Design considerations for a multisite POTS-based telemammography system

As the number of mammographic examinations increases, it becomes clear that in many underserved. locations, there is a lack of expertise that is required for consistent, highly accurate, and timely diagnosis. Hence, mammograms are frequently sent to other medical facilities, and a significant fraction of women (typically 3-10%) are recalled for additional examinations. It is the purpose of this project to develop, test, and clinically evaluate a telemammography system that will operate between several remote locations and a large breast cancer center. In this manuscript we describe the design considerations, implementation, and initial testing that were undertaken, to date. The system digitizes a mammogram at 50 mum pixel size, compresses the resulting image file (similar to75:1), and transmits it over a telephone line to the central site where the data received are decompressed and displayed on a high-resolution workstation in approximately 4 minutes per image. Initial testing of the system indicates that a relatively inexpensive system for "almost real-time" telernammography can be employed in any geographic area that possesses standard telephone lines, and this approach to enhance communication may make it possible to offer better mammographic services at remote locations.