Abstract
Objective: To date, few studies have compared the diagnostic performance and visibility of microcalcifications obtained using digital breast tomosynthesis (DBT) with those obtained from full-field digital mammography (FFDM). The visualization and characterization of microcalcifications with DBT remain controversial. The purpose of this study was to compare the visibility of microcalcifications and determine whether DBT exhibits a diagnostic advantage for visualizing microcalcifications over FFDM. Methods: We retrospectively reviewed 120 cases including DBT and FFDM imaging (60 histologically verified as breast cancers and 60 as benign microcalcifications or normal). DBT images with a wide scan-angle of 50° and FFDM images were obtained using a flat-panel system (MAMMOMAT Inspiration, Siemens). Images were independently reviewed by four board-certified radiologists and evaluated for the presence of microcalcifications, probability of malignancy (BI-RADS classification), and visibility. Results: In predicting the malignancy of detected microcalcifications, no significant difference was found between readers’ areas under the receiver operating characteristic curve for DBT and FFDM (p = 0.068). The visibility scores of detected microcalcifications were 3.74 ± 1.06 for DBT and 3.46 ± 0.93 for FFDM, respectively. The visibility of microcalcifications when using DBT was found to be significantly superior to that of FFDM (p < 0.05). Conclusion: Our results suggest that the image quality of DBT with a wide scan-angle is comparable or superior to that obtained with FFDM in terms of both visibility and assessment of microcalcifications.
Highlights
Digital breast tomosynthesis (DBT) is an increasingly used technique for both breast cancer screening and assessment, and it has shown promise in improving the visualization and characterization of lesions [1] [2] [3]
To date, few studies have compared the diagnostic performance and visibility of microcalcifications obtained using digital breast tomosynthesis (DBT) with those obtained from full-field digital mammography (FFDM)
Our results suggest that the image quality of DBT with a wide scanangle is comparable or superior to that obtained with FFDM in terms of both visibility and assessment of microcalcifications
Summary
Digital breast tomosynthesis (DBT) is an increasingly used technique for both breast cancer screening and assessment, and it has shown promise in improving the visualization and characterization of lesions [1] [2] [3]. The combination of FFDM and DBT improved breast cancer accuracy, decreased the false-negative rate, and increased the sensitivity relative to using only FFDM [6]-[11]. This does not apply to the assessment of microcalcifications and the detectability of microcalcifications using DBT remains controversial
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