'In vivo' average glandular dose evaluation: one-to-one comparison between digital breast tomosynthesis and full-field digital mammography.

We analysed 300 patients X rayed with digital breast tomosynthesis (DBT), full-field digital mammography (FFDM) and 'COMBO' (single view both in FFDM and DBT in a single breast compression)-Hologic Selenia Dimension-W/Rh-Ag-Al: three different anode-filter combinations-automatic exposure control modalities. Examination parameter data collection (EPDC) and 'in vivo' dosimetry using metal oxide semiconductor field effect transistor (MOSFET) were utilised to determine and compare entrance skin air kerma (ESAK) and average glandular dose (AGD) from a radioprotection viewpoint in the DBT and COMBO modalities. MOSFET has been tested to be introduced in clinical routine. EPDC of DBT underlines increase in ESAK and AGD compared with FFDM (p < 0.05). The mean percentage increase was 34 % (+17 %) in ESAK and 46 % (+16 %) in AGD. In the COMBO modality, the mean percentage increase in ESAK was 162 % (+41 %) and in AGD was 202 % (+61 %). Differences between MOSFET measurement and calculated values were <8 % for breasts thicker than 30 mm; otherwise, the errors are >15 %. DBT increases ESAK and AGD, due to the 3D acquisition modality. MOSFET may be considered in DBT as a routine check.

Mammographic density estimation: one-to-one comparison of digital mammography and digital breast tomosynthesis using fully automated software.

OBJECTIVE: To compare breast density on digital mammography and digital breast tomosynthesis using fully automated software. METHODS: Following institutional approval and written informed consent from all participating women, both digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) were obtained. Breast percentage density was calculated with software on DBT and FFDM. RESULTS: Fifty consecutive patients (mean age, 51 years; range, 35-83 years) underwent both FFDM and DBT. Using a method based on the integral curve, breast density showed higher results on FFDM (68.1 ± 12.1 for FFDM and 51.9 ± 6.5 for DBT). FFDM overestimated breast density in 16.2% (P < 0.0001). Using a method based on maximum entropy thresholding, breast density showed higher results on FFDM (68.1 ± 12.1 for FFDM and 51.9 ± 6.5 for DBT). FFDM overestimated breast density in 11.4% (P < 0.0001). There was a good correlation among BI-RADS categories on a four-grade scale and the density evaluated with DBT and FFDM (r = 0.54, P < 0.01 and r = 0.44, P < 0.01). CONCLUSION: Breast density appeared to be significantly underestimated on digital breast tomosynthesis. KEY POINTS: Breast density is considered to be an independent risk factor for cancer Density can be assessed on full-field digital mammography and digital breast tomosynthesis Objective automated estimation of breast density eliminates subjectivity Automated estimation is more accurate than BI-RADS quantitative evaluation Breast density may be significantly underestimated on digital breast tomosynthesis.

One-to-one comparison between digital spot compression view and digital breast tomosynthesis.

OBJECTIVE: To assess if digital breast tomosynthesis (DBT) is at least equal to digital spot compression view (DSCV). METHODS: Following institutional approval and written informed consent, both DBT and DSCV were obtained in women with a screening abnormality. The diagnostic accuracy of DBT and DSCV was evaluated by two radiologists of varying experience (Reader1 and Reader2). RESULTS: 52 consecutive recalled women without calcification (mean age: 51 ± 12 years) underwent DSCV and DBT. Overall sensitivity was equal for both techniques (100% [95% CI, 91-100%] for DBT and 100% [95% CI, 91-100%] for DSCV). Overall specificity was higher for DBT (100% [95%CI, 91-100%]) than for DSCV (94% [95% CI, 91-100%]). Specificity for DSCV was higher for Reader1 (95% [95% CI, 91-100%]). Reader2 had lower values of specificity (92% [95% CI, 90-92%]). On DSCV, three and two false positives were recorded by Reader2 and Reader1, respectively. Overall, the area under the curve (AUC) was greater for DBT (AUC = 1) than for DSCV (AUC = 0.963). The mean difference between the two techniques was not significantly different (P = 0.43). CONCLUSION: In this dataset, diagnostic accuracy of digital breast tomosynthesis is at least equal to that of digital spot compression. KEY POINTS: • Digital spot compression views (DSCVs) are often needed in breast screening programmes. • Digital breast tomosynthesis (DBT) now offers an alternative to DSCV • In recalls without calcification, DBT was at least equally accurate as DSCVs • DBT has a lower mean glandular dose than DSCVs • Thus DBT has the potential to help reduce the recall rate.