Initial Clinical Experience with Stationary Digital Breast Tomosynthesis.

Area of Science:

• Medical Imaging
• Radiology
• Biomedical Engineering

Background:

• Digital breast tomosynthesis (DBT) offers improved breast cancer detection over mammography.
• Stationary DBT (sDBT) utilizes a linear array of carbon nanotube-enabled x-ray sources, eliminating the need for x-ray tube movement.
• This study reports initial clinical experience with a first-generation sDBT device.

Purpose of the Study:

• To evaluate the clinical performance of a novel stationary digital breast tomosynthesis (sDBT) system.
• To compare reader performance and preference between sDBT and conventional mammography for suspicious breast abnormalities.

Main Methods:

• A paired-image study involving 43 women with Breast Imaging Reporting and Data System 4 lesions awaiting biopsy.
• Four radiologists interpreted both mammograms and sDBT image stacks, providing feedback via questionnaires.
• Reader performance was assessed using areas under the receiver operating characteristic curve; preferences were analyzed using multivariate analysis.

Main Results:

• sDBT demonstrated significantly higher areas under the receiver operating characteristic curve than mammography across all breast densities and thicknesses (p < 0.05).
• Radiologists preferred sDBT for evaluating mass margins, shape, architectural distortion, and asymmetry.
• Mammography was preferred for microcalcification characterization.

Conclusions:

• sDBT offers superior diagnostic accuracy and reader preference for soft-tissue breast lesion evaluation compared to mammography.
• The study highlights the need for technological and image-processing improvements to enhance microcalcification conspicuity in future sDBT devices.