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With 14 imaging locations in the Raleigh-Durham metropolitan
area, also known as “the Triangle,” Wake Radiology offers a wide array of
imaging exams in the outpatient setting, including both screening and
diagnostic mammography. Renowned for state-of-the-art care, in August 2013 Wake
Radiology began to upgrade to 3D mammography, or DBT, and now exclusively
offers DBT at all 14 locations, all of which are designated as American College
of Radiology Breast Imaging Centers of Excellence (BICOE).

“We pride ourselves on being on the cutting edge of
technology as a way to distinguish ourselves from other providers of imaging
service in the area, which led to our decision to upgrade to 3D mammography
systems,” said Matt Dewey, Chief Information Officer (CIO) at Wake Radiology.
“But with the transition to 3D mammography, the radiologists found it difficult
to keep up with the volume of studies being performed. The number of images to
review increased so much with 3D compared to 2D mammography, our mammographers
kept lamenting that they simply couldn’t keep up.”

“Radiologists can experience a lot of fatigue when reading
DBT,” agreed William G. Way Jr., MD, a diagnostic radiologist at Wake
Radiology. “An enormous amount of diagnostic information is depicted in 3D
mammography datasets in comparison with 2D mammography.”

In an effort to manage the challenges posed by this increase
in workload, the team at Wake Radiology decided to explore all available AI
solutions for mammography, including ProFound AI for DBT.

“We were already early adopters of AI in diagnostic
radiology and had worked with several different AI vendors,” added Dr. Way. “As
a consequence, we were very optimistic about the potential for ProFound AI and
were convinced from the outset that it was worth testing.”

The Proof of Concept

In order to make an informed decision on which AI solution
to adopt, the team first launched a proof-of-concept process that evaluated ProFound AI and compared it
to other available breast AI solutions.

“We launched a trial of ProFound AI in October of 2020; we
also compared ProFound AI to a number of other breast AI technologies from
January to April in 2021,” said Dewey. “After comparing all available options,
we felt that iCAD’s technology was simply the best.”

“I was a proponent of ProFound AI because breast imaging AI
is iCAD’s core business, in comparison with other vendors in this same
technological space,” said Dr. Way.

With Wake Radiology being equipped with a full fleet of
Hologic systems and Intelerad PACS, both Dr. Way and Dewey also noted that
ProFound AI’s multivendor flexibility was a key point of differentiation.

“We needed an AI solution that would allow us to read
mammograms from either the Hologic workstation or from Intelerad PACS and
ProFound AI, which supports multiple output formats, was able to provide that
flexibility,” said Dewey. Additionally, some of the other AI products display
the CAD marks on a separate monitor rather than directly on the tomographic
images in the primary viewer. The radiologists felt it was better to highlight
the areas of concern detected by AI as overlays on the diagnostic monitors,
rather than forcing the radiologists to take their eye off the images to view
the CAD marks on a separate monitor.”

“I prefer reading mammography from PACS with the standard
set of tools available in my PACS interface rather than reading mammograms from
a separate, independent workstation,” said Dr. Way. “Other breast AI solutions
require that you read mammograms from their proprietary workstations. From an
economic standpoint, it was important to me that the ProFound AI output is
compatible with multiple PACS vendors that would allow us to read mammograms
from the viewer of our choosing rather than force us to be locked into using a
single dedicated mammography workstation in perpetuity.”

The team first began using ProFound AI for screening
mammograms, but in June 2021 they also began using it for diagnostic

“As a diagnostic radiologist, I’m not reading nearly as many
mammograms as someone reading screening mammograms, but I have still grown to
rely on the technology. I see a fair number of screening callbacks, and when I
review the diagnostic images, I rely heavily on the areas of concern detected
by ProFound AI on the original screening mammogram,” said Dr. Way. “When my
findings at the time of the diagnostic workup are concordant with ProFound AI
from the original screening examination, I feel much better about signing off
on the case as a BIRADS 2 or 3. I have come to appreciate that when ProFound AI
indicates the risk of malignancy is low, you can almost always trust it. And
for my colleagues who do large volume screening mammography, ProFound AI serves
as a reliable ‘second reader’ that helps them avoid making errors in

Ongoing Improvements Make for Continued Satisfaction 

After a year of implementing the technology, the team at Wake Radiology reports
continued satisfaction with ProFound AI, particularly as it improves over time
with ongoing updates and new versions.

“iCAD is definitely continuing to put resources into
improving their technology. Over the last year of using ProFound AI in our
clinical practice, we’ve seen the technology advance over time, with noticeable
improvements for the latest versions compared to its predecessor,” said Dewey.
“Not only has the algorithm itself improved since we adopted it, the formatting
has also improved, making it even better for our radiologists,” said Dewey.

Ultimately, the team at Wake Radiology found ProFound AI
gives them a competitive edge and positions their practice as a leader in
breast care in the Triangle.

“Having the latest in AI at our fingertips shows
that we are on the leading edge of advances in breast imaging,” added Dr. Way.
“It inspires confidence in our patients that we are committed to the deployment
of state-of-the-art technologies that are clinically proven to enhance patient

Learn more about Wake Radiology or read our other customer case studies to discover how iCAD’s technology is enhancing patient care for our customers across the U.S. and worldwide.