life of the product or service.

Criterion 4: Customer Service Experience
Requirement: Customer service is accessible, fast, stress-free, and of high quality. 

Criterion 5: Brand Equity
Requirement: Customers have a positive view of the brand and exhibit high brand loyalty.

Research Methodology

Frost & Sullivan’s 360-degree research methodology represents the analytical rigor of our research process. It offers a 360-degree-view of industry challenges, trends, and issues by integrating all 7 of Frost & Sullivan's research methodologies. Too often companies make important
growth decisions based on a narrow understanding of their environment, leading to errors of both omission and commission. Successful growth strategies are founded on a thorough understanding of market, technical, economic, financial, customer, best practices, and demographic
analyses. The integration of these research disciplines into the 360-degree research methodology provides an evaluation platform for benchmarking industry participants and for identifying those performing at best-in-class levels.