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Comparison of synthetic mammography, reconstructed from digital breast tomosynthesis, and digital mammography: evaluation of lesion conspicuity and BI-RADS assessment categories

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Abstract

Purpose

To compare the interpretive performance of synthetic mammography (SM), reconstructed from digital breast tomosynthesis (DBT), and full-field digital mammography (FFDM) in a diagnostic setting, covering different conditions of breast density and mammographic signs.

Methods

A retrospective analysis was conducted on 231 patients, who underwent FFDM and DBT (from which SM images were reconstructed) between September 2014–September 2015. The study included 250 suspicious breast lesions, all biopsy proven: 148 (59.2%) malignant and 13 (5.2%) high-risk lesions were confirmed by surgery, 89 (35.6%) benign lesions had radiological follow-up. Two breast radiologists, blinded to histology, independently reviewed all cases. Readings were performed with SM alone, then with FFDM, collecting data on: probability of malignancy for each finding, lesion conspicuity, mammographic features and dimensions of detected lesions.

Results

Agreement between readers was good for BI-RADS classification (Cohen’s k-coefficient = 0.93 ± 0.02) and for lesion dimension (Wilcoxon’s p = 0.76). Visibility scores assigned to SM and FFDM for each lesion were similar for non-dense and dense breasts, however, there were significant differences (p = 0.0009) in distribution of mammographic features subgroups. SM and FFDM had similar sensitivities in non-dense (respectively 94 vs. 91%) and dense breasts (88 vs. 80%) and for all mammographic signs (93 vs. 87% for asymmetric densities, 96 vs. 75% for distortion, 92 vs. 85% for microcalcifications, and both 94% for masses). Based on all data, there was a significant difference in sensitivity for SM (92%) vs. FFDM (87%), p = 0.02, whereas the two modalities yielded similar results for specificity (SM: 60%, FFDM: 62%, p = 0.21).

Conclusions

SM alone showed similar interpretive performance to FFDM, confirming its potential role as an alternative to FFDM in women having tomosynthesis, with the added advantage of halving the patient’s dose exposure.

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Acknowledgements

Prof Houssami receives support via a National Breast Cancer Foundation (NBCF, Australia) Breast Cancer Research Leadership Fellowship.

Funding

Prof Houssami receives support via a National Breast Cancer Foundation (NBCF, Australia) Breast Cancer Research Leadership Fellowship.

Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Città della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126, Turin, Italy

    Giovanna Mariscotti, Manuela Durando, Mirella Fasciano, Davide Bosco, Cristina Casella, Paolo Fonio & Giovanni Gandini

  2. Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia

    Nehmat Houssami

  3. Department of Experimental Medicine, University of Genoa, IRCCS AOU San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, 16132, Genoa, Italy

    Alberto Tagliafico

  4. Department of Diagnostic and Interventional Radiology, AUSL Valle d’Aosta, Regional Hospital, Viale Ginevra 3, 11100, Aosta, Italy

    Camilla Bogetti

  5. Department of Surgical Sciences, University of Torino, Azienda Ospedaliera Città della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, 10126, Turin, Italy

    Laura Bergamasco

Authors
  1. Giovanna Mariscotti
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  2. Manuela Durando
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  3. Nehmat Houssami
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  4. Mirella Fasciano
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  5. Alberto Tagliafico
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  6. Davide Bosco
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  7. Cristina Casella
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  8. Camilla Bogetti
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  9. Laura Bergamasco
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  10. Paolo Fonio
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  11. Giovanni Gandini
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Corresponding author

Correspondence to Giovanna Mariscotti.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mariscotti, G., Durando, M., Houssami, N. et al. Comparison of synthetic mammography, reconstructed from digital breast tomosynthesis, and digital mammography: evaluation of lesion conspicuity and BI-RADS assessment categories. Breast Cancer Res Treat 166, 765–773 (2017). https://doi.org/10.1007/s10549-017-4458-3

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  • DOI: https://doi.org/10.1007/s10549-017-4458-3

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