Laurie R. Margolies MD, Presenter: Consultant, FUJIFILM Holdings Corporation Consultant, Konica Minolta Group

Janet R. Szabo MD, Abstract Co-Author: Consultant, Siemens AG Consultant, FUJIFILM Holdings Corporation Consultant, Konica Minolta Group

Emily B. Sonnenblick MD, Abstract Co-Author: Nothing to Disclose

To understand the role of synthesized images in digital breast tomosynthesis,  their benefits and potential pitfalls compared to FFDM by using a case based interactive approach.

1. FFDM vs. C-view: the FDA mandate.  When DBT was first approved  dual exposure was mandated and patients received about double the radiation dose.  Subsequently, the FDA approved the use of a synthesized 2D image. 2. Dose reduction with C-view; when synthesized 2D images replace acquired 2D images, the patient only recieves the dose of the tomosynthesis acquisition 3. C-view and masses: some masses are easily seen on FFDM, DBT and synthesized images, but some, however, are less conspicuous on synthesized images.  This will be illustrated with examples of benign and malignant masses. 4.C-view and calcifications.  Synthesized images show calcifications clearly and cases where calcifications were only seen prospectively on the synthesized image will be shown along with subsequent magnification views and pathology results. 5. C-view technical issues.  Issues such as calcifications which are not seen on the synthesized view will be discussed.  Examples of skin calcifications clearly seen on FFDM, but not on the synthesized image or DBT will illustrate the possibility that eliminating the FFDM may lead to missing some superficial abnormalities.

http://abstract.rsna.org/uploads/2014/14002676/14002676_gwxf.pdf

Margolies, L, Szabo, J, Sonnenblick, E, Synthesize or Acquire? - Do Synthesized 2D Images from a DBT Data Set Improve Breast Cancer Detection?  Benefits and Concerns from the Viewbox.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002676.html