Ji Soo Choi MD, PhD, Presenter: Nothing to Disclose

Boo-Kyung Han MD, PhD, Abstract Co-Author: Nothing to Disclose

Eun Young Ko MD, PhD, Abstract Co-Author: Nothing to Disclose

Eun Sook Ko MD, Abstract Co-Author: Nothing to Disclose

Soo Yeon Hahn MD, Abstract Co-Author: Nothing to Disclose

To evaluate the interpretative performance of synthetic two-dimensional (2D) mammography (C-View) reconstructed from digital breast tomosynthesis (DBT) for detection and characterization of small invasive cancers, compared to digital 2D mammography (DM).

This study consecutively enrolled 107 patients (mean age 52.1 years) with T1-stage invasive breast cancers (≤2cm in size, mean size 12.9±4.3 mm) confirmed by surgical excision from January to June 2013. For each patient, DM and DBT were performed, and C-View was reconstructed from each set of DBT slices. Three breast radiologists, blinded to histology, interpreted DM and C-view, and recorded visibility (four-point scale; 1 no visible finding, 2 low conspicuity, 3 medium conspicuity, 4 high conspicuity) and morphology of detected cancers. Diagnostic performance of C-View was compared with that of DM in terms of detectability and visibility. Subgroup analyses were performed according to mammographic density (dense 29/ non-dense 78)..

There was no significant difference in detection sensitivity of T1 breast cancers between C-View (range 62.6-71.0%) and DM (60.7-71.0%) for all readers (P>0.05). The visibility scores of C-View and DM were also not significantly different for each observer (range of mean scores 2.6-2.9 for C-View, 2.4-2.9 for DM; P>0.05). Common presentation of detected cancers on both C-View and DM were irregular spiculated masses (67.7% vs. 69.0%) and microcalcifications (14.5% vs. 15.5%). In the subgroup analysis according to mammographic density, C-View and DM showed no significant difference in detectability and visibility of T1 breast cancers. These two modes of dense breast group showed lower detection sensitivity (range 53.8-65.4% for C-View, 51.3-65.4% for DM) and lower visibility scores (range of mean visibility score 2.3-2.7 for C-View, 2.1-2.7 for DM), compare to those of non-dense group (detection sensitivity 86.2% for C-View, 86.2% for DM; range of mean visibility score 3.2-3.4 for C-view, 3.1-3.5 for DM).

Diagnostic performance of C-View and DM are comparable for detection of T1 breast cancers. Therefore, our results indicate that C-view may eliminate the need for addition of DM during DBT-based screening.

Synthetic 2D mammography may eliminate the need for addition of digital 2D mammogarphy during DBT-based screening, and keep the dose of DBT the same as that of digital 2D mammogarphy.    

Choi, J, Han, B, Ko, E, Ko, E, Hahn, S, Comparison with Synthetic 2D Mammography Reconstructed from Digital Breast Tomosynthesis and Digital 2D Mammography for the Detection of T1 Breast Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017172.html