Stereoscopic interpretation of low-dose breast tomosynthesis projection images

The purpose of this study was to evaluate stereoscopic perception of low-dose breast tomosynthesis projection images. In this Institutional Review Board exempt study, craniocaudal breast tomosynthesis cases (N = 47), consisting of 23 biopsy-proven malignant mass cases and 24 normal cases, were retrospectively reviewed. A stereoscopic pair comprised of two projection images that were ±4° apart from the zero angle projection was displayed on a Planar PL2010M stereoscopic display (Planar Systems, Inc., Beaverton, OR, USA). An experienced breast imager verified the truth for each case stereoscopically. A two-phase blinded observer study was conducted. In the first phase, two experienced breast imagers rated their ability to perceive 3D information using a scale of 1-3 and described the most suspicious lesion using the BI-RADS® descriptors. In the second phase, four experienced breast imagers were asked to make a binary decision on whether they saw a mass for which they would initiate a diagnostic workup or not and also report the location of the mass and provide a confidence score in the range of 0-100. The sensitivity and the specificity of the lesion detection task were evaluated. The results from our study suggest that radiologists who can perceive stereo can reliably interpret breast tomosynthesis projection images using stereoscopic viewing.