Abstract
Synthesized 2D images can be reconstructed from tomosynthesis images in breast imaging. This study aims to investigate the diagnostic efficacy of synthesized 2D images (C-View) in comparison to full field digital mammography (FFDM) when used with digital breast tomosynthesis (DBT) in multi-ethnic Malaysian population. FFDM and C-View images (n = 380) were independently evaluated by three readers through Breast Imaging Reporting and Data System (BI-RADS) categorisation, breast density and lesion characterisation. Statistical analysis was done comparing sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of C-View + DBT with FFDM + DBT as standard of reference. Very good interreader agreement in BI-RADS category and density assessment between C-View + DBT and FFDM + DBT, with high sensitivity, specificity, PPV and NPV of C-View + DBT when compared with FFDM + DBT. There was comparable PPV between C-View + DBT and FFDM + DBT, with histopathology as gold standard. High level of interreader agreement in BI-RADS category and density assessment for FFDM + DBT and C-View + DBT. There was good agreement between FFDM + DBT and C-View + DBT in mass characterization, and almost perfect agreement in calcification and asymmetric density. 52.2% lower radiation dose incurred when using C-View + DBT. Hence, synthesized 2D images are comparable to FFDM with reduction in radiation dose within the limits of Malaysian multi-ethnic population.
Highlights
This means increasing the radiation dose[7,8,9], albeit still within the Mammography Quality Standards Acts (MQSA) recommendation which limits the average glandular dose to 3mGy per breast
The purpose of our study is to assess whether the synthesized 2D images are comparable to full field digital mammography (FFDM) in Breast Imaging Reporting and Data System (BI-RADS) categorisation, breast density assessment, detection of calcifications, mass, asymmetric density and architectural distortions when reviewed with tomosynthesis
Of the 380 patients included, 41 patients were subjected to biopsy and 61% (n: 25) of these were of malignant histopathology (Table 2)
Summary
This means increasing the radiation dose[7,8,9], albeit still within the Mammography Quality Standards Acts (MQSA) recommendation which limits the average glandular dose to 3mGy per breast. One study included symptomatic patients[9], whilst the rest were on screening population These early studies demonstrated that the synthesized mammography www.nature.com/scientificreports/. Imaged from tomosynthesis may be an acceptable alternative to FFDM, as evidenced by reduced recall rates and comparable cancer detection rates. None of these studies looked into women in an Asian population, who have higher breast densities[13,14,15] and tend to develop breast cancer at a younger age (40–50 years old for Asians versus 70–80 years old in Western countries)[16]. We hypothesized that the synthesized 2D images are equivalent to FFDM and can replace FFDM in routine clinical practice
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