title: Digital breast tomosynthesis versus digital mammography: a clinical performance study.
abstract: 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.
authors.affiliation: Department of Radiology, Venetian Oncological Institute (IOV), IRCCS, Padua, Italy. gisella.gennaro@ioveneto.it
authors.forename: Gisella
authors.initials: G
authors.lastname: Gennaro
authors.forename: Alicia
authors.initials: A
authors.lastname: Toledano
authors.forename: Cosimo
authors.initials: C
authors.lastname: di Maggio
authors.forename: Enrica
authors.initials: E
authors.lastname: Baldan
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bezzon
authors.forename: Manuela
authors.initials: M
authors.lastname: La Grassa
authors.forename: Luigi
authors.initials: L
authors.lastname: Pescarini
authors.forename: Ilaria
authors.initials: I
authors.lastname: Polico
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proietti
authors.forename: Aida
authors.initials: A
authors.lastname: Toffoli
authors.forename: Pier Carlo
authors.initials: PC
authors.lastname: Muzzio
mesh_terms: 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