September 10, 2015

Image Parity: The Latest Buzzword in Radiology

We've all heard of price parity, but did you know there is a large push towards IMAGE parity throughout the healthcare system? 

Consistent and standard work is something we all strive for. No one thinks that is a bad idea, but can it be done in regards to mammographic imaging where there are so many variables at play?    

I work with many large and prestigious healthcare systems and say yes, it can!  It won't happen overnight, but it doesn't require a large investment or fancy equipment. However, it will take consensus-building, persistence, and consistency in practice by all to make it happen.    

Eliminate the variability in skin marking between physicians, technologists, and facilities within your healthcare system and what do you have? 


Standardization of your skin marking protocol makes life easier for everyone involved. Let's say you have one radiologist who prefers indicating a marking palpable masses with a triangle, yet another prefers using a pellet or BB-style marker. That inconsistency can lead to confusion and time consuming efforts by all when comparing previous to current images. By using “text book marking protocols” across your healthcare system you can establish a universal language that helps to maximize your efficiency with regards to read-time and aid in eliminating questions that can lead to additional imaging or other unnecessary procedures.  

But how to start?  

Your radiology team can begin by using the ACR Amended BIRADS (July 2014) guidelines. Section E on page 5, concerns the practice of skin markers in mammography: “Markers may be used to identify areas of clinical concern or for other situations that could impact an appropriate interpretation (e.g., raised skin lesions, palpable findings, and post-surgical changes). The facility should adopt a policy requiring consistent use of two different shapes of radiopaque devices for palpable and skin lesions, respectively”  

So at the very least, start with using ring-shaped markers exclusively for skin lesions/moles and triangular-shaped skin markers exclusively for indicating palpable masses. The triangle is the universal sign of WARNING in every country and every language.  If that film travels to another location/state, there will be no doubt what that triangle represents.

If you want to go a step further, and particularly if you are considering or currently using digital breast tomosynthesis, implement linear scar markers to indicate areas of previous surgeries.

Linear markers for scars have come a long way since the days of when wire and tape were used in analog.  Today's scar markers are made of low density materials that subtly highlight the area of a surgical scar that can help explain an area of architectural distortion seen on the image without hiding other important tissue details.

So save that BB for marking nipples.  They are a great landmark to measure back from and provide image assistance with many different body habitus.  

At Beekley Medical, we can help in your efforts in achieving Image Parity for your facility or healthcare system.  

From educational materials, mini-posters, technology-specific skin markers for every application, and most importantly, a dedicated Account Manager for your specific healthcare system to help walk you through it - a real live person on who can help you with any questions, challenges or obstacles you may encounter.

Learn more at or give us a call.      

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Heather O'Meara
Sr. National Accounts Manager

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