Digital breast tomosynthesis versus digital mammography: a clinical performance study.
OBJECTIVE
To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population.


METHODS
The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores.


RESULTS
Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%.


CONCLUSIONS
Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views.
Gennaro
Gisella
G
Department of Radiology, Venetian Oncological Institute (IOV), IRCCS, Padua, Italy. gisella.gennaro@ioveneto.it
Toledano
Alicia
A
di Maggio
Cosimo
C
Baldan
Enrica
E
Bezzon
Elisabetta
E
La Grassa
Manuela
M
Pescarini
Luigi
L
Polico
Ilaria
I
Proietti
Alessandro
A
Toffoli
Aida
A
Muzzio
Pier Carlo
PC
D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity