Accuracy Of Digital Breast Tomosynthesis Research Articles

Diagnostic accuracy of digital breast tomosynthesis and digital mammography in women with dense or non-dense breast tissue: A systematic review and meta-analysis.

Despite its excellent screening effectiveness and sensitivity for breast cancer (BC), digital breast tomosynthesis (DBT) is controversial due to its high radiation exposure and long reading time. This study examines the diagnostic accuracy of DBT and digital mammography (DM) for BC screening and diagnosis in women with dense or non-dense breast tissue. PRISMA-compliant searches were performed on Medline, Embase, PubMed, Web of Science, and the Cochrane databases for articles comparing DBT and DM for BC screening until March 2023. Meta-analysis was performed using RevMan sofware, and the Cochrane Risk of Bias Assessment Tool was employed to assess study quality. This meta-analysis included 11 trials with a total of 2,124,018 individuals. Screening with DBT resulted in a greater cancer detection rate, as demonstrated by a risk ratio (RR) of 1.27 (95% confidence interval (95% CI): 1.14-1.41). Digital breast tomosynthesis also had a reduced recall rate, with a RR of 0.88 (95% CI: 0.78-0.99), higher sensitivity and specificity values (pooled sensitivity of 0.91 (95% CI: 0.59-0.99)) and pooled specificity of 0.90 (95% CI: 0.42-1.0)) than DM (pooled sensitivity of 0.86 (95% CI: 0.52-1.0) and pooled specificity of 0.81 (95% CI: 0.12-1.0)). All acquired data exhibited reliability, lack of bias and statistical significance (p < 0.05). Digital breast tomosynthesis is a more effective screening and diagnostic assessment tool for women with dense or non-dense breasts than DM in terms of incremental cancer detection, sensitivity and recall rate.

Assessment of Diagnostic Accuracy of Digital Breast Tomosynthesis in Distinguishing Malignant and Benign Breast Lesions

Objective: The study aims to determine the diagnostic accuracy of digital breast tomosynthesis in diagnosing malignant and benign lesions, keeping histopathology as the gold standard.Study Design: Cross-sectional study.Place and Duration of Study: The study was carried out at the Department of Diagnostic Radiology, POF th th Hospital, Wah Cantt, Pakistan over a period of six months from 11th July 2021 to 11th January 2022.Methods: A total of 200 women presenting with suspicion of breast malignancy were selected consecutively from the outpatient department, and Digital Breast Tomosynthesis(DBT) was performed, followed by a biopsy of the specimen to confirm the findings on histopathology. Results: The average age of the sample was 48.3 + 7.1 years, ranging between 35 and 60 years. Palpable breast lump was recorded in 44.5%, pain in 33%, and nipple discharge in 35.5%. Family history of breast Ca was present in 25.5. On Digital Breast Tomosynthesis (DBT), 58.5% of lesions were labeled as malignant, while 53.5% were labeled as malignant on follow-up histopathology. On applying the formulae for calculation, the sensitivity of DBT was found to be 86% and specificity 73.1%. The positive predictive value of the DBT is 78.6%, and the negative predictive value is 81.9%.Conclusion: In conclusion, Digital Breast Tomosynthesisis a significantly sensitive and specific tool for detecting malignant breast lesions in women suspected of breast carcinoma.How to cite this: Afzal K, Gul N, Mehmood K, Jawwad S, Iqbal B. Assessment of Diagnostic Accuracy of Digital Breast Tomosynthesis in Distinguishing Malignant and Benign Breast Lesions. Life and Science. 2024; 5(1): 3-8. doi: http://doi.org/10.37185/LnS.1.1.416&#x0D;

Impact of breast density on diagnostic accuracy in digital breast tomosynthesis versus digital mammography: results from a European screening trial

