Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation

Area of Science:

• Radiology
• Medical Imaging
• Breast Cancer Screening

Background:

• Accurate breast density assessment is crucial for mammography interpretation.
• Digital 2D mammography is a standard screening tool.
• Synthetic 2D mammography offers potential advantages in image acquisition and processing.

Purpose of the Study:

• To compare breast density assessments between synthetic 2D mammography and conventional digital 2D mammograms.
• To evaluate the impact of synthetic 2D mammography on clinical decision-making for supplemental screening.

Main Methods:

• Retrospective analysis of screening mammograms from women with negative or benign outcomes.
• Three experienced radiologists assessed breast density using BI-RADS categories on both digital 2D and synthetic 2D images.
• Inter- and intrareader agreement were calculated using percent agreement and Cohen kappa coefficient.

Main Results:

• High agreement (80.3%) was observed between digital and synthetic 2D mammography for BI-RADS density categories (κ = 0.73).
• Agreement for combined dense/nondense categories was even higher (91.9%).
• Minor shifts between categories occurred, with some reader variability noted.

Conclusions:

• Synthetic 2D mammography is a viable alternative to digital 2D mammography for breast density assessment.
• Adoption of synthetic 2D mammography is unlikely to affect density assessment or supplemental screening recommendations.
• Radiologists can confidently integrate synthetic 2D mammography into screening practices.