title: Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography.
abstract: OBJECTIVE
  To determine the performance of combined single-view mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus single-view cranio-caudal (CC) mammography (MX) compared with that of standard two-view digital mammography.
  
  
  METHODS
  A multi-reader multi-case (MRMC) receiver-operating characteristic (ROC) study was conducted, involving six breast radiologists. Two hundred fifty patients underwent bilateral MX and DBT imaging. MX and DBT images with the adjunct of the CC-MX view from 469 breasts were evaluated and rated independently by six readers. Differences in mean areas under the ROC curves (AUCs), mean sensitivity and mean specificity were analysed by analysis of variance (ANOVA) to assess clinical performance.
  
  
  RESULTS
  The combined technique was found to be non-inferior to standard two-view mammography (MX((CC+MLO))) in mean AUC (difference: +0.021;95 % LCL = -0.011), but was not statistically significant for superiority (P = 0.197). The combined technique had equivalent sensitivity to standard mammography (76.2 % vs. 72.8 %, P = 0.269) and equivalent specificity (84.9 % vs. 83.0 %, P = 0.130). Specificity for benign lesions was significantly higher with the combination of techniques versus mammography (45.6 % vs. 36.8 %, P = 0.002).
  
  
  CONCLUSIONS
  In this enriched study population, the combination of single-view MLO tomosynthesis plus single-view CC mammography was non-inferior to that of standard two-view digital mammography in terms of ROC curve area, sensitivity and specificity.
authors.affiliation: Veneto Institute of Oncology (IOV)-IRCCS, via Gattamelata 64, 35128 Padua, Italy. gisella.gennaro@ioveneto.it
authors.forename: Gisella
authors.initials: G
authors.lastname: Gennaro
authors.forename: R Edward
authors.initials: RE
authors.lastname: Hendrick
authors.forename: Patricia
authors.initials: P
authors.lastname: Ruppel
authors.forename: Roberta
authors.initials: R
authors.lastname: Chersevani
authors.forename: Cosimo
authors.initials: C
authors.lastname: di Maggio
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: Enrica
authors.initials: E
authors.lastname: Baldan
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bezzon
authors.forename: Fabio
authors.initials: F
authors.lastname: Pomerri
authors.forename: Pier Carlo
authors.initials: PC
authors.lastname: Muzzio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008327:Mammography / Q000379:methods*; D056888:Patient Positioning / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*