BackgroundThe diagnostic accuracy of digital breast tomosynthesis (DBT) and digital mammography (DM) in breast cancer screening may vary per breast density subgroup. The purpose of this study was to evaluate which women, based on automatically assessed breast density subgroups, have the greatest benefit of DBT compared with DM in the prospective Malmö Breast Tomosynthesis Screening Trial.Materials and methodsThe prospective European, Malmö Breast Tomosynthesis Screening Trial (n = 14,848, Jan. 27, 2010–Feb. 13, 2015) compared one-view DBT and two-view DM, with consensus meeting before recall. Breast density was assessed in this secondary analysis with the automatic software Laboratory for Individualized Breast Radiodensity Assessment. DBT and DM’s diagnostic accuracies were compared by breast density quintiles of breast percent density (PD) and absolute dense area (DA) with confidence intervals (CI) and McNemar’s test. The association between breast density and cancer detection was analyzed with logistic regression, adjusted for ages < 55 and ≥ 55 years and previous screening participation.ResultsIn total, 14,730 women (median age: 58 years; inter-quartile range = 16) were included in the analysis. Sensitivity was higher and specificity lower for DBT compared with DM for all density subgroups. The highest breast PD quintile showed the largest difference in sensitivity and specificity at 81.1% (95% CI 65.8–90.5) versus 43.2% (95% CI 28.7–59.1), p < .001 and 95.5% (95% CI 94.7–96.2) versus 97.2% (95% CI 96.6–97.8), p < 0.001, respectively. Breast PD quintile was also positively associated with cancer detected via DBT at odds ratio 1.24 (95% CI 1.09–1.42, p = 0.001).ConclusionWomen with the highest breast density had the greatest benefit from digital breast tomosynthesis compared with digital mammography with increased sensitivity at the cost of slightly lower specificity. These results may influence digital breast tomosynthesis’s use in an individualized screening program stratified by, for instance, breast density.Trial registration. Trial registration at https://www.ClinicalTrials.gov: NCT01091545, registered March 24, 2010.

Predicting Breast Density of Digital Breast Tomosynthesis from 2D Mammograms

Breast density may be used as a predictor of breast cancer risk and can measure the condition of tissues on mammograms. This research developed a computer-aided diagnosis (CAD) system to predict breast density on digital breast tomosynthesis (DBT) images. We used two-dimensional (2D) mammograms to train the linear discriminant analysis (LDA) classifier. Then load the DBT projection image to predict breast density. Experimental results show that LDA is better than other classification methods, such as one rule, naive Bayes, decision tree and support vector machine. The breast density prediction accuracy of DBT is 80%.

Diagnostic accuracy of resection margin in specimen radiography: digital breast tomosynthesis versus full-field digital mammography.

We investigated the accuracy of digital breast tomosynthesis compared to full-field digital mammography for evaluating tumor-free resection margins in the intraoperative specimen during breast-conserving surgery, reducing re-excision rates. In total, 170 patients, with proven breast cancer and eligible for breast-conserving surgery, were enrolled. Intraoperative specimens underwent digital mammography and digital breast tomosynthesis. Two breast radiologists, with ten years of experience in breast imaging, in batch mode, evaluated tumor-free resection margins and the distance between the margins and lesion. Histopathological findings were considered the standard of reference. We used the correlation analysis to evaluate the agreement between measures oftumor-free resection margins obtained with digital mammography and the true value (histopathological findings), and between digital breast tomosynthesis and histopathological findings. The size evaluation determined by digital breast tomosynthesis was more accurately correlated with that found by pathology; the calculated Pearson's correlation coefficient of digital breast tomosynthesis and digital mammography to the pathologically determined tumor-free resection margins were 0.92 and 0.79 in CC view and 0.92 and 0.72 in LL view, respectively. Compared with the pathologically determined tumor-free resection margins, the size determined by both imaging modalities was, on average, overestimated. Bland-Altman analysis showed an excellent inter readers agreement. Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.

Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis.

