Digital Breast Tomosynthesis: Observer Performance Study
July 21st, 2009 Posted by: admin
OBJECTIVE. The purpose of this study was to compare in a
retrospective observer study the diagnostic performance of full-field digital
mammography (FFDM) with that of digital breast tomosynthesis.
MATERIALS AND METHODS. Eight experienced radiologists interpreted
images from 125 selected examinations, 35 with verified findings of cancer and
90 with no finding of cancer. The four display conditions included FFDM alone,
11 low-dose projections, reconstructed digital breast tomosynthesis images,
and a combined display mode of FFDM and digital breast tomosynthesis images.
Observers rated examinations using the screening BI-RADS rating scale and the
free-response receiver operating characteristic paradigm. Observer performance
levels were measured as the proportion of examinations prompting recall of
patients for further diagnostic evaluation. The results were presented in
terms of true-positive fraction and false-positive fraction. Performance
levels were compared among the acquisitions and reading modes. Time to view
and interpret an examination also was evaluated.
RESULTS. Use of the combination of digital breast tomosynthesis and
FFDM was associated with 30% reduction in recall rate for cancer-free
examinations that would have led to recall if FFDM had been used alone
(p < 0.0001 for the participating radiologists, p = 0.047
in the context of a generalized population of radiologists). Use of digital
breast tomosynthesis alone also tended to reduce recall rates, an average of
10%, although the observed decrease was not statistically significant
(p = 0.09 for the participating radiologists). There was no
convincing evidence that use of digital breast tomosynthesis alone or in
combination with FFDM results in a substantial improvement in sensitivity.
CONCLUSION. Use of digital breast tomosynthesis for breast imaging
may result in a substantial decrease in recall rate.
