Diagnosing breast cancer in women with extremely dense breasts often comes down to MRI, but the scans take long and are expensive. Research confirms that shorter protocols also yield accurate results.
Using radiomics on mammograms of over 30,000 women, researchers have identified six breast texture patterns that may be associated with increased cancer risk.
A novel deep-learning approach automatically finds and classifies microcalcifications found in mammography images—bringing both accuracy and consistency to breast-cancer screening.
At the San Antonio Breast Cancer Symposium (SABCS), three experts presented new approaches and study results for the treatment of breast cancer in young women.
Despite their improving diagnostic accuracy, medical AI systems are often met with skepticism by radiologists. Their patients, however, seem more inclined to embrace this technology, a study shows.
New findings show how AI-assisted mammography may not only reveal breast cancer, but can also assess calcium buildup in the arteries within breast tissue—an indicator of cardiovascular health.
AI-supported screening for breast cancer can detect more cancer cases compared with traditional screening, and find more invasive cancers at an early stage, results from the MASAI trial indicate.
Improved breast cancer detection, reduced workload for radiologists: The world’s largest prospective study on AI in Germany’s Mammography Screening Program reveals the technology's benefits.
In the world of theatre, the ‘deus ex machina’, the god from the machine, is a dramaturgical trick to resolve seemingly unsolvable conflicts. Can artificial intelligence (AI) also be such a universal problem solver for internal medicine? At the Annual Congress of the German Society of Internal Medicine (DGIM), Dr Isabella Wiest explored the potential – and limitations – of AI helpers.
Measuring the calcium build up in the arteries of the breast, researchers have developed an AI-generated score for predicting cardiovascular disease in women from their mammograms.
Evidence of the superiority of tomosynthesis for breast cancer detection is stacking up, with new results from a 10-year study further demonstrating the 3D imaging technique's benefits.
Mammography can lead to “false positives,” meaning they do not result in a breast cancer diagnosis. This may discourage some women from future screenings, according to a new study.
Researchers have developed an artificial intelligence which can differentiate cancer cells from normal cells, as well as detect the very early stages of viral infection inside cells.
Although the Covid-19 pandemic is behind us, healthcare facilities continue to experience workflow challenges and resource constraints impacting women’s health and a patient’s ability to receive a timely diagnosis. Clinical specialties like breast radiology and cytology are especially susceptible to these issues and continue to experience backlogs, which impact their ability to deliver timely…
Using artificial intelligence (AI), breast radiologists in Denmark have improved breast cancer screening performance and reduced the rate of false-positive findings.
Current AI systems for detecting breast cancer from mammography exams are more likely to produce false-positive results in black women and older patients, a new study finds.
A team of Danish and Dutch researchers has combined an AI diagnostic tool with a mammographic texture model to improve the assessment of short- and long-term breast cancer risk. This new approach represents a significant step forward in refining the ability to predict the complexities of breast cancer risk.
A clinical trial has revealed the effectiveness of '3D mammography' in reducing by almost half the incidence of interval breast cancer appearing between two rounds of screening.
A combination of PET and MR imaging could help doctors spot signs that breast cancer is beginning to spread in a patient. This insight can then be used to adapt treatment strategies.
Hologic, Inc. unveils new research in artificial intelligence (AI) and offering innovative educational opportunities at the annual European Congress of Radiology (ECR) in Vienna, Austria.
Breast MRI is increasingly being used as a primary breast cancer screening exam for young women. It brings benefits in women with dense breasts, who are at an elevated risk of developing breast cancer. The technique is also being ordered as a supplemental screening exam following mammography or breast ultrasound for women of all ages at high risk. But use of breast MRI as a screening tool is…
A newly-developed biosensor could be an alterative to MRI and mammography for breast cancer screening. The handheld device uses saliva on test strips to determine whether cancer is present.
A new breast imaging technique provides high sensitivity for detecting cancer while significantly reducing the likelihood of false positive results, according to a new study.
Researchers in Singapore have developed an AI-based software to assist in the early detection of breast cancer. Using thermal imaging, the program assesses the malignancy of a tumour.
While having more centers adopt digital breast tomosynthesis (DBT) for breast cancer screenings into their practice is a positive change, it also presents some challenges for radiologists—particularly the increased number of images for radiologists to review. This challenge has paved the way for AI to offer innovative workflow solutions for radiologists that do not sacrifice accuracy.
