title: Application of breast tomosynthesis in screening: incremental effect on mammography acquisition and reading time.
abstract: OBJECTIVE
  The aim of this study was to supplement the paucity of information available on logistical aspects of the application of three-dimensional (3D) mammography in breast screening.
  
  
  METHODS
  We prospectively examined the effect on radiographers' and radiologists' workload of implementing 3D mammography in screening by comparing image acquisition time and screen-reading time for two-dimensional (2D) mammography with that of combined 2D+3D mammography. Radiologists' accuracy was also calculated.
  
  
  RESULTS
  Average acquisition time (measured from start of first-view breast positioning to compression release at completion of last view) for seven radiographers, based on 20 screening examinations, was longer for 2D+3D (4 min 3 s; range 3 min 53 s-4 min 18 s) than 2D mammography (3 min 13 s; range 3 min 0 s-3 min 26 s; p<0.01). Average radiologists' reading time per screening examination (three radiologists reading case-mix of 100 screens: 10 cancers, 90 controls) was longer for 2D+3D (77 s; range 60-90 s) than for 2D mammography (33 s; range 25-46 s; p<0.01). 2D+3D screen-reading was associated with detection of more cancers and with substantially fewer recalls than 2D mammography alone.
  
  
  CONCLUSIONS
  Relative to standard 2D mammography, combined 2D+3D mammography prolongs image acquisition time and screen-reading time (at initial implementation), and appears to be associated with improved screening accuracy.
  
  
  CONCLUSIONS
  These findings provide relevant information to guide larger trials of integrated 3D mammography (2D+3D) and its potential implementation into screening practice.
authors.affiliation: U O Senologia Clinica e Screening Mammografico, Dipartimento di Radiodiagnostica, APSS, Trento, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Bernardi
authors.forename: S
authors.initials: S
authors.lastname: Ciatto
authors.forename: M
authors.initials: M
authors.lastname: Pellegrini
authors.forename: V
authors.initials: V
authors.lastname: Anesi
authors.forename: S
authors.initials: S
authors.lastname: Burlon
authors.forename: E
authors.initials: E
authors.lastname: Cauli
authors.forename: M
authors.initials: M
authors.lastname: Depaoli
authors.forename: L
authors.initials: L
authors.lastname: Larentis
authors.forename: V
authors.initials: V
authors.lastname: Malesani
authors.forename: L
authors.initials: L
authors.lastname: Targa
authors.forename: P
authors.initials: P
authors.lastname: Baldo
authors.forename: N
authors.initials: N
authors.lastname: Houssami
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002983:Clinical Competence / Q000592:standards*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000592:standards*; D008327:Mammography / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D011871:Radiology / Q000592:standards*; D013997:Time Factors; D016526:Workload