Survey on Current Utilization and Perception of Synthesized Mammography

Area of Science:

• Radiology
• Medical Imaging
• Breast Imaging Technology

Background:

• Digital breast tomosynthesis (DBT) is increasingly used for breast cancer screening.
• Synthesized mammography (SM) is a 2D image reconstruction technique for DBT, potentially reducing radiation dose and improving workflow.
• Understanding radiologist utilization and perceptions of SM is crucial for its adoption and optimization.

Purpose of the Study:

• To assess the current utilization of 2D synthesized mammography (SM) in conjunction with digital breast tomosynthesis (DBT) among practicing U.S. breast radiologists.
• To evaluate radiologists' confidence and perceptions regarding the advantages and disadvantages of using SM for mammographic interpretation.

Main Methods:

• An anonymized 23-question survey was distributed to U.S. Society of Breast Imaging (SBI) members.
• The survey collected data on radiologist demographics, screening protocols, confidence levels, and perceived pros and cons of SM.
• Statistical analysis was performed to identify factors associated with higher confidence and fewer disadvantages.

Main Results:

• A response rate of 13.4% (371/2771) was achieved.
• 56.1% of respondents were currently screening with DBT/SM, indicating its widespread adoption.
• Radiologists reported high confidence in evaluating masses, asymmetries, and distortions with SM, but mixed confidence for calcifications.
• Lower radiation dose was the most cited advantage (81.2%), while reconstruction algorithm false positives were the most cited disadvantage (57.4%).
• Greater SM experience, screening with DBT/SM, and using specific vendor equipment (Hologic) were associated with higher confidence and fewer perceived disadvantages.

Conclusions:

• Synthesized mammography (SM) has become the primary 2D imaging modality in DBT screening for a majority of surveyed U.S. breast radiologists.
• Radiologists with more experience and those utilizing SM in their current workflow reported increased confidence and fewer concerns.
• SM offers a potential benefit of reduced radiation dose, though managing false positives from reconstruction algorithms remains a consideration.