ObjectiveTo compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis.Materials and MethodsOvid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies.ResultsTwenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86–0.93) and 0.90 (95% CI 0.84–0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68–0.83) and 0.83 (95% CI 0.73–0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93–0.97) for DBT and 0.86 (95% CI 0.82–0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses.ConclusionUse of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

Diagnostic accuracy of digital breast tomosynthesis in combination with 2D mammography for the characterisation of mammographic abnormalities

This study aims to assess the diagnostic accuracy of digital breast tomosynthesis in combination with full field digital mammography (DBT + FFDM) in the charaterisation of Breast Imaging-reporting and Data System (BI-RADS) category 3, 4 and 5 lesions. Retrospective cross-sectional study of 390 patients with BI-RADS 3, 4 and 5 mammography with available histopathology examination results were recruited from in a single center of a multi-ethnic Asian population. 2 readers independently reported the FFDM and DBT images and classified lesions detected (mass, calcifications, asymmetric density and architectural distortion) based on American College of Radiology-BI-RADS lexicon. Of the 390 patients recruited, 182 malignancies were reported. Positive predictive value (PPV) of cancer was 46.7%. The PPV in BI-RADS 4a, 4b, 4c and 5 were 6.0%, 38.3%, 68.9%, and 93.1%, respectively. Among all the cancers, 76% presented as masses, 4% as calcifications and 20% as asymmetry. An additional of 4% of cancers were detected on ultrasound. The sensitivity, specificity, PPV and NPV of mass lesions detected on DBT + FFDM were 93.8%, 85.1%, 88.8% and 91.5%, respectively. The PPV for calcification is 61.6% and asymmetry is 60.7%. 81.6% of cancer detected were invasive and 13.3% were in-situ type. Our study showed that DBT is proven to be an effective tool in the diagnosis and characterization of breast lesions and supports the current body of literature that states that integrating DBT to FFDM allows good characterization of breast lesions and accurate diagnosis of cancer.

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts \u2013 a systematic review and meta-analysis

BackgroundThis study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis.MethodsTwo independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity.ResultsSixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84%–90%) versus DM alone (69%–86%) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95% CI 1.02–1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95% CI 1.20–1.47 for retrospective studies; RR: 1.52, 95% CI 1.08–2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95% CI 0.64–0.80) but not in two prospective studies (RR: 1.12, 95% CI 0.76–1.63).ConclusionIn women with mammographically dense breasts, DBT+/−DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/−DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.

Diagnostic Accuracy of Digital Breast Tomosynthesis in the Evaluation of Palpable Breast Abnormalities

The role of digital breast tomosynthesis (DBT) in evaluating palpable abnormalities has not been evaluated and its accuracy compared to 2D mammography is unknown. The purpose of this study was to evaluate combined 2D mammography, DBT, and ultrasound (US) at palpable sites. Two breast imagers reviewed blinded consecutive cases with combined 2D mammograms and DBT examinations performed for palpable complaints. By consensus, 2D and DBT findings were recorded and compared to US. Patient characteristics, demographics, subsequent workup, and outcome were recorded. A total of 229 sites in 188 patients were included, with 50 biopsies performed identifying 18 cancers. All 18 cancers were identified on 2D and US, whereas 17 cancers were identified on DBT. Cancer detection sensitivities for 2D, DBT, and US were 100.0%, 94.4%, and 100.0%. The negative predictive value, when combined with US, was 100% for both. The sensitivity and the specificity for both benign and malignant findings with 2D and DBT were 70.5% versus 75.4% (P = 0.07) and 95.3% versus 99.1% (P = 0.125). Palpable findings not identified by 2D and DBT were smaller than those identified (11.5 ± 8.3 mm vs 23.9 ± 12.8 mm, P < 0.001). Patients with dense breasts were more likely to have mammographically occult findings than patients with nondense breasts (27.4% vs 8.3%). DBT did not improve cancer detection over 2D or US. Both mammographic modalities failed to identify sonographically confirmed findings primarily in dense breasts. The diagnostic use of DBT at palpable sites provided limited benefit over combined 2D and US. When utilizing DBT, US should be performed to adequately characterize palpable sites.

Accuracy of Digital Breast Tomosynthesis for Depicting Breast Cancer Subgroups in a UK Retrospective Reading Study (TOMMY Trial).

