Tomosíntesis de mama: mamografía sintetizada versus mamografía digital. Impacto en la dosis

Abstract

ObjectiveTo compare the detectability and visibility of lesions in synthesized and digital mammography. To estimate the dose saving due to the use of synthesized images in tomosynthesis examinations. Patients and methodsSeven observers scored the detectability and visibility of objects simulating microcalcifications in digital and synthesized images of a phantom. Four observers retrospectively assessed the images from a sample of 20 patients with histologically confirmed lesions. Mean glandular dose values were retrospectively estimated in a sample of 50 patients. ResultsThe detectability and visibility of microcalcifications in the structural background of phantom images were 50% and 100% higher, respectively, for synthesized images. The visibility of the findings in the clinical images was similar for both types of images, except for distortions, which were better visualized on synthesized images (p=10−5). Sixteen percent of malignant findings were not detected in digital images and 7% were undetected in synthesized images. The mean glandular dose per breast for a two-view examination (average breast) was 3.2mGy (digital mammography), 4.1mGy (tomosynthesis) and 7.3mGy (digital mammography+tomosynthesis). ConclusionsThe detectability and visibility of synthesized images was comparable to that of digital mammography. Replacing digital mammography with synthesized imaging would result in a dose saving of 44% (average breast).