Skip to main content

Advertisement

Log in

Comparison of synthetic and digital mammography with digital breast tomosynthesis or alone for the detection and classification of microcalcifications

European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare the performance of synthetic mammography (SM) and digital mammography (DM) with digital breast tomosynthesis (DBT) or alone for the evaluation of microcalcifications.

Methods

This retrospective study includes 198 mammography cases, all with DM, SM, and DBT images, from January to October 2013. Three radiologists interpreted images and recorded the presence of microcalcifications and their conspicuity scores and final BI-RADS categories (1, 2, 3, 4a, 4b, 4c, 5). Readers' area under the ROC curves (AUCs) were analyzed for SM plus DBT vs. DM plus DBT and SM alone vs. DM alone using the BI-RADS categories for the overall group and dense breast subgroup.

Results

Conspicuity scores of detected microcalcifications were neither significantly different between SM and DM with DBT nor alone (p>0.05). In predicting malignancy of detected microcalcifications, no significant difference was found between readers' AUCs for SM and DM with DBT or alone in the overall group or dense breast subgroup (p>0.05).

Conclusions

Diagnostic performances of SM and DM for the evaluation of microcalcifications are not significantly different, whether performed with DBT or alone.

Key Points

• In DBT-imaging, SM and DM show comparable performances when evaluating microcalcifications.

• For BI-RADS classification of microcalcifications, SM and DM show similar AUCs.

• DBT with SM may be sufficient for diagnosing microcalcifications, without DM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

AUC:

Area under the receiver operating characteristic curve

BI-RADS:

Breast Imaging Reporting and Data System

DBT:

Digital breast tomosynthesis

DM:

Digital mammography

ICC:

Intraclass correlation coefficient

SM:

Synthetic mammography

References

  1. D’Orsi C, Sickles E, Mendelson E, Morris E (2013) ACR BI-RADS® Atlas, breast imaging reporting and data system. American College of Radiology, Reston

    Google Scholar 

  2. D’Orsi CJ, Mendelson EB, Ikeda DM (2003) ACR breast imaging and reporting data system: breast imaging atlas. American College of Radiology, Reston

    Google Scholar 

  3. Conant EF (2014) Clinical implementation of digital breast tomosynthesis. Radiol Clin North Am 52:499–518

    Article  Google Scholar 

  4. Spangler ML, Zuley ML, Sumkin JH et al (2011) Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol 196:320–324

    Article  Google Scholar 

  5. Skaane P, Hofvind S, Skjennald A (2007) Randomized trial of screen-film versus full-field digital mammography with soft-copy reading in population-based screening program: follow-up and final results of Oslo II study. Radiology 244:708–717

    Article  Google Scholar 

  6. Vigeland E, Klaasen H, Klingen TA, Hofvind S, Skaane P (2008) Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County Study. Eur Radiol 18:183–191

    Article  Google Scholar 

  7. Gilbert FJ, Tucker L, Young KC (2016) Digital breast tomosynthesis (DBT): a review of the evidence for use as a screening tool. Clin Radiol 71:141–150

    Article  Google Scholar 

  8. Gur D, Abrams GS, Chough DM et al (2009) Digital breast tomosynthesis: observer performance study. AJR Am J Roentgenol 193:586–591

    Article  Google Scholar 

  9. Skaane P, Gullien R, Bjorndal H et al (2012) Digital breast tomosynthesis (DBT): initial experience in a clinical setting. Acta Radiol 53:524–529

    Article  Google Scholar 

  10. Wallis MG, Moa E, Zanca F, Leifland K, Danielsson M (2012) Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer study. Radiology 262:788–796

    Article  Google Scholar 

  11. Zuley ML, Bandos AI, Ganott MA et al (2013) Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology 266:89–95

    Article  Google Scholar 

  12. Gilbert FJ, Tucker L, Gillan MG et al (2015) Accuracy of Digital Breast Tomosynthesis for Depicting Breast Cancer Subgroups in a UK Retrospective Reading Study (TOMMY Trial). Radiology 277:697–706

    Article  Google Scholar 

  13. Kopans D, Gavenonis S, Halpern E, Moore R (2011) Calcifications in the breast and digital breast tomosynthesis. Breast J 17:638–644

    Article  Google Scholar 

  14. Tagliafico A, Mariscotti G, Durando M et al (2015) Characterisation of microcalcification clusters on 2D digital mammography (FFDM) and digital breast tomosynthesis (DBT): does DBT underestimate microcalcification clusters? Results of a multicentre study. Eur Radiol 25:9–14

    Article  Google Scholar 

  15. Skaane P, Bandos AI, Gullien R et al (2013) Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program. Radiology 267:47–56

    Article  Google Scholar 

  16. Rafferty EA, Park JM, Philpotts LE et al (2013) Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial. Radiology 266:104–113

