Richard H. Moore MD, PhD, Presenter: Research support, General Electric Company

Daniel B. Kopans MD, Abstract Co-Author: Research support, General Electric Company

Elizabeth Ann Rafferty MD, Abstract Co-Author: Research grant, Hologic, Inc

Dianne Georgian-Smith MD, Abstract Co-Author: Nothing to Disclose

Rachel Ann Hitt MD, MPH, Abstract Co-Author: Nothing to Disclose

Eren D. Yeh MD, Abstract Co-Author: Nothing to Disclose

Deborah A. Hall MD, Abstract Co-Author: Nothing to Disclose

Kathleen A. McCarthy MD, Abstract Co-Author: Nothing to Disclose

Helen Anne D'Alessandro MD, Abstract Co-Author: Nothing to Disclose

Mary Staffa MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Measure the callback rate for Digital Breast Tomosynthesis (DBT) compared to call back rates for conventional 2D, 4-view digital mammography (CM) in a screening population. Look at callback rates by ACR density, age and compressed thickness in this group.

1957 women ( age35-93, mean 58.5) accrued to date into the NCI 3000-women DBT screening trial initiated in August 2005 using the GE Gen 1.5 DBT clinical prototype. One MLO view per breast was acquired as 15 low-dose projections over a 40-degree arc in 14-23 seconds using standard clinical compression. Eight-iteration maximum-likelihood expectation-maximization (MLEM) reconstruction yielded one slice per mm of breast thickness rendered for review on an ultra-performance DBT review workstation integrated into the PACS. CM were read in the usual clinical workflow with results recorded in ink on case forms by 10 clinical staff radiologists (4-33 years experience). DBT studies were read both with (P) without previous study reference (noP) by two expert breast radiologists (10-33 years experience) Each of the four readings was in turn recorded in ink. The DBT reading without priors were timed.

ACR BIRADS radiographic density 1-124 (6%), 2-589(28.2%), 3-1252(60%), 4-121(5.%)), age and compressed thickness (22 to 70mm, mean 54mm) were cross-tabulated with ACR outcome score (0,1,2,3,4,5) for each of the reading conditions. Overall, callback rates were distributed DBT-P (93(4.4%), DBT-noP- 214(10.4%), CM-noP-271(13.1%), CM-P-158(7.5%) out of 2083 cases. The DBT-P density-callback rates were 1-4.0%, 2-4.1%, 3-4.5%, 4-4.6%. For comparison, the CM-P density-callback rates were 1-5.7%, 2-5.6%, 3-8.8%, 4-8.0%.

DBT markedly reduced the callback rate in a 1957-women sample of the screening population from 7.5 to 4.3 percent, a 43% reduction. Callback rates appear similar across ACR radiographic density 1-4, age and compressed thickness

DBT improves tissue visualization by removing overlying and underlying tissue to permit improved lesion characterization which can reduce callback rate in a screening setting

Moore, R, Kopans, D, Rafferty, E, Georgian-Smith, D, Hitt, R, Yeh, E, Hall, D, McCarthy, K, D'Alessandro, H, Staffa, M, et al, , et al, , Initial Callback Rates for Conventional and Digital Breast Tomosynthesis Mammography Comparison in the Screening Setting.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004025.html