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Comparison of diagnostic performances in the evaluation of breast microcalcifications: synthetic mammography versus full-field digital mammography

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Abstract

Background

Although several studies proved that SM could substitute for FFDM, the efficacy of SM in microcalcification evaluation remains controversial.

Aims

To investigate the diagnostic performance of synthetic mammography (SM) in the evaluation of microcalcifications in comparison with full-field digital mammography (FFDM).

Methods

In this retrospective study, 76 mammograms of 76 patients who underwent FFDM and digital breast tomosynthesis (DBT) acquisitions concomitantly between 2018 and 2019 and whose final mammography interpretation revealed microcalcifications (28 malignant microcalcifications and 48 benign microcalcifications) were included. All mammograms were reviewed independently by three radiologists with different levels of breast imaging experience. Readers were blinded to patient outcomes and interpreted each case in two separate reading sessions (first FFDM, second SM + DBT), according to the BI-RADS lexicon. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated using ROC analysis in all cases for FFDM and SM + DBT sessions. The readers also assigned conspicuity scores to mammograms. The interobserver agreement was calculated using intraclass correlation coefficients (ICC).

Results

The overall AUCs for malignant microcalcifications were 0.80 (95% CI: 0.75–0.85) in FFDM and 0.85 (95% CI: 0.80–0.89) in SM, and no significant difference was found between the groups (p = 0.0603). The sensitivity of the readers increased slightly with experience. The ICC values of BI-RADS categorization between readers were 0.93 (95% CI: 0.90–0.95) and 0.94 (95% CI: 0.91–0.96) for FFDM and SM, respectively.

Conclusions

SM had similar diagnostic performance in the evaluation of breast microcalcifications in comparison with FFDM, regardless of reader experience levels.

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References

  1. Zuckerman SP, Maidment ADA, Weinstein SP et al (2017) Imaging with synthesized 2d mammography: differences, advantages, and pitfalls compared with digital mammography. AJR Am J Roentgenol 209(1):222–229

    Article  Google Scholar 

  2. Durand MA (2018) Synthesized mammography: clinical evidence, appearance, and implementation. Diagnostics (Basel) 8(2)

  3. Zuley ML, Guo B, Catullo VJ et al (2014) Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images. Radiology 271(3):664–671

    Article  Google Scholar 

  4. Skaane P, Bandos AI, Eben EB et al (2014) Two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images. Radiology 271(3):655–663

    Article  Google Scholar 

  5. Zuckerman SP, Conant EF, Keller BM et al (2016) Implementation of synthesized two-dimensional mammography in a population-based digital breast tomosynthesis screening program. Radiology 281(3):730–736

    Article  Google Scholar 

  6. Alabousi M, Wadera A, Kashif Al-Ghita M, et al (2021) Performance of digital breast tomosynthesis, synthetic mammography, and digital mammography in breast cancer screening: a systematic review and meta-analysis. JNCI: J Natl Cancer Inst 113(6):680–90

  7. Mariscotti G, Durando M, Houssami N et al (2017) 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(3):765–773

    Article  CAS  Google Scholar 

  8. Hwang E, Szabo J, Sonnenblick EB et al (2018) Variable appearances of ductal carcinoma in situ calcifications on digital mammography, synthesized mammography, and tomosynthesis: a pictorial essay. Can Assoc Radiol J 69(1):2–9

    Article  Google Scholar 

  9. Nelson JS, Wells JR, Baker JA, Samei E (2016) How does c-view image quality compare with conventional 2d ffdm? Med Phys 43(5):2538

    Article  Google Scholar 

  10. Ratanaprasatporn L, Chikarmane SA, Giess CS (2017) Strengths and weaknesses of synthetic mammography in screening. Radiographics 37(7):1913–1927

    Article  Google Scholar 

  11. Spangler ML, Zuley ML, Sumkin JH et al (2011) Detection and classification of calcifications on digital breast tomosynthesis and 2d digital mammography: a comparison. AJR Am J Roentgenol 196(2):320–324

    Article  Google Scholar 

  12. Tagliafico A, Mariscotti G, Durando M et al (2015) Characterisation of microcalcification clusters on 2d digital mammography (ffdm) and digital breast tomosynthesis (dbt): does dbt underestimate microcalcification clusters? Results of a multicentre study. Eur Radiol 25(1):9–14

