One-to-one comparison between digital spot compression view and digital breast tomosynthesis

To assess if digital breast tomosynthesis (DBT) is at least equal to digital spot compression view (DSCV).

Following institutional approval and written informed consent, both DBT and DSCV were obtained in women with a screening abnormality. The diagnostic accuracy of DBT and DSCV was evaluated by two radiologists of varying experience (Reader1 and Reader2).

52 consecutive recalled women without calcification (mean age: 51 ± 12 years) underwent DSCV and DBT. Overall sensitivity was equal for both techniques (100% [95% CI, 91-100%] for DBT and 100% [95% CI, 91-100%] for DSCV). Overall specificity was higher for DBT (100% [95%CI, 91-100%]) than for DSCV (94% [95% CI, 91-100%]). Specificity for DSCV was higher for Reader1 (95% [95% CI, 91-100%]). Reader2 had lower values of specificity (92% [95% CI, 90-92%]). On DSCV, three and two false positives were recorded by Reader2 and Reader1, respectively. Overall, the area under the curve (AUC) was greater for DBT (AUC = 1) than for DSCV (AUC = 0.963). The mean difference between the two techniques was not significantly different (P = 0.43).

In this dataset, diagnostic accuracy of digital breast tomosynthesis is at least equal to that of digital spot compression.

• Digital spot compression views (DSCVs) are often needed in breast screening programmes. • Digital breast tomosynthesis (DBT) now offers an alternative to DSCV • In recalls without calcification, DBT was at least equally accurate as DSCVs • DBT has a lower mean glandular dose than DSCVs • Thus DBT has the potential to help reduce the recall rate.