Abstract
ObjectivesTo evaluate the diagnostic performance in the assessment setting of three protocols: one-view wide-angle digital breast tomosynthesis (WA-DBT) with synthetic mammography (SM), two-view WA-DBT/SM, and two-view digital mammography (DM).MethodsIncluded in this retrospective study were patients who underwent bilateral two-view DM and WA-DBT. SM were reconstructed from the WA-DBT data. The standard of reference was histology and/or 2 years follow-up. Included were 205 women with 179 lesions (89 malignant, 90 benign). Four blinded readers randomly evaluated images to assess density, lesion type, and level of suspicion according to BI-RADS. Three protocols were evaluated: two-view DM, one-view (mediolateral oblique) WA-DBT/SM, and two-view WA-DBT/SM. Detection rate, sensitivity, specificity, and accuracy were calculated and compared using multivariate analysis. Reading time was assessed.ResultsThe detection rate was higher with two-view WA-DBT/SM (p = 0.063). Sensitivity was higher for two-view WA-DBT/SM compared to two-view DM (p = 0.001) and one-view WA-DBT/SM (p = 0.058). No significant differences in specificity were found. Accuracy was higher with both one-view WA-DBT/SM and two-view WA-DBT/SM compared to DM (p = 0.003 and > 0.001, respectively). Accuracy did not differ between one- and two-view WA-DBT/SM. Two-view WA-DBT/SM performed better for masses and asymmetries. Reading times were significantly longer when WA-DBT was evaluated.ConclusionsOne-view and two-view WA-DBT/SM can achieve a higher diagnostic performance compared to two-view DM. The detection rate and sensitivity were highest with two-view WA-DBT/SM. Two-view WA-DBT/SM appears to be the most appropriate tool for the assessment of breast lesions.Key Points• Detection rate with two-view wide-angle digital breast tomosynthesis (WA-DBT) is significantly higher than with two-view digital mammography in the assessment setting.• Diagnostic accuracy of one-view and two-view WA-DBT with synthetic mammography (SM) in the assessment setting is higher than that of two-view digital mammography.• Compared to one-view WA-DBT with SM, two-view WA-DBT with SM seems to be the most appropriate tool for the assessment of breast lesions.
Highlights
Digital breast tomosynthesis (DBT) is emerging as the standard imaging modality for breast cancer diagnosis, based on improvements in both diagnostic and screening imaging outcomes [1,2,3,4,5,6,7]
Specificity was better for wide-angle digital breast tomosynthesis (WA-DBT) reading protocols, though the difference was not statistically significant compared to two-view digital mammography (DM) (Fig. 2)
The results of our study demonstrate that, in an assessment setting, two-view WA-DBT with synthetic mammography (SM) achieves a higher detection rate and diagnostic performance compared to two-view DM
Summary
Digital breast tomosynthesis (DBT) is emerging as the standard imaging modality for breast cancer diagnosis, based on improvements in both diagnostic and screening imaging outcomes [1,2,3,4,5,6,7]. Based on the improved resolution of wide-angle systems, several studies have been performed that suggest the use of one-view (mediolateral oblique) wide-angle DBT (WA-DBT) only, with or without the second-view (cranio-caudal) DM [13,14,15]. The one-view WA-DBT strategy would allow a further reduction of the radiation dose and add to the reduction already achieved with SM. This could lead to a reduction in reading time, as well as a reduction in radiologists’ fatigue when reading two-view DBT [16,17,18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
