Evaluating Efficiency of Time Use and Operational Costs in a Breast Clinic Workflow: A Comparative Analysis Between Automated Breast Ultrasound and Handheld Ultrasound.

Objective: The aim of this study was to evaluate efficiency of time use for radiologists and operational costs of automated breast ultrasound (ABUS) versus handheld breast ultrasound (HHUS). Materials and Methods: This study was approved by the Institutional Review Board, and informed consent was waived. One hundred and fifty-three patients, aged 21-81 years, underwent both ABUS and HHUS. The time required for the ABUS scanning and radiologist interpretation and the combined scanning and interpretation time for HHUS were recorded for screening and diagnostic exams. One-Way ANOVA test was used to compare the methods, and Cohen Kappa statistics were used to achieve the agreement levels. Finally, the cost of the methods and return of interest were compared by completing a cost analysis. Results: The overall mean ± standard deviation examination time required for ABUS examination was 676.2±145.42 seconds while mean scan time performed by radiographers was 411.76±67.79 seconds, and the mean radiologist time was 234.01±81.88 seconds. The overall mean examination time required for HHUS was 452.52±171.26 seconds, and the mean scan time and radiologist time were 419.62±143.24 seconds. The reduced time translated into savings of 7.369 TL/month, and savings of 22% in operational costs was achieved with ABUS. Conclusion: The radiologist's time was reduced with ABUS in both screening and diagnostic scenarios. Although a second-look HHUS is required for diagnostic cases, ABUS still saves radiologists time by enabling a focused approach instead of a complete evaluation of both breasts. Thus, ABUS appears to save both medical staff time and operational costs.

ABUS examination time: An observational study of operators' experience.

OBJECTIVE: In this study we aimed to evaluate the operation times of ABUS by technologists during the learning time course and share the learning experience. MATERIALS AND METHOD: The first consequent 400 examinations after the installation of an ABUS unit in the breast clinic between August 2017 and December 2017 were included. Total examination time was measured for each procedure. The initial and final examination times during the learning period were compared. Data were analyzed with the Mann-Whitney Test. RESULTS: The acquisition times for routine six position examination ranged between eight and 36 minutes with an average of 13.2 ± 3.58 min. The examination time for the eight position examination ranged between 18 and 32 min, with an average of 22.9 ± 3.93 min. The overall average examination time was 13.3 ± 3.98 min. There was a significant difference (p = 0.00) between the average initial and final examination times of the learning period with an average decrease of 10.6 min. CONCLUSION: The average time of an ABUS examination for an average breast is less than 15 min. ABUS examination time reduced as technologists became familiar with the sonographic anatomy of the breast and experienced in positioning technique during the learning curve.

A New Technical Mode in Mammography: Self-Compression Improves Satisfaction.

OBJECTIVE: We aimed to evaluate the mammography experience of patients using a manually controlled self- compression tool compared to their previous experience based on technician performed breast compression by a questionnaire survey study. MATERIALS AND METHODS: The survey studies of 365 patients who underwent screening or diagnostic mammography between April 2017 and July 2017 at our center were reviewed retrospectively. Each patient had completed a 12-item questionnaire following mammography examinations. Women who never had a mammography before or who had a previous mammography examination more than 2 years ago or who did not want to use the self-compression device were excluded from the study. 106 women were included in the study. RESULTS: Patient satisfaction was high. Regarding the comparison of the experience of the exam to previous ones, 70.8% said it was a better experience. The examination was found comfortable by 85.4% of the participants and 75.5% found the examination more comfortable compared to previous ones. Only 11.3% were anxious and 52.8% declared they were less anxious compared to previous examinations. Regarding the attractiveness of the new design, 66.9% declared they found the new design attractive, 39.7% found it more attractive than previous examinations, and 27.3% said the new design decreased anxiety. In the evaluation of impact of patient-assisted compression (PAC) on comfort, 80.2% said that they found it more comfortable and 64.2% said that PAC decreased anxiety. Furthermore, 72.6% said the exam was shorter. CONCLUSION: Self-compression technique decreases pain and anxiety of women during mammography examinations and promises to enhance compliance of clients and patients with follow-up mammography recommendations.