Mammographic screening is used to detect breast cancer, but is prone to false findings. Could an AI reader help improve this? UK researchers compared the performance of man and machine.
Can per- and polyfluoroalkyl substances (PFAS) increase the risk of breast cancer? A new study by US researchers examines the effects of the so-called “forever chemicals”.
A new safety analysis finds AI-supported mammography analysis is as good as two breast radiologists working together to detect breast cancer, almost halving the screen-reading workload.
With the recent recommendation changes from the European Council in 2022, how radiologists screen for breast cancer is changing. Mammography has long been an essential technology in screening for breast cancer, and in the recommendations the Council formally recognized the advantages of digital breast tomosynthesis (DBT). This landmark acknowledges the research on and benefits of DBT, advocating…
A new device, designed by MIT researchers, could detect breast cancer earlier. The scanner, which can be incorporated into a bra, could allow more frequent monitoring of high-risk patients.
Mammography has been an essential imaging technology for breast cancer detection for decades. As the industry has continued to innovate, one advancement in mammography has particularly changed the landscape of breast imaging: digital breast tomosynthesis (DBT), also known as 3D mammography.
Ultrasound is an effective standalone diagnostic method in patients with focal breast complaints, according to a study published in Radiology, a journal of the Radiological Society of North America (RSNA). Focal breast complaints can refer to pain, lumps, nipple discharge or other symptoms and conditions confined to a specific area of the breast.
As ChatGPT becomes more popular among those seeking health advice, researchers try to find out whether the information provided by the AI chatbot is reliable and accurate.
In a study of over a million women, digital breast tomosynthesis (DBT) showed improved breast cancer screening outcomes over screening with standard digital mammography alone.
Compared to other common supplemental screening methods, breast MRI was superior at detecting breast cancer in women with dense breasts, according to a new study.
The need for breast cancer screening of transgender individuals has been a topic of uncertainty until recently, due to lack of reliable patient data, consensus by radiologists, published research, and recommended guidelines. A 2021 survey of Society of Breast Imaging (SBI) members revealed that ‘breast radiologists differ in their practice and knowledge regarding screening of transgender…
The risk of developing breast cancer is higher in breasts with high density. But why is that? Researchers at Linköping University have shown major biological differences that promote cancer growth.
Women with high-risk breast lesions (HRLs) and no family history of breast cancer or BRCA mutations are generally considered to be at moderate risk of developing breast cancer. Breast cancer screening guidelines suggest breast MRI be considered as a supplement to mammography. But is this expensive exam necessary?
When double reading screening mammograms, radiographers trained for the task perform as well as radiologists in key areas, according to a new publication.
The interplay between the patient’s BMI, tumour size and cancer-specific proteins is of importance for the prognosis of breast cancer, a study from Sweden shows.
Clinical laboratories need to be proactive to attract transgender patients for testing and to ensure that they are comfortable with the services provided. This issue is of great importance to the American Association for Clinical Chemistry (AACC), which conducted a scientific session on transgender health at its recent annual meeting in Chicago.
Contrast-enhanced mammography (CEM) has gone a long way since it was first approved by the Food and Drug Administration (FDA) in 2011. An Italian expert explained how useful the modality has become in breast imaging in a dedicated course at ECR 2022.
A major new study shows that artificial intelligence (AI) is a promising tool for breast cancer detection in screening mammography programs.
A software based on deep learning with convolutional neural networks can accurately and consistently classify breast density on mammograms according to BI-RADS criteria.
Annual MRI screenings starting at ages 30-35 may reduce breast-cancer mortality by more than 50% among women who carry certain genetic changes in three genes, according to a new modeling analysis.
Artificial intelligence (AI) models that evaluate medical images have potential to speed up and improve accuracy of cancer diagnoses, but they may also be vulnerable to cyberattacks.
Artificial intelligence (AI) is changing our healthcare systems. It can help us detect diseases earlier, improve patient care and reduce healthcare costs. However, there is still a lack of trust, of rules and safety regulations and of broad data pools. How can we use AI successfully in healthcare systems and what role will it play in the future?
