Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer...

Area of Science:

• Radiology
• Medical Imaging
• Breast Cancer Detection

Background:

• Digital breast tomosynthesis (DBT) is an advancement over 2D mammography.
• Assessing DBT's diagnostic performance across different views is crucial.

Purpose of the Study:

• To compare the diagnostic accuracy of 2D full-field digital mammography (FFDM) with two-view and single-view tomosynthesis.
• Evaluate performance based on reader experience.

Main Methods:

• Observer study with 220 women (130 in test set) with dense breasts (BI-RADS 2-4).
• Ten readers evaluated cases using FFDM and two-view tomosynthesis; another ten used FFDM and single-view tomosynthesis.
• Multireader, multicase receiver operating characteristic (ROC) analysis was performed.

Main Results:

• Two-view tomosynthesis showed significantly higher diagnostic accuracy (AUC=0.851) than FFDM (AUC=0.772, P=.021).
• This improvement was significant for masses and microcalcifications (P=.037, P=.049).
• Benefits were primarily observed in readers with less experience (<10 years). No significant difference was found between FFDM and single-view tomosynthesis (AUC=0.774 vs 0.775, P=.79).

Conclusions:

• Two-view tomosynthesis offers superior diagnostic performance over FFDM, particularly for novice readers.
• The advantages extend to the detection of both masses and microcalcifications.
• Single-view tomosynthesis does not provide a significant diagnostic advantage over FFDM.