    Article  Google Scholar 

  13. Poplack SP, Tosteson TD, Kogel CA, Nagy HM (2007) Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography. AJR Am J Roentgenol 189(3):616–623

    Article  Google Scholar 

  14. Gilbert FJ, Tucker L, Gillan MG et al (2015) Accuracy of digital breast tomosynthesis for depicting breast cancer subgroups in a uk retrospective reading study (tommy trial). Radiology 277(3):697–706

    Article  Google Scholar 

  15. Gur D, Zuley ML, Anello MI et al (2012) Dose reduction in digital breast tomosynthesis (dbt) screening using synthetically reconstructed projection images: an observer performance study. Acad Radiol 19(2):166–171

    Article  Google Scholar 

  16. Lai YC, Ray KM, Lee AY et al (2018) Microcalcifications detected at screening mammography: synthetic mammography and digital breast tomosynthesis versus digital mammography. Radiology 289(3):630–638

    Article  Google Scholar 

  17. Choi JS, Han BK, Ko EY et al (2019) Comparison of synthetic and digital mammography with digital breast tomosynthesis or alone for the detection and classification of microcalcifications. Eur Radiol 29(1):319–329

    Article  Google Scholar 

  18. Hanley JA, McNeil BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148(3):839–843

    Article  CAS  Google Scholar 

  19. Dodelzon K, Simon K, Dou E, et al (2020) Performance of 2d synthetic mammography versus digital mammography in the detection of microcalcifications at screening. AJR Am J Roentgenol 1–9

  20. Skaane P, Bandos AI, Niklason LT et al (2019) Digital mammography versus digital mammography plus tomosynthesis in breast cancer screening: the Oslo Tomosynthesis Screening Trial. Radiology 291(1):23–30

    Article  Google Scholar 

  21. Abdullah P, Alabousi M, Ramadan S et al (2021) Synthetic 2D mammography versus standard 2D digital mammography: a diagnostic test accuracy systematic review and meta-analysis. Am J Roentgenol 217(2):314–325

    Article  Google Scholar 

  22. Aujero MP, Gavenonis SC, Benjamin R et al (2017) Clinical performance of synthesized two-dimensional mammography combined with tomosynthesis in a large screening population. Radiology 283(1):70–76

    Article  Google Scholar 

  23. Freer PE, Riegert J, Eisenmenger L et al (2017) Clinical implementation of synthesized mammography with digital breast tomosynthesis in a routine clinical practice. Breast Cancer Res Treat 166(2):501–509

    Article  Google Scholar 

  24. Zuckerman SP, Sprague BL, Weaver DL et al (2020) Survey results regarding uptake and impact of synthetic digital mammography with tomosynthesis in the screening setting. J Am Coll Radiol 17(1):31–37

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Gazi University, 06500, Beşevler, Ankara, Turkey

    Pinar Kilic, Halit Nahit Sendur, Serap Gultekin, Isil Imge Gultekin, Emetullah Cindil & Mahinur Cerit

  2. Department of Radiology, Faculty of Medicine, Gazi University, Yenimahalle, Ankara, 06500, Turkey

    Pinar Kilic

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  1. Pinar Kilic
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  2. Halit Nahit Sendur
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  3. Serap Gultekin
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  5. Emetullah Cindil
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  6. Mahinur Cerit
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Contributions

All authors contributed to the study conception and project development and design. Material preparation and data collection and analysis were performed by PK, HNS, SG, and IIG. The first draft of the manuscript was written by PK and SG, and all authors commented on previous versions of the manuscript. IIG, EC, and MC edited the manuscript up to submission. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pinar Kilic.

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Ethics approval

All procedures performed in studies 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.This study was approved by the ethics committee of Gazi University (Date 12.11.2018/No. 819).

Informed consent

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

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All authors read and approved the final manuscript.

Conflict of interest

The authors declare no competing interests.

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Kilic, P., Sendur, H.N., Gultekin, S. et al. Comparison of diagnostic performances in the evaluation of breast microcalcifications: synthetic mammography versus full-field digital mammography. Ir J Med Sci 191, 1891–1897 (2022). https://doi.org/10.1007/s11845-021-02744-7

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  • DOI: https://doi.org/10.1007/s11845-021-02744-7

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