title: Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density.
abstract: OBJECTIVE
  To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density.
  
  
  METHODS
  MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method.
  
  
  RESULTS
  The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD.
  
  
  CONCLUSIONS
  MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD.
  
  
  CONCLUSIONS
  • DBT has higher diagnostic performance and potential to overcome limitations of DM. • Dose differences (DBT-DM, ΔAGD) were inversely correlated with breast thickness and density. • Figure of merit of MLO-DBT/CC-DM was higher than that of two-view DM. • In dense breasts, MLO-DBT/CC-DM provides better diagnostic performance with a small AGD increase.
authors.affiliation: Department of Radiology, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul, 100-744, Korea.
authors.forename: Sung Ui
authors.initials: SU
authors.lastname: Shin
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.forename: Min Sun
authors.initials: MS
authors.lastname: Bae
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.forename: Mirinae
authors.initials: M
authors.lastname: Seo
authors.forename: Won Hwa
authors.initials: WH
authors.lastname: Kim
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D014056:Tomography, X-Ray / Q000379:methods*; D055815:Young Adult