To compare the diagnostic performance of two-dimensional (2D) mammography, 2D mammography plus digital breast tomosynthesis (DBT), and synthetic 2D mammography plus DBT in depicting malignant radiographic features. In this multicenter, multireader, retrospective reading study (the TOMMY trial), after written informed consent was obtained, 8869 women (age range, 29-85 years; mean, 56 years) were recruited from July 2011 to March 2013 in an ethically approved study. From these women, a reading dataset of 7060 cases was randomly allocated for independent blinded review of (a) 2D mammography images, (b) 2D mammography plus DBT images, and (c) synthetic 2D mammography plus DBT images. Reviewers had no access to results of previous examinations. Overall sensitivities and specificities were calculated for younger women and those with dense breasts. Overall sensitivity was 87% for 2D mammography, 89% for 2D mammography plus DBT, and 88% for synthetic 2D mammography plus DBT. The addition of DBT was associated with a 34% increase in the odds of depicting cancer (odds ratio [OR] = 1.34, P = .06); however, this level did not achieve significance. For patients aged 50-59 years old, sensitivity was significantly higher (P = .01) for 2D mammography plus DBT than it was for 2D mammography. For those with breast density of 50% or more, sensitivity was 86% for 2D mammography compared with 93% for 2D mammography plus DBT (P = .03). Specificity was 57% for 2D mammography, 70% for 2D mammography plus DBT, and 72% for synthetic 2D mammography plusmDBT. Specificity was significantly higher than 2D mammography (P < .001in both cases) and was observed for all subgroups (P < .001 for all cases). The addition of DBT increased the sensitivity of 2D mammography in patients with dense breasts and the specificity of 2D mammography for all subgroups. The use of synthetic 2D DBT demonstrated performance similar to that of standard 2D mammography with DBT. DBT is of potential benefit to screening programs, particularly in younger women with dense breasts. (©) RSNA, 2015.

Digital breast tomosynthesis improves the accuracy of the diagnosis of circumscribed lesions because of increase of margin visibility

Circumscribed masses are a common cause of recall for assessment but most are benign. The aim of this study is to compare the accuracy of digital breast tomosynthesis (DBT) with digital mammography (DM) in assessing the margin of circumscribed lesions as a predictor of benign or malignant disease.

The accuracy of digital breast tomosynthesis compared with coned compression magnification mammography in the assessment of abnormalities found on mammography

To compare the diagnostic accuracy of the digital breast tomosynthesis (DBT) with coned compression magnification mammography (CCMM). The study design included two reading sessions completed by seven experienced radiologists. In the first session, all readers read bilateral standard two-view mammograms and a CCMM view of the lesion before giving a combined score for assessment. In the second session, readers read bilateral standard two-view mammograms plus one-view DBT. The two reading sessions of the experiment were separated by at least 2 weeks to reduce the chance of reader memory of the images read in the previous session from influencing the performance in the subsequent session. Three hundred and fifty-four lesions were assessed and receiver-operative characteristic (ROC) analysis was used to evaluate the difference between the two modes. For standard two-view mammography plus CCMM, the area under the curve (AUC) was 0.87 [95% confidence interval (CI): 0.83-0.91] and for standard two-view mammography plus DBT the AUC was 0.93 (95% CI: 0.91-0.95). The difference between the AUCs was 0.06 with p-value of 0.0014. Two-view mammography with one-view DBT showed significantly improved accuracy compared to two-view mammography and CCMM in the assessment of mammographic abnormalities. These results show that DBT can be used effectively in the further evaluation of mammographic abnormalities found at screening and in symptomatic diagnostic practice.