Mammograms are a safe, effective way to detect the presence of breast cancer in women. But doctors recommend most females should start getting mammograms after the age of 40 in part because the procedure involves small doses of ionizing radiation. While the risk of getting breast cancer is higher for older people, it can strike at any age. Studies show that 5% to 7% of females with breast cancer…
How will digital technology impact healthcare in 2030? If challenges to acceptance and utilisation can be overcome, healthcare providers and patients will benefit significantly, according to physicians participating in a recent online seminar on this topic.
Contact shielding is one of the most divisive areas in radiography. Is it still essential in protecting patients from radiation, or has new technology made this precaution obsolete? Two experts debated the issue at the ISRRT congress in Dublin.
The Covid-19 pandemic continues to impact people’s health across the world. This goes beyond the disease itself, as healthcare systems adapt how they provide services. Routine screening has been severely affected with screening programmes reduced or paused.
The contribution of Artificial intelligence (AI) has great potential in breast imaging efficiency, Professor Linda Moy MD told attendees at the 2021 Society of Breast Imaging/American College of Radiology (SBI/ACR) Breast Imaging Symposium this April. AI models for breast imaging have focused mainly on the diagnostic classification and detection of breast cancer.
In just the last two years, artificial intelligence has become embedded in scores of medical devices that offer advice to ER doctors, cardiologists, oncologists, and countless other health care providers. But how much do either regulators or doctors really know about the accuracy of these tools? A new study led by researchers at Stanford, some of whom are themselves developing devices, suggests…
Medical technology company iCAD, Inc. announced that ProFound AI for 2D Mammography might notably reduce the risk of interval breast cancer, according to a new retrospective analysis. The aim of the study was to determine if adding AI to reading mammography as a supportive tool may help in decreasing the interval cancer rate in population-based organized mammography screening programs in Germany.
One of the leading figures in global radiology has highlighted the importance of fostering a strong eco-system to advance the safe and effective implementation of AI in medical imaging. Dr Geraldine McGinty said that to fully leverage the power of AI, all stakeholders must work together but underlined the unique responsibility physicians have to ensure patient interests are best served.
Digital breast tomosynthesis (DBT) increases detection of breast cancer in symptomatic women under the age of 60, especially in dense breasts. A large, multi-institutional study conducted in the United Kingdom comparing the sensitivity of full-field digital mammography (FFDM), DBT, and FFDM plus DBT supports findings of two similar published studies, both conducted in China in the same time frame.
A new deep learning system to help radiologists improve their workflow efficiency when reading high volumes of screening mammograms is being developed at Johns Hopkins University’s Radiology Artificial Intelligence Lab (RAIL) in Baltimore, MD. DeepCAT (Deep Computer-Aided Triage) is focused on workflow prioritization.
Implementation of artificial intelligence into Scotland’s national breast screening service is moving closer following an initial success with a trial project. While Scotland’s breast screening trial has delivered highs and lows, significant hurdles have been overcome in terms of approvals, governance and patient acceptance.
The impact of Covid-19 has been devastating; countless lives lost, millions of infections worldwide, health systems overwhelmed and economies rapidly shrinking. Screening, such as for breast or cervical cancer, is an area particularly affected, with numerous appointments delayed.
For many women, swollen lymph nodes are a red flag pointing to breast cancer – but may also be a normal immune reaction to a Covid-19 vaccination. In this Q&A, breast imaging experts address the most important facts on the topic.
AI can help tackle inequities and bias in healthcare but it also brings partiality issues of its own, experts explained in a Hot Topic session entitled "Artificial Intelligence and Implications for Health Equity: Will AI Improve Equity or Increase Disparities?" at RSNA.
Displaying medical images from different modalities such as CT, CR/DR, MR, ultrasound or mammography and pathology on one monitor - that is what most radiologists want. Many of them still use several medical displays next to each other. JVCKenwood's new CL-S1200 30.9-inch colour monitor makes this a thing of the past. The 12 megapixel device (4,200 horizontal and 2,800 vertical) can display…
Women with incident and proliferative benign breast diseases (BBD) are likelier to develop breast cancer, a Spanish researcher explained during the 12th European Breast Cancer Conference in October. These findings support the idea of designing personalised breast cancer screening strategies to improve effectiveness.
Tumours with the same biology have different prognoses based on their method of detection, and this information should be taken into account when deciding which treatments might be needed, a Dutch researcher explained at the 12th European Breast Cancer Conference.
