Comparison of a Stationary Digital Breast Tomosynthesis System to Magnified 2D Mammography Using Breast Tissue Specimens

Abstract

The objective of this study was to compare the stationary digital breast tomosynthesis (s-DBT) system to a conventional mammography system in a study of breast specimens. Radiologist evaluation of image quality was assessed in a reader study. This study represents the first human tissue imaging with the novel carbon nanotube-based s-DBT device. Thirty-nine patients, with known breast lesions (Breast Imaging Reporting and Data System 4 or 5) by conventional mammography and scheduled for needle localization biopsy, were recruited under an institutional review board-approved protocol. Specimen images were obtained using a two-dimensional (2D) mammography system with a ×1.8 magnification factor and an s-DBT system without a high magnification factor. A reader study was performed with four breast fellowship-trained radiologists over two separate sessions. Malignancy scores were recorded for both masses and microcalcifications (MCs). Reader preference between the two modalities for MCs, masses, and surgical margins was recorded. The s-DBT system was found to be comparable to magnified 2D mammography for malignancy diagnosis. Readers preferred magnified 2D mammography for MC visualization (P < .05). However, readers trended toward a preference for s-DBT with respect to masses and surgical margin assessment. Here, we report on the first human data acquired using a stationary digital breast tomosynthesis system. The novel s-DBT system was found to be comparable to magnified 2D mammography imaging for malignancy diagnosis. Given the trend of preference for s-DBT over 2D mammography for both mass visibility and margin assessment, s-DBT could be a viable alternative to magnified 2D mammography for imaging breast specimens.