Letter to the Editor re: Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: A meta-analysis

To the Editor, I have a concern regarding a recently published article in European Radiology entitled 'Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis' [1]. The authors claim to investigate one-view digital breast tomosynthesis (DBT) versus digital mammography (DM) in a meta-analysis based on seven studies [2–8], but in fact, only four of the studies [2,3,7,8] investigate these particular imaging techniques. Out of these four studies, only one study showed significant improvement using one-view DBT in comparison with regular mammography (DM). That study material was enriched with subtle cases, more difficult than typically encountered in the clinical practice, with a relatively low frequency of DCIS. These factors may have increased the effect sizes. However, when the studies are stratified and analysed according to projection views, the pooled sensitivity and specificity may not correlate with the conclusions drawn, e.g. ‘the present study revealed that one-view DBT had higher sensitivity and specificity for the diagnosis of benign and malignant lesions in the breasts. These results illustrated the superior diagnostic accuracy of DBT relative to DM using meta-analysis’. Readers of the article might get the impression that one-view DBT alone is superior to DM in a general population of women, which may not be true. The following studies [4–6] did not investigate DBT in one view, but used other DBT techniques:

Reply to Letter to the Editor re: Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis

Dear Editor, We were very pleased to receive your letter and appreciate the opportunity to respond to the concern raised about our article [1]. One of our criteria for pooling the data was that digital breast tomosynthesis (DBT) and digital mammography (DM) were used as the reference for diagnosing breast lesions. However, we placed no limitation on whether DBT was performed in one-view or two-view mode; so in agreement with the aforementioned letter, Michell et al. [2], Teerstra et al. [3] and Gur et al. [4] comparedDBT in two views versus DM. The other four studies [5–8] compared DBT in one view versus DM.We did not present this information in our article because the studies satisfied the criterion mentioned above, i.e. they were characterised as using DBT. Moreover, the heterogeneity analysis which we investigated as a possible factor in the oneview or two-view mode in the meta-regression analysis failed to provide any evidence of heterogeneity. Our prime objective was to evaluate the diagnostic performance of DBT and DM for benign and malignant lesions in breasts. Wementioned that “the present study usedmeta-analysis to evaluate whether there was a higher diagnostic accuracy of one-view DBTand two-view DM relative to the gold standard in breast lesions in the discussion part”. Table 1 shows the sensitivity and specificity of one-view or two-view DBT vs gold standard. We appreciate that the sensitivity and specificity of two-view DBT are higher than those of one-view DBT, but in consideration of certain factors, including cost, radiation dose, and discomfort for patients [9–11], we still maintain the conclusion that one-view DBT has a high sensitivity and specificity for the diagnosis of benign and malignant lesions in breasts [9]. Again, we would like to thank European Radiology for publishing our original article and the opportunity to clarify the diagnostic accuracy of DBT versus DM for benign and malignant breast lesions.

Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis

To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for benign and malignant lesions in breasts. Document retrieval was conducted on PubMed, EMBASE, the Cochrane Library, Web of Science and Chinese Biomedical Literature Database, etc., from 1950 to June 2013. Metadisc1.4 software was used to analyse the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratio. The heterogeneity was assessed using forest plots and the inconsistency index (I(2)). Before statistical comparison, the area under (AUC) the summary receiver-operating characteristic curve (SROC) of two different diagnostic methods was calculated respectively. A total of seven studies involving 2,014 patients and 2,666 breast lesions were included. Compared with the gold standard (histological results), the pooled sensitivity and specificity of DBT were 90.0% and 79.0%, and for DM they were 89.0% and 72.0%, respectively. The pooled positive likelihood ratio of DBT and DM was 3.50 and 2.83; the pooled negative likelihood ratio of DBT and DM was 15% and 18%; the pooled DOR for DBT and DM was 26.04 and 16.24, respectively. Digital breast tomosynthesis has a higher sensitivity and specificity in breast diagnosis than digital mammography. • Digital breast tomosynthesis has high sensitivity and specificity in breast diagnosis.• DBT appears to have superior diagnostic accuracy relative to digital mammography. • DBT images were captured at a lower dose than 2D images. • DBT displays abnormal features of lesions more clearly than DM. • Digital breast tomosynthesis could become the first choice for assessing breast lesions.