A French expert in breast imaging looked at the latest Deep Learning (DL) applications in her field, screening their strengths and weaknesses in improving breast cancer detection. It is really important to understand which types of data sets need to be checked when evaluating an AI model for image interpretation, according to Isabelle Thomassin-Naggara, Professor of Radiology at Sorbonne…
The field of AI-enhanced imaging provides radiologists with an unprecedented opportunity to shape patient care, leading Austrian radiologist Katja Pinker-Domenig explained at ECR 2020.
Breast cancers that are detected in the interval between national screening programme mammograms have a worse prognosis than those detected at the time of a screening, even if they have the same biology, according to research presented at the 12th European Breast Cancer Conference. Analysis of results from over eight years’ follow-up of the international MINDACT randomised phase III clinical…
40 years ago, anticipating the huge impact of computers in radiology, a group of visionaries formed the Radiology Information System Consortium (RISC). In 1989, RISC created the Society for Computer Applications (SCAR) to promote computer applications in digital imaging. Those organisations became the Society for Imaging Informatics in Medicine (SIIM). At SIIM 2020, a virtual meeting, experts…
Researchers have developed the first blood test that can accurately detect more than 50 types of cancer and identify in which tissue the cancer originated, often before there are any clinical signs or symptoms of the disease. In a paper published in the leading cancer journal Annals of Oncology, the researchers show that the test, which could eventually be used in national cancer screening…
Examining the safety of AI integration into clinical workflow during at the British Institute of Radiology (BIR) annual congress in London, this November, Professor Nicola Strickland focused on issues of data quantity and quality, regulation, validation and testing of algorithms. She also urged radiologists and computer scientists to work more closely together to develop safe, effective and…
A computer algorithm has been shown to be as effective as human radiologists in spotting breast cancer from x-ray images. The international team behind the study, which includes researchers from Google Health, DeepMind, Imperial College London, the NHS and Northwestern University in the US, designed and trained an artificial intelligence (AI) model on mammography images from almost 29,000 women.…
Although breast cancer (BC) mammography screening enables early detection of breast cancer, mammography presents issues such as variability between the radiology readings and shortage of radiologists. This area of medical imaging is where artificial intelligence (AI) could help make the biggest difference and improve patient outcome.
A new, portable breast imaging system under development in Buffalo has the potential to better identify breast cancer in women with dense breast tissue. That is among the findings of a study published in the journal IEEE Transactions on Biomedical Engineering. The study was led by University at Buffalo researchers in collaboration with Roswell Park Comprehensive Cancer Center and Windsong…
Breast cancer is rare for women under 40. So, a breast cancer diagnosis can be shocking news for a young woman to hear. “Breast cancer in young women can have its own risk factors and traits, and young women have their own considerations when deciding on a treatment,” says Nadine Tung, MD, head of breast medical oncology and cancer genetics at Beth Israel Deaconess Medical Center (BIDMC).…
The U.S. Food and Drug Administration (FDA) announced important new steps to modernize breast cancer screening and help empower patients with more information when they are considering important decisions regarding their breast health care. For the first time in more than 20 years of regulating mammography facilities, the agency is proposing amendments to key regulations that would help improve…
MRI offers unequalled sensitivity and specificity in breast cancer detection. Yet, it is poorly accepted preoperatively. Recently, eminent radiologist Francesco Sardanelli, professor for radiology at Milan University and Chief of Radiology at the IRCCS Policlinico San Donato in Italy, unveiled preliminary results that could further MRI acceptance among multidisciplinary teams.
The selection of a first-line chemotherapy drug to treat many types of cancer is often a clear-cut decision governed by standard-of-care protocols, but what drug should be used next if the first one fails? That’s where Georgia Institute of Technology researchers believe their new open source decision support tool could come in. Using machine learning to analyze RNA expression tied to…
Driving breast cancer screening compliance is an essential part of improving clinical outcomes, and one way to do this is to educate women about their breast density, advises Tracy Accardi, Hologic’s Global Vice President of Research and Development for Breast Health & Skeletal Solutions.