    Article  Google Scholar 

  17. Gur D, Bandos AI, Rockette HE et al (2011) Localized detection and classification of abnormalities on FFDM and tomosynthesis examinations rated under an FROC paradigm. AJR Am J Roentgenol 196:737–741

    Article  Google Scholar 

  18. Gennaro G, Toledano A, di Maggio C et al (2010) Digital breast tomosynthesis versus digital mammography: a clinical performance study. Eur Radiol 20:1545–1553

    Article  Google Scholar 

  19. Ciatto S, Houssami N, Bernardi D et al (2013) Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol 14:583–589

    Article  Google Scholar 

  20. Olgar T, Kahn T, Gosch D (2012) Average glandular dose in digital mammography and breast tomosynthesis. Rofo 184:911–918

    Article  CAS  Google Scholar 

  21. Houssami N, Skaane P (2013) Overview of the evidence on digital breast tomosynthesis in breast cancer detection. Breast 22:101–108

    Article  Google Scholar 

  22. Garayoa J, Chevalier M, Castillo M et al (2018) Diagnostic value of the stand-alone synthetic image in digital breast tomosynthesis examinations. Eur Radiol 28:565–572

    Article  Google Scholar 

  23. Zuley ML, Guo B, Catullo VJ et al (2014) Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images. Radiology 271:664–671

    Article  Google Scholar 

  24. Skaane P, Bandos AI, Eben EB et al (2014) Two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images. Radiology 271:655–663

    Article  Google Scholar 

  25. Hajian-Tilaki K (2014) Sample size estimation in diagnostic test studies of biomedical informatics. J Biomed Inform 48:193–204

    Article  Google Scholar 

  26. Choi JS, Han BK, Ko EY et al (2016) Comparison between two-dimensional synthetic mammography reconstructed from digital breast tomosynthesis and full-field digital mammography for the detection of T1 breast cancer. Eur Radiol 26:2538–2546

    Article  Google Scholar 

  27. Park IH, Ko K, Joo J et al (2014) High volumetric breast density predicts risk for breast cancer in postmenopausal, but not premenopausal, Korean women. Ann Surg Oncol 21:4124–4132

    Article  Google Scholar 

  28. Choi JS, Lee CW, Seo HJ et al. (2012) Mammographic density assessment: comparison of VolparaTM software and visual BI-RADS classification. J Korean Soc Breast Screen 9: 127–132.

    Google Scholar 

  29. Gur D, Zuley ML, Anello MI et al (2012) Dose reduction in digital breast tomosynthesis (DBT) screening using synthetically reconstructed projection images: an observer performance study. Acad Radiol 19:166–171

    Article  Google Scholar 

  30. Kromke M, Palomino-Schatzlein M, Mayer H et al (2016) Profiling human blood serum metabolites by nuclear magnetic resonance spectroscopy: a comprehensive tool for the evaluation of hemodialysis efficiency. Transl Res 171(71-82):e71–e79

    Article  Google Scholar 

  31. DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845

    Article  CAS  Google Scholar 

  32. Barlow WE, Chi C, Carney PA et al (2004) Accuracy of screening mammography interpretation by characteristics of radiologists. J Natl Cancer Inst 96:1840–1850

    Article  Google Scholar 

  33. Peters S, Hellmich M, Stork A et al (2017) Comparison of the Detection Rate of Simulated Microcalcifications in Full-Field Digital Mammography, Digital Breast Tomosynthesis, and Synthetically Reconstructed 2-Dimensional Images Performed With 2 Different Digital X-ray Mammography Systems. Invest Radiol 52:206–215

    Article  Google Scholar 

  34. Zuckerman SP CE, Weinstein S, Korhonen K, Synnestvedt M, McDonald E (2015) Early implementation of synthesized 2D in screening with digital breast tomosynthesis: a pictorial essay of early outcomes [abstr]. In: Radiological Society of North America Scientific Assembly and Annual Meeting Program. Oak Brook, Ill: Radiological Society of North America 220

Download references

Acknowledgements

The authors are grateful to Seonwoo Kim, Ph.D and Min-Ji Kim, MS from Samsung Biomedical Research Institute, Samsung Medical Centre, for help in the statistical analyses.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Boo-Kyung Han.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Boo-Kyung Han.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Seonwoo Kim, Ph.D, Samsung Biomedical Research Institute, Samsung Medical Center helped the statistical analyses of the study.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choi, J.S., Han, BK., Ko, E.Y. et al. Comparison of synthetic and digital mammography with digital breast tomosynthesis or alone for the detection and classification of microcalcifications. Eur Radiol 29, 319–329 (2019). https://doi.org/10.1007/s00330-018-5585-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-018-5585-x

Keywords

Navigation