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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2025; 35(01): 025-034
DOI: 10.1055/s-0044-1788606
Original Article

Comparison of Full-Field Digital Mammography with Synthesized Mammography from Tomosynthesis in a Diagnostic population: Prospective Study

Ekta Dhamija 
1   Department of Radiodiagnosis and Interventional Radiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
,
Supraja Laguduva Mohan
2   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
,
Roshni Anand
2   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
,
Maroof Ahmad Khan
3   Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
,
Sankaravamsam Venkata Suryanarayana Deo
4   Department of Surgical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
,
Smriti Hari
2   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
› Institutsangaben Funding None.
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Abstract

Background Synthesized mammography (SM) refers to two-dimensional (2D) images derived from the digital breast tomosynthesis (DBT) data. It can reduce the radiation dose and scan duration when compared with conventional full-field digital mammography (FFDM) plus tomosynthesis.

Purpose To compare the diagnostic performance of 2D FFDM with synthetic mammograms obtained from DBT in a diagnostic population.

Materials and Methods A total of 1,468 mammograms with both FFDM and SM + DBT images were obtained and analyzed over 2 years, after obtaining approval from the institute ethics committee. The images were reported and compared as per the 2013 American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) lexicon in terms of breast density, morphological features of mass, calcifications, and presence of asymmetry or architectural distortion followed by the BI-RADS category. The agreement between the two modalities was studied using the Kappa value, and the radiation exposure dose was recorded in both groups.

Results FFDM and SM + DBT showed strong agreement for breast density, mass characteristics, and detection of calcifications (kappa > 0.8). Downstaging of breast density and mass density were seen by SM + DBT without any statistically significant difference. The nipple–areola complex visualization was poor in SM (50.34 vs. 76.29% in FFDM), and there were SM-specific artifacts mainly related to the reconstruction algorithm. The radiation dose was higher with SM.

Conclusion FFDM has comparable performance to SM + DBT in diagnostic setup. The latter may be particularly helpful in patients with dense breasts.

Keywords

synthesized mammography - digital breast tomosynthesis - full-field digital mammography


Publikationsverlauf

Artikel online veröffentlicht:
01. August 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Monticciolo DL, Malak SF, Friedewald SM. et al. Breast cancer screening recommendations inclusive of all women at average risk: update from the ACR and Society of Breast Imaging. J Am Coll Radiol 2021; 18 (09) 1280-1288
    CrossrefPubMedSuche in Google Scholar
  • 2 Duffy SW, Tabár L, Yen AMF. et al. Mammography screening reduces rates of advanced and fatal breast cancers: results in 549,091 women. Cancer 2020; 126 (13) 2971-2979
    CrossrefPubMedSuche in Google Scholar
  • 3 Dhamija E, Gulati M, Deo SVS, Gogia A, Hari S. Digital breast tomosynthesis: an overview. Indian J Surg Oncol 2021; 12 (02) 315-329
    CrossrefPubMedSuche in Google Scholar
  • 4 Mann RM, Athanasiou A, Baltzer PAT. et al; European Society of Breast Imaging (EUSOBI). Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol 2022; 32 (06) 4036-4045
    CrossrefPubMedSuche in Google Scholar
  • 5 Rangarajan K, Hari S, Thulkar S, Sharma S, Srivastava A, Parshad R. Characterization of lesions in dense breasts: does tomosynthesis help?. Indian J Radiol Imaging 2016; 26 (02) 210-215
    Thieme ConnectPubMedSuche in Google Scholar
  • 6 Ali RMKM, England A, Tootell AK, Hogg P. Radiation dose from digital breast tomosynthesis screening - a comparison with full field digital mammography. J Med Imaging Radiat Sci 2020; 51 (04) 599-603
    CrossrefPubMedSuche in Google Scholar
  • 7 Zuckerman SP, Maidment ADA, Weinstein SP, McDonald ES, Conant EF. Imaging with synthesized 2D mammography: differences, advantages, and pitfalls compared with digital mammography. Am J Roentgenol 2017; 209 (01) 222-229
    CrossrefPubMedSuche in Google Scholar
  • 8 Hofvind S, Hovda T, Holen ÅS. et al. Digital breast tomosynthesis and synthetic 2D mammography versus digital mammography: evaluation in a population-based screening program. Radiology 2018; 287 (03) 787-794
    CrossrefPubMedSuche in Google Scholar
  • 9 Heywang-Köbrunner SH, Jänsch A, Hacker A, Weinand S, Vogelmann T. Digital breast tomosynthesis (DBT) plus synthesised two-dimensional mammography (s2D) in breast cancer screening is associated with higher cancer detection and lower recalls compared to digital mammography (DM) alone: results of a systematic review and meta-analysis. Eur Radiol 2022; 32 (04) 2301-2312
    CrossrefPubMedSuche in Google Scholar
  • 10 Simon K, Dodelzon K, Drotman M. et al. Accuracy of synthetic 2D mammography compared with conventional 2D digital mammography obtained with 3D tomosynthesis. Am J Roentgenol 2019; 212 (06) 1406-1411
    CrossrefPubMedSuche in Google Scholar
  • 11 Heindel W, Weigel S, Gerß J. et al; TOSYMA Screening Trial Study Group. Digital breast tomosynthesis plus synthesised mammography versus digital screening mammography for the detection of invasive breast cancer (TOSYMA): a multicentre, open-label, randomised, controlled, superiority trial. Lancet Oncol 2022; 23 (05) 601-611
    CrossrefPubMedSuche in Google Scholar
  • 12 Durand MA. Synthesized mammography: clinical evidence, appearance, and implementation. Diagnostics (Basel) 2018; 8 (02) 22
    CrossrefPubMedSuche in Google Scholar
  • 13 Mumin NA, Rahmat K, Fadzli F. et al. Diagnostic efficacy of synthesized 2D digital breast tomosynthesis in multi-ethnic Malaysian population. Sci Rep 2019; 9 (01) 1459
    CrossrefPubMedSuche in Google Scholar
  • 14 Zuley ML, Guo B, Catullo VJ. et al. Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images. Radiology 2014; 271 (03) 664-671
    CrossrefPubMedSuche in Google Scholar
  • 15 You C, Zhang Y, Gu Y. et al. Comparison of the diagnostic performance of synthesized two-dimensional mammography and full-field digital mammography alone or in combination with digital breast tomosynthesis. Breast Cancer 2020; 27 (01) 47-53
    CrossrefPubMedSuche in Google Scholar
  • 16 Aase HS, Danielsen AS, Hoff SR. et al. Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography. Eur J Radiol 2021; 141: 109753
    CrossrefPubMedSuche in Google Scholar
  • 17 Ratanaprasatporn L, Chikarmane SA, Giess CS. Strengths and weaknesses of synthetic mammography in screening. Radiographics 2017; 37 (07) 1913-1927
    CrossrefPubMedSuche in Google Scholar
  • 18 Zuckerman SP, Conant EF, Keller BM. et al. Implementation of synthesized two-dimensional mammography in a population-based digital breast tomosynthesis screening program. Radiology 2016; 281 (03) 730-736
    CrossrefPubMedSuche in Google Scholar
  • 19 Aujero MP, Gavenonis SC, Benjamin R, Zhang Z, Holt JS. Clinical Performance of synthesized two-dimensional mammography combined with tomosynthesis in a large screening population. Radiology 2017; 283 (01) 70-76
    CrossrefPubMedSuche in Google Scholar
  • 20 Gastounioti A, McCarthy AM, Pantalone L, Synnestvedt M, Kontos D, Conant EF. Effect of mammographic screening modality on breast density assessