2D or Synthetic 2D? A Reader Study of Visualization of Amorphous Calcifications

Area of Science:

• Radiology
• Medical Imaging
• Breast Cancer Screening

Background:

• Digital breast tomosynthesis (DBT) reduces radiation exposure by generating synthetic 2D (s2D) images from DBT datasets, potentially replacing 2D digital mammography (DM).
• Evaluating the efficacy of s2D images in detecting subtle findings like amorphous calcifications is crucial for screening mammography.

Purpose of the Study:

• To compare the visibility and detection rates of amorphous calcifications on s2D images versus traditional 2D DM.
• To assess the impact of s2D imaging on recall decisions in screening mammography.

Main Methods:

• Retrospective reader study involving 36 screening mammograms (28 with suspicious calcifications, 8 with benign findings).
• Four breast radiologists interpreted randomized 2D DM and s2D images in two rounds.
• Radiologists assessed calcification visibility (1-5 scale) and determined recall recommendations.

Main Results:

• No significant difference in the detection rates of amorphous calcifications between 2D DM (75.9%) and s2D (75.0%) (P=1.000).
• Amorphous calcifications were rated as significantly more visible on s2D images (mean score 3.4) compared to 2D DM (mean score 3.0) (P=0.005).

Conclusions:

• Synthetic 2D imaging maintains the identification capabilities of 2D DM for amorphous calcifications.
• While detection rates are similar, radiologists perceive amorphous calcifications as more visible on s2D images, suggesting potential benefits for interpretation.