Assessment of extent of breast cancer: Comparison between digital breast tomosynthesis and full-field digital mammography

To compare the accuracy of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in preoperative assessment of local extent of breast cancer. Lesion sizes of breast cancers on DBT and FFDM images were independently evaluated by breast radiologists. Each lesion was flagged as either mis-sized or not depending on whether the assessment of size at imaging was within 1 cm of the lesion size at surgery. Additional analyses were made by mammographic parenchymal density and by lesion size, using 2 cm as the boundary to separate the two subgroups. Statistical comparisons were performed using a repeated measures linear model on the percent mis-sized. P-values < 0.05 were considered statistically significant. The dataset included 173 malignant breast lesions (mean size 23.8 mm, 43% of lesions were ≤2 cm in size) in 169 patients, two-thirds of which had heterogeneously or extremely dense breasts. Overall, the percentage of lesions mis-sized at DBT was significantly lower than at FFDM (19% versus 29%, p = 0.003). There was significantly less mis-sizing at DBT in both heterogeneously dense breasts (11.1% difference between DBT and FFDM, p = 0.016) and extremely dense breasts (15.8% difference, p = 0.024). DBT also had significantly less mis-sizing than FFDM in the subgroup of lesions that were ≤2 cm in size (14.7% difference, p = 0.005). DBT was significantly superior to FFDM for the evaluation of lesion size overall, and specifically for small lesions and for lesions in dense breasts. The superiority of DBT versus FFDM increased with parenchymal density.

Can digital breast tomosynthesis offer an alternative to MRI in preoperative imaging of lobular carcinoma?

Digital breast tomosynthesis (DBT) is an emerging breast imaging technique which we have shown in our institution to more accurately size tumours when compared with 2D mammography. In this study we have looked at the accuracy of DBT in the sizing of invasive lobular carcinoma (ILC) when compared with MRI, the current imaging technique of choice.

A comparison of the accuracy of digital breast tomosynthesis with supplementary views in the diagnostic workup of mammographic lesions

Supplementary views (SV) are routinely used in the diagnostic workup of mammographic lesions. Previous studies have demonstrated that digital breast tomosynthesis (DBT) increases the accuracy of classification of mammographic lesions [1]. In this study the diagnostic accuracy of SV is compared with DBT.

One-to-one comparison between digital spot compression view and digital breast tomosynthesis

To assess if digital breast tomosynthesis (DBT) is at least equal to digital spot compression view (DSCV). Following institutional approval and written informed consent, both DBT and DSCV were obtained in women with a screening abnormality. The diagnostic accuracy of DBT and DSCV was evaluated by two radiologists of varying experience (Reader1 and Reader2). 52 consecutive recalled women without calcification (mean age: 51 ± 12 years) underwent DSCV and DBT. Overall sensitivity was equal for both techniques (100% [95% CI, 91-100%] for DBT and 100% [95% CI, 91-100%] for DSCV). Overall specificity was higher for DBT (100% [95%CI, 91-100%]) than for DSCV (94% [95% CI, 91-100%]). Specificity for DSCV was higher for Reader1 (95% [95% CI, 91-100%]). Reader2 had lower values of specificity (92% [95% CI, 90-92%]). On DSCV, three and two false positives were recorded by Reader2 and Reader1, respectively. Overall, the area under the curve (AUC) was greater for DBT (AUC = 1) than for DSCV (AUC = 0.963). The mean difference between the two techniques was not significantly different (P = 0.43). In this dataset, diagnostic accuracy of digital breast tomosynthesis is at least equal to that of digital spot compression. • Digital spot compression views (DSCVs) are often needed in breast screening programmes. • Digital breast tomosynthesis (DBT) now offers an alternative to DSCV • In recalls without calcification, DBT was at least equally accurate as DSCVs • DBT has a lower mean glandular dose than DSCVs • Thus DBT has the potential to help reduce the recall rate.

Digital breast tomosynthesis: a comparison of the accuracy of digital breast tomosynthesis, two-dimensional digital mammography and two-dimensional screening mammography (film-screen)

Digital breast tomosynthesis (DBT) may improve the accuracy of mammography by enabling visual separation of overlapping tissues (Andersson et al. 2008, Poplack et al. 2007).