November 28, 2018

Practice Leaders at RSNA Hear How to Take Part in Landmark TMIST Trial

At a recent RSNA session, radiology practice leaders learned how taking part in the landmark Tomosynthesis Mammographic Imaging Screening Trial (TMIST) can benefit their patients and practices.

TMIST is the first large randomized, controlled trial (RCT) that would identify women in which digital breast tomosynthesis (DBT) may outpace (2D) digital mammography at reducing advanced breast cancer development.

“Decision makers rarely update clinical or payment policy without RCT data. I urge imaging practices to take part in TMIST and help shape future breast imaging care,” principal investigator Etta Pisano, MD, told ACR Advocacy in Action e-news.

Pisano informed attendees that TMIST is enrolling 165,000 healthy women, ages 45 to 74, at 130 sites throughout North America. Nearly 50 sites are already open and accruing patients.

Many more can still take part in this first U.S. breast cancer screening RCT since the 1980s. TMIST site registration is being streamlined to ease participation and TMIST reimbursement can enable sites to hire a study coordinator to run their on-site TMIST operations.

“TMIST participation enables imaging providers to advance breast cancer screening and their ability to offer the DBT screening option to patients” said Pisano, who also serves as American College of Radiology Chief Research Officer.

She pointed out that DBT generally uses more radiation, costs more and takes more time to interpret than digital mammography. However, Pisano added that about 30 percent of US facilities now have DBT and that the technology holds promise.

Some previous, smaller prospective studies have shown that tomosynthesis use reduces call backs and false positive exams, and finds more cancers than standard mammography.

This research led to federal funding of TMIST, which will also create the world’s largest curated dataset of breast cancer screening clinical data, images and bio-specimens.

To receive information on becoming a TMIST study site, contact TMIST Project Manager Jessica Howell at

For more TMIST information visit: