Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison.
OBJECTIVE
The purpose of this article is to compare the ability of digital breast tomosynthesis and full field digital mammography (FFDM) to detect and characterize calcifications.


METHODS
One hundred paired examinations were performed utilizing FFDM and digital breast tomosynthesis. Twenty biopsy-proven cancers, 40 biopsy-proven benign calcifications, and 40 randomly selected negative screening studies were retrospectively reviewed by five radiologists in a crossed multireader multimodal observer performance study. Data collected included the presence of calcifications and forced BI-RADS scores. Receiver operator curve analysis using BI-RADS was performed.


RESULTS
Overall calcification detection sensitivity was higher for FFDM (84% [95% CI, 79-88%]) than for digital breast tomosynthesis (75% [95% CI, 70-80%]). [corrected] In the cancer cohort, 75 (76%) of 99 interpretations identified calcification in both modes. Of those, a BI-RADS score less than or equal to 2 was rendered in three (4%) and nine (12%) cases with FFDM and digital breast tomosynthesis, respectively. In the benign cohort, 123 (62%) of 200 interpretations identified calcifications in both modes. Of those, a BI-RADS score greater than or equal to 3 was assigned in 105 (85%) and 93 (76%) cases with FFDM and digital breast tomosynthesis, respectively. There was no significant difference in the nonparametric computed area under the receiver operating characteristic curves (AUC) using the BI-RADS scores (FFDM, AUC = 0.76 and SD = 0.03; digital breast tomosynthesis, AUC = 0.72 and SD = 0.04 [p = 0.1277]).


CONCLUSIONS
In this small data set, FFDM appears to be slightly more sensitive than digital breast tomosynthesis for the detection of calcification. However, diagnostic performance as measured by area under the curve using BI-RADS was not significantly different. With improvements in processing algorithms and display, digital breast tomosynthesis could potentially be improved for this purpose.
Department of Radiology, University of Pittsburgh Medical Center, 3950 Presby South Towers, 200 Lothrop St., Pittsburgh, PA 15213, USA. spanglerml@upmc.edu
M Lee
ML
Spangler
Margarita L
ML
Zuley
Jules H
JH
Sumkin
Gordan
G
Abrams
Marie A
MA
Ganott
Christiane
C
Hakim
Ronald
R
Perrin
Denise M
DM
Chough
Ratan
R
Shah
David
D
Gur
D000328:Adult; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000145:classification* / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging; D006801:Humans; D008327:Mammography / Q000379:methods*; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric