Paola Clauser MD, Presenter: Nothing to Disclose

Cristina Molinari MD, Abstract Co-Author: Nothing to Disclose

Viviana Londero MD, Abstract Co-Author: Nothing to Disclose

Rossano Girometti MD, Abstract Co-Author: Nothing to Disclose

Angelo Taibi PhD, Abstract Co-Author: Nothing to Disclose

Chiara Zuiani MD, Abstract Co-Author: Nothing to Disclose

Massimo Bazzocchi MD, Abstract Co-Author: Nothing to Disclose

Based on a novel approach, Digital Breast Tomosynthesis (DBT) may simultaneously acquire 2D and 3D images of the breast. Variable dose geometry is used to give a sufficient dose in the central projection for that image to be a 2D mammogram (2D-CP). We aimed to assess the detection rate for suspicious lesions (ACR-BIRADS 3-5) of Digital Mammography (DM) vs 2D-CP and the diagnostic yield (DY) of both modalities.

152 women recalled from regional screening program underwent DM and DBT with 2D-CP to characterize a suspicious finding. Examinations were retrospectively reviewed by two experienced radiologists, blinded to final diagnosis, in separate sessions. They assessed breast lesions as benign or suspicious in case of ACR BIRADS scoring of 1-2 and 3-5, respectively. Discordant cases were reviewed in consensus. Agreement was assessed with weighted-kappa statistic. We estimated the diagnostic yield (DY) of both modalities for the patients who had 6 months follow up, a negative contrast enhanced Magnetic Resonance (CE-MR) or histology of the finding.

DM detected 95 lesions, and 52 were assessed as suspicious (55.3%; 95%CI=45.3%-65.3%); 2D-CP detected 93 lesions, and 51 were assessed as suspicious (54.8%; 95%CI=44.69%-64.91%). The agreement was good (k=0.78; Weighted-Kappa). Twenty-six patients underwent short-term follow up, CE-MR or histology and 13 malignant lesions were found. True positive for both modalities were 13 on 13. No false negatives were found. DM had 10 false positive and 3 true negative; 2D-CP, instead, had 8 false positive and 5 true negative. DY for DM was 61.5%, and for 2D-CP was 69.2%.

All-in-one, dose sparing, 2D-CP provides a good agreement with DM in detection of breast lesions, and is comparable to DM both in lesion detection and in DY for malignancy.

DBT examination with 2D-CP is an all-in-one, low dose, approach that has the potential to replace DM in association with DBT.

Clauser, P, Molinari, C, Londero, V, Girometti, R, Taibi, A, Zuiani, C, Bazzocchi, M, Can 2D Central Projection Acquired during Digital Breast Tomosynthesis Replace Digital Mammography?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044435.html