Mark Alan Helvie MD, Presenter: Institutional grant, General Electric Company

Marilyn A. Roubidoux MD, Abstract Co-Author: Nothing to Disclose

Lubomir M. Hadjiiski PhD, Abstract Co-Author: Nothing to Disclose

Yiheng Zhang PhD, Abstract Co-Author: Nothing to Disclose

Paul Langford Carson PhD, Abstract Co-Author: Research Collaboration, General Electric Company

Heang-Ping Chan PhD, Abstract Co-Author: Nothing to Disclose

To compare breast digital tomosynthesis mammography (DTM) and conventional mammography (CM) for breast mass detection and characterization.

IRB approval and individual subject informed consent obtained. A prototype combined DTM and whole breast ultrasound system was developed with GE Global Research. DTM images were reconstructed to 1 mm slice spacing. We report DTM data. Subjects were women with breast masses diagnosed by mammography, sonography, or physical exam. All had a 2 view CM and DTM. 3 readers (MQSA fellowship trained, experienced (14 years mean) academic breast radiologists) blinded to outcome, scored randomly presented DTM and CM exams of each subject at different reading sessions. Readers assessed images and recorded findings for BI-RADS >= 3 breast masses at a workstation. Each mass was graded on visibility (1-10 scale, 1=obvious), % margin depicted, likelihood of malignancy, density, and size. Truth was established by pathology (or ultrasound if simple cyst). Imaging assessments were correlated with pathologic results. We report 30 new consecutive subjects (age 30-69, mean 50) of an ongoing study.

6/30 masses were invasive cancer, 24/30 benign. Masses ranged in size from 8-26 mm (mean=15) for cancers and 5-56 mm (mean=16) for all masses. Breast density was I 4%, II 41%, III 48%, IV 7%. Average results over 3 readers are reported. 36% more masses were found by DTM than CM (49 vs 36 p=.02). Mass visibility was better with DTM (1.8 vs 3.7 p<.005). 48% more margin was visualized by DTM vs CM (77% vs 52%, p <.0008). By case, 6/6 (100%) cancers were detected by DTM and 5/6 (83 %) by CM. By view, one cancer was not included in imaged field in CC projection on either DTM or CM due to location. 11/11 (100%) cancers were detected by DTM and 9.7/11 (88%) by CM . Malignant cases were rated 48% higher likelihood of malignancy on DTM vs CM (68 vs 46%). Benign cases had same malignancy rating (18%).

More masses were detected on DTM than CM. DTM provided better margin assessment and malignant characterization. DTM identified CM occult cancer. More cases are being accrued. Supported by USPHS grants CA91713, CA95153.

DTM shows promise for mammography.

Helvie, M, Roubidoux, M, Hadjiiski, L, Zhang, Y, Carson, P, Chan, H, Tomosynthesis Mammography versus Conventional Mammography: Comparison of Breast Masses Detection and Characterization.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004644.html