Tomosynthesis is under international review, with a surprising number of enticing studies carried out in Northern European countries, among them one headed by Professor Sophia Zackrisson at Lund University, Sweden. In our interview, she not only revealed surprising trial results, but also shared her thoughts on practical implementation and unusual speed-reading methods. ‘Our institute’s…
The UNESCO World Heritage City Bergen is seen as the gateway to the fiords of Norway. However, for radiologists the city offers an even more interesting attraction than Scandinavian landscapes. Bergen features one of the largest randomised control trials to compare digital breast tomosynthesis (DBT) with digital mammography (DM): the To-Be trial. Professor Solveig Hofvind, head of BreastScreen…
What beats digital mammography to detect breast cancer in asymptomatic women? Digital breast tomosynthesis (DBT) – was a big discussion at RSNA 2017. Sarah M Friedewald MD, medical director of the Lynn Sage Comprehensive Breast Center of Northwestern Memorial Hospital in Chicago and its division chief of breast and women’s imaging, discussed the clinical implications of DBT for routine…
A new optical imaging system developed at Columbia University uses red and near-infrared light to identify breast cancer patients who will respond to chemotherapy. The imaging system may be able to predict response to chemotherapy as early as two weeks after beginning treatment. Findings from a first pilot study of the new imaging system—a noninvasive method of measuring blood flow dynamics in…
Half of cancers can be avoided if institutions would exchange knowledge, according to Joxel García, executive director of the University of Texas MD Anderson Cancer Center in Houston, who opened the Center’s meeting in Madrid in October 2016. Technology has progressed enormously and there has never been that much knowledge of cancer to prevent it and find treatment tools.
The use of deep learning (DL) technology could help radiologists increase the quality of breast cancer screening programs, lower costs, and reduce the variability in the cancer detection process. And the role of DL technology in imaging doesn't stop there. In fact, it is likely that DL computers can be trained to read mammograms as well as radiologists and — in the future — maybe even…
Scientists are using Artificial Intelligence (AI) to support more effective breast cancer detection. The researchers at Massachusetts Institute of Technology (MIT) Computer Science and Artificial Intelligence Laboratory (CSAIL), Massachusetts General Hospital (MGH), and Harvard Medical School, are using the machine learning system to predict whether breast lesions identified from a biopsy will…
Hologic, Inc. announced that it will provide all mammography systems for the Dutch Breast Cancer Screening Program in partnership with Tromp Medical, Hologic’s distributor in the Netherlands. Under the tender, Hologic’s new, state-of-the-art 3Dimensions mammography systems will be installed in mobile and stationary screening facilities across the country, starting in 2018. The multi-year…
A controversy regarding the benefit of early screening programmes for breast cancer continues. Germany, Austria and Switzerland have developed individual strategies. European Hospital asked three experts from these countries to outline each chosen system. Markus Hahn MD, senior consultant at the University Breast Centre in Tübingen, Martin Daniaux, MD, Head of Breast Diagnostics at the Breast…
‘Clinicians across Europe have made clear their desire for breast cancer screening technology that offers improved accuracy, clarity and workflow, and the 3Dimensions system addresses each of those specific areas,’ Hologic’s Jan Verstreken, Regional President for EMEA and Canada, pointed out during the launch of the new system. This is the latest in the firm’s breast cancer screening,…
Despite rigorous quality assurance of breast cancer screening programs, ‘both, over- and under-diagnosis of breast cancer is a challenge,’ says leading radiologist Christiane K Kuhl, from the Department of Diagnostic and Interventional Radiology, at the University of Aachen, Germany. ‘Mammography is a good screening test – but has its limitations especially, but not only, in women with…
In a potential major breakthrough in breast cancer research, scientists at the Center for Translational Cancer Research (CTCR) at the Helen F. Graham Cancer Center & Research Institute of Christiana Care Health System have developed a revolutionary new blood test to diagnose breast cancer.
Hologic, Inc. announced that the 3Dimensions mammography system, the fastest, highest resolution breast tomosynthesis system ever, is available for purchase in Europe. The new product is the latest addition to Hologic's portfolio of market-leading breast cancer screening, diagnostic and interventional solutions. It offers a variety of groundbreaking features designed to provide higher quality 3D…
Dr Massimo Calabrese, head of the Complex Operative Unit of Diagnostic Senology in Genoa’s San Martino Hospital, examines aspects of stereotactic breast biopsy procedures and workflow and the need for improvements in certain areas of breast diagnostics.
