Case Study - Lake Medical Imaging

At a glance

Lake Medical Imaging, a full-service diagnostic imaging practice in Central Florida, was the nation’s first independent outpatient imaging center to receive the Diagnostic Imaging Center of Excellence designation from the American College of Radiology
(ACR). Performing more than 55,000 mammograms every year, Lake Medical provides customized breast imaging for all women through technologies including 3D screening and diagnostic mammography, contrast enhanced mammography, breast MRI, screening ABUS, and breast ultrasound. LMI implemented Transpara Breast AI in 2023 to help radiologists more easily find cancers and stratify normal cases, in order to improve patient outcomes.

Cathrine E. Keller, MD, Emeritus President and Managing Physician, discusses the workload challenges that led Lake Medical to adopt Breast AI and emphasizes the role of radiologists in using AI as an assistant rather than a replacement.

Find cancer more easily

Lake Medical Imaging of Central Florida operates six large imaging centers, one in Leesburg and five in The Villages. As an ACR Breast Imaging Center of Excellence, Lake Medical provides a full range of breast imaging solutions and performs more than 55,000 mammograms each year.

Following the example of Dr. Keller, over a dozen general and breast radiologists provide customized breast imaging for all women. In 2023, Dr. Keller led the adoption of Transpara breast AI with the goal of helping radiologists find cancer and recognize normal cases more easily. She is focused on the best way to leverage new technology in order to improve patient outcomes and has been a consistent early adopter of new imaging techniques that create clinical benefits. Transpara is FDA cleared and has European CE Marking (MDR) for both abnormality detection and density assessment for use with 2D and 3D mammography from multiple manufacturers.

It has been used to analyze more than 10 million mammograms at leading breast centers in more than 30 countries, delivering consistent results across regions and demographics.

“First and foremost, radiologists must be comfortable with AI and the potential benefits it brings to improving patient care,” said Dr Keller. “However, it was workload challenges that led me to consider implementing breast AI. As the number of radiologists reading mammography in my group diminished, we had a hard time absorbing the growing exam volume and had to find a sustainable solution to improve workload and reduce burn-out.”

Real-world time savings

As breast AI gained traction in the market, claims about time savings and increased efficiency from using breast AI caught Dr. Keller’s attention in hopes of achieving those same gains at Lake Medical.

“The time savings reported by some companies is often in relation to reader studies alone, which is not the real-world. They’re not looking at prior mammograms, they’re not analyzing the mammogram in the same way as when you’re really reading,” noted Dr. Keller. “With Transpara, we have realized time savings, in part because the negative predictive value is so high. It really helps get through normal mammograms faster. At the same time, for more difficult cases, it is helpful to have potentially suspicious findings highlighted to give those areas that might have been overlooked, more scrutiny.”

Many studies have proven the workload benefits associated with Transpara Detection. This includes, “An Artificial Intelligence–based Mammography Screening Protocol for Breast Cancer: Outcome and Radiologist Workload,” published in Radiology. The research showed that the use of Transpara Detection reduced false positives and radiologists’ workload by up to 62.6% in the largest Danish screening program.

In another landmark study, “Screening performance and characteristics of breast cancer detected in the Mammography Screening with Artificial Intelligence trial (MASAI),” republished in The Lancet Digital Health in April 2025, Transpara-assisted workflow helped detect 29% more cancers while safely reducing reading workload by 44% with no change in recall rate. MASAI is the first time that a Breast AI solution was featured in a randomized controlled trial.

Lower recalls and greater diagnostic confidence

Lake Medical offers same-day results in an effort to eliminate potential weeks of worry. If a woman’s mammogram detects something suspicious, follow-up imaging is performed
immediately. Dr. Keller and her team pride themselves on providing the best screening and diagnostic services available, and Lake Medical has a lower recall rate for several reasons.

First, the vast majority of women have prior mammograms that are reviewed whenever possible, resulting in a significant impact on recall rates. Using contrast enhanced mammography enables radiologists to quickly resolve potential BI-RADS 3 findings that previously would have been recalled.

“Ultimately, the Transpara Breast AI helps speed up the identification of normal cases and provides greater confidence,” added Dr. Keller. “When our radiologists, particularly the general radiologists who read mammograms, review a mammogram of a dense breast that Transpara has marked as low risk, they feel much more comfortable and confident in the decision- making process to not recall that patient.”

How to evaluate Breast AI

“Lake Medical has always been dedicated to adopting leading-edge technology to improve patient care and reduce workload for our staff and this includes Breast AI,” noted Dr. Keller. “I know that AI is relatively new, and clinicians and administrators don’t want to make a mistake and adopt the wrong technology. However, not moving forward based on analysis paralysis does nothing to improve patient care. That’s why I am sharing some of the questions that guided my due diligence process for selecting Transpara.”

According to Dr. Keller, Breast AI providers must be committed to improve accuracy and consistency while reducing unnecessary recalls which cause anxiety, cost, and inconvenience for women undergoing mammography. This commitment must be demonstrated through evidence-based performance, clinically validated through reader studies and prospective and retrospective trials conducted by leading breast imaging researchers around the world.

Other criteria Dr. Keller reviewed include:

• Is it FDA cleared for use with 2D and 3D mammography in the United States and available for clinical use?
  
  
• Has the tool’s actual performance been validated? Is there performance data that has been evaluated by external third parties and been made public via peer-reviewed studies and conference presentations? Can these results be validated by studies involving mammograms and radiologists from both the United States and Europe that show that radiologists, regardless of their experience level, increased their accuracy?
  
  
• How easy is the company to work with on IT integration? On training? How flexible are they on contracting? How committed is the company to ongoing and proactive algorithm improvements as well as continuous testing and validation to ensure accurate and consistent results?

“I chose Transpara, not only because of the strength of its published data, but also all of the company’s dedication to technical and business support designed to ensure our success,” said Dr. Keller. “Once it was deployed at all of our sites, the Transpara team collaborated with us on training and ramp up and within six weeks or so, I saw a growing confidence with the system across the entire team.”

Artificial intelligence is here to stay

Dr. Keller emphasizes, “as the radiologist you are still responsible for the interpretation. Breast AI is a tool that can support your decision-making process if you use AI like an assistant that can speed up the process by highlighting potential abnormalities.”

“Ultimately, AI is like the internet, you’re not going to get rid of it. The main thing is for radiologists to learn to be comfortable with the entire concept of AI – it has never been about replacing radiologists. The only radiologists who should be concerned about getting replaced are the ones who do not use AI to improve cancer detection and patient care.”

Now with Transpara, Lake Medical Imaging is:

• Finding more cancers earlier and with better workflow delivered with Transpara
• Delivering outstanding patient care by combining their strong radiology skills and cutting edge imaging tools together with the confidence they get from Transpara
• Confident that their robust evaluation of Breast AI and selection of Transpara gave them a solution that will continue to grow with their practice