title: Diagnostic performance of digital breast tomosynthesis with a wide scan angle compared to full-field digital mammography for the detection and characterization of microcalcifications.
abstract: OBJECTIVE
  To assess the diagnostic performance of digital breast tomosynthesis (DBT), with a wide scan-angle, compared to full-field digital mammography (FFDM), for the detection and characterization of microcalcifications.
  
  
  METHODS
  IRB approval was obtained for this retrospective study. We selected 150 FFDM and DBT (50 benign and 50 malignant histologically verified microcalcifications, 50 cases classified as BI-RADS 1). Four radiologists evaluated, in separate sessions and blinded to patients' history and histology, the presence of microcalcifications. Cases with microcalcifications were assessed for visibility, characteristics, and grade of suspicion using BI-RADS categories. Detection rate and diagnostic performance were calculated. Visibility, lesions' characteristics and reading time were analysed.
  
  
  RESULTS
  Detection rate and visibility were good for both FFDM and DBT, without intra-reader differences (P=0.510). Inter-reader differences were detected (P<0.018). Only two lesions were not detected by any reader on either FFDM or DBT. Diagnostic performance with DBT was as good as that of FFDM, but a significant inter-reader difference was found (P=0.041). High inter-reader variability in the use of the descriptors was found. Reading time for DBT was almost twice that for FFDM (44 and 25s, respectively).
  
  
  CONCLUSIONS
  Wide scan-angle DBT enabled the detection and characterization of microcalcifications with no significant differences from FFDM. Inter-reader variability was seen.
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. Electronic address: paola.clauser@meduniwien.ac.at.
authors.forename: Paola
authors.initials: P
authors.lastname: Clauser
authors.affiliation: Department for Radiology and Interventional Radiology, Landesklinikum Horn, Spitalgasse 10, 3580 Horn, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Nagl
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. Electronic address: thomas.helbich@meduniwien.ac.at.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Helbich
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Katja
authors.initials: K
authors.lastname: Pinker-Domenig
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kapetas
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: Bernathova
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Pascal A T
authors.initials: PAT
authors.lastname: Baltzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008327:Mammography / Q000592:standards*; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000592:standards*; D012189:Retrospective Studies; D016037:Single-Blind Method
keywords: Breast cancer; Comparative studies; Digital breast tomosynthesis; Mammography; Microcalcifications