Biannual mammography can help to reduce breast cancer mortality by 40% in women aged 50-69, but the benefits for women under 35 years old are questionable, eminent Spanish radiologists highlighted during a session held by SERAM, their national society of radiology, last November, during the International Radiology Day.
The University of Southern California (USC) Norris Comprehensive Cancer Center is actively recruiting for a clinical trial that is researching the effectiveness of a breath test for breast cancer diagnostics. The BreathLink device, manufactured by Menssana Research, Inc., captures a two-minute sample of a patient’s breath and provides immediate results on whether there are indications of breast…
The job title radiographer has a firm place in many European and non-European countries. The academic training reflects the complex range of responsibilities the role entails.
Radiologists and radiographers all over the world will once again celebrate the International Day of Radiology (IDoR) on November 8, which this year takes breast imaging as its main theme. The IDoR is an initiative of the European Society of Radiology (ESR), the American College of Radiology (ACR) and the Radiological Society of North America (RSNA).
Italian-led research has highlighted the value of utilising additional screening technologies to help diagnose breast cancer in some women. Interim analysis from the Adjunct Screening with Tomosynthesis or Ultrasound in Women with Mammography-Negative Dense Breasts (ASTOUND) study has delivered evidence of the potential benefit of adding either ultrasound or tomosynthesis to standard mammograms…
Preliminary tests have demonstrated that a new device may enable existing breast cancer imagers to provide up to six times better contrast of tumors in the breast, while maintaining the same or better image quality and halving the radiation dose to patients. The advance is made possible by a new device developed for 3D imaging of the breast by researchers at the Department of Energy's Thomas…
The ongoing debate about breast cancer diagnostics has left many women confused — particularly over what age they should get mammograms and who needs treatment. An issue with current methods is that they often identify lumps but cannot conclusively pinpoint which ones are cancerous. To help resolve this uncertainty, researchers have developed a pill that could improve imaging techniques so that…
Results from recent trials are promising: an almost 40% increased breast cancer detection rate from digital breast tomosynthesis (DBT) screening compared to conventional mammography.
A new EU-funded project HYPMED is developing a ground-breaking imaging method for more accurate detection of breast cancer and a better, more personalised, understanding of its response to therapy.
In a comprehensive modeling study, researchers from UC Davis and other institutions have found that breast cancer screening with digital mammography poses only a small risk of radiation-induced breast cancer for most women. However, the research showed increased risk for women with large breasts or breast implants, who must often receive extra screening views, increasing their radiation exposure.
A magnetic resonance (MR) breast imaging technique that uses no ionizing radiation or contrast agent could reduce unnecessary biopsies by providing additional information about suspicious findings on X-ray screening mammography, according to a new study published online in the journal Radiology.
Each year, approximately 1.6 million women in the USA have breast biopsies to diagnose or rule out cancer. Pathological diagnosis is considered the gold standard – how accurate are these diagnoses? Report: Cynthia E. Keen
Imaging tests like mammograms or CT scans can detect tumors, but figuring out whether a growth is or isn’t cancer usually requires a biopsy to study cells directly. Now results of a Johns Hopkins study suggest that MRI could one day make biopsies more effective or even replace them altogether by noninvasively detecting telltale sugar molecules shed by the outer membranes of cancerous cells.
It is tough enough to be a clinician reading dozens of mammograms every day to detect early signs of breast cancer. Now those same radiologists must become statisticians in order to decrypt dozens of studies, challenging whether it is worth reading mammograms in the first place. Report: John Brosky
Women over the age of 50 are not only at higher risk of developing breast cancer but also osteoporosis. Would it not be practical to use the same method to detect both diseases early on? Definitely, decided Sectra, the Swedish company specialising in PACS and mammography systems.
The Koning Breast CT (KBCT) system, which has been granted FDA approval, provides 3D breast of the entire breast from any orientation for diagnoses.
At the recent North American IHE Connectathon in Cleveland, Sectra (STO: SECT B) successfully completed testing of the IHE profiles MAMMO and DBT (Digital Breast Tomosynthesis). The testing was done using Sectra PACS which implements the Image Display and Image Manager actors of these profiles.
Carestream will show enhancements to its digital breast tomosynthesis (DBT) module including a slabbing tool, improved workflow capabilities and the display of DICOM-compliant 2D synthetic views (which are generated from the 3D dataset) at the 2015 European Conference of Radiology. The latest DBT module is currently available.