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Comparison between two-dimensional synthetic mammography reconstructed from digital breast tomosynthesis and full-field digital mammography for the detection of T1 breast cancer

European Radiology volume 26, pages 2538–2546 (2016)Cite this article

Abstract

Objective

To evaluate the interpretative performance of two-dimensional (2D) synthetic mammography (SM) reconstructed from digital breast tomosynthesis (DBT) in the detection of T1-stage invasive breast cancers, compared to 2D full-field digital mammography (FFDM).

Methods

This retrospective study enrolled 214 patients. For each patient, FFDM and DBT were performed between January and June 2013, and SM was reconstructed from DBT data. Three radiologists interpreted images and recorded visibility scores and morphologies of cancers. Diagnostic performances of SM and FFDM were compared. Percentages of detected cancers and visibility scores were compared for tumour size, and presence of calcifications for each observer.

Results

Observer sensitivity showed no difference for detection with SM and FFDM (P > 0.05). One observer showed a higher specificity (P = 0.02) and higher positive predictive value with SM (95 % CI 0.6–16.4), but the differences in the corresponding values between SM and FFDM for the other observers were not statistically significant. In subgroup analyses according to tumour size and presence of calcifications, percentages of detected cancers and visibility scores were not significantly different.

Conclusions

Diagnostic performances of SM and FFDM are comparable for detecting T1-stage breast cancers. Therefore, our results indicate that SM may eliminate the need for additional FFDM during DBT-based imaging.

Key Points

• DBT plus FFDM increases radiation dose compared to FFDM alone.

• Detecting T1-stage cancers with only SM is comparable to detection with FFDM.

• Two-dimensional SM may replace dose-requiring FFDM in DBT-based imaging.

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Fig. 1
Fig. 2

Abbreviations

DBT:

digital breast tomosynthesis

SM:

synthetic mammography

FFDM:

full-field digital mammography

2D:

two-dimensional

3D:

three-dimensional

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Acknowledgments

The authors are grateful to Seonwoo Kim, PhD, Samsung Biomedical Research Institute, Samsung Medical Center, for help in the statistical analyses. The scientific guarantor of this publication is Boo-Kyung Han. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Affiliations

  1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, South Korea

    Ji Soo Choi, Boo-Kyung Han, Eun Young Ko, Eun Sook Ko, Soo Yeon Hahn & Jung Hee Shin

  2. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea

    Min Jung Kim

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  1. Ji Soo Choi
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  2. Boo-Kyung Han
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  4. Eun Sook Ko
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Correspondence to Boo-Kyung Han.

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Choi, J.S., Han, BK., Ko, E.Y. et al. Comparison between two-dimensional synthetic mammography reconstructed from digital breast tomosynthesis and full-field digital mammography for the detection of T1 breast cancer. Eur Radiol 26, 2538–2546 (2016). https://doi.org/10.1007/s00330-015-4083-7

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  • DOI: https://doi.org/10.1007/s00330-015-4083-7

Keywords

  • digital breast tomosynthesis
  • synthetic mammography
  • digital mammography
  • breast cancer
  • T1 stage