European Radiology

, Volume 24, Issue 3, pp 595–602 | Cite as

Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis

  • Junqiang Lei
  • Pin Yang
  • Li Zhang
  • Yinzhong Wang
  • Kehu YangEmail author



To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for benign and malignant lesions in breasts.


Document retrieval was conducted on PubMed, EMBASE, the Cochrane Library, Web of Science and Chinese Biomedical Literature Database, etc., from 1950 to June 2013. Metadisc1.4 software was used to analyse the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratio. The heterogeneity was assessed using forest plots and the inconsistency index (I2). Before statistical comparison, the area under (AUC) the summary receiver-operating characteristic curve (SROC) of two different diagnostic methods was calculated respectively.


A total of seven studies involving 2,014 patients and 2,666 breast lesions were included. Compared with the gold standard (histological results), the pooled sensitivity and specificity of DBT were 90.0 % and 79.0 %, and for DM they were 89.0 % and 72.0 %, respectively. The pooled positive likelihood ratio of DBT and DM was 3.50 and 2.83; the pooled negative likelihood ratio of DBT and DM was 15 % and 18 %; the pooled DOR for DBT and DM was 26.04 and 16.24, respectively.


Digital breast tomosynthesis has a higher sensitivity and specificity in breast diagnosis than digital mammography.

Key Points

Digital breast tomosynthesis has high sensitivity and specificity in breast diagnosis.

DBT appears to have superior diagnostic accuracy relative to digital mammography.

DBT images were captured at a lower dose than 2D images.

DBT displays abnormal features of lesions more clearly than DM.

Digital breast tomosynthesis could become the first choice for assessing breast lesions.


Digital breast tomosynthesis Mammography Breast neoplasms Diagnosis Meta-analysis 



Digital breast tomosynthesis


Full field digital mammography


Diagnostic odds ratio


Summary receiver-operating characteristic curve


Area under the curve






Likelihood ratio


Confidence interval




Medio-lateral oblique



The authors would like to thank Prof. Jinhui Tian from the Evidence-based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, for his help with the meta-analysis approach and some related statistical software for radiological diagnosis applications used in this study. The other authors have no conflict of interest to disclose.


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Junqiang Lei
    • 1
    • 2
  • Pin Yang
    • 1
    • 2
  • Li Zhang
    • 1
  • Yinzhong Wang
    • 1
  • Kehu Yang
    • 2
    Email author
  1. 1.The First Clinical Medical School of Lanzhou UniversityLanzhouChina
  2. 2.Evidence-based Medicine Center, School of Basic Medical SciencesLanzhou UniversityLanzhouChina

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