Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy

• Published in: British journal of radiology Vol. 85; no. 1019; pp. e1074 - e1082
• Main Authors: Svahn, T M, Chakraborty, D P, Ikeda, D, Zackrisson, S, Do, Y, Mattsson, S, Andersson, I
• Format: Journal Article
• Language: English
• Published: England The British Institute of Radiology 01.11.2012
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adult; Aged; Breast - pathology; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - pathology; Carcinoma, Lobular - diagnostic imaging; Carcinoma, Lobular - pathology; Clinical Medicine; Female; Humans; Imaging, Three-Dimensional - methods; Klinisk medicin; Mammography - methods; Mammography - standards; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Radiographic Image Interpretation, Computer-Assisted - methods; Radiologi och bildbehandling; Radiology, Nuclear Medicine and Medical Imaging; Sensitivity and Specificity; Tomography, X-Ray Computed - methods
• ISSN: 0007-1285; 1748-880X; 1748-880X
• DOI: 10.1259/bjr/53282892

Our aim was to compare the ability of radiologists to detect breast cancers using one-view breast tomosynthesis (BT) and two-view digital mammography (DM) in an enriched population of diseased patients and benign and/or healthy patients. All participants gave informed consent. The BT and DM examinations were performed with about the same average glandular dose to the breast. The study population comprised patients with subtle signs of malignancy seen on DM and/or ultrasonography. Ground truth was established by pathology, needle biopsy and/or by 1-year follow-up by mammography, which retrospectively resulted in 89 diseased breasts (1 breast per patient) with 95 malignant lesions and 96 healthy or benign breasts. Two experienced radiologists, who were not participants in the study, determined the locations of the malignant lesions. Five radiologists, experienced in mammography, interpreted the cases independently in a free-response study. The data were analysed by the receiver operating characteristic (ROC) and jackknife alternative free-response ROC (JAFROC) methods, regarding both readers and cases as random effects. The diagnostic accuracy of BT was significantly better than that of DM (JAFROC: p=0.0031, ROC: p=0.0415). The average sensitivity of BT was higher than that of DM (∼90% vs ∼79%; 95% confidence interval of difference: 0.036, 0.108) while the average false-positive fraction was not significantly different (95% confidence interval of difference: -0.117, 0.010). The diagnostic accuracy of BT was superior to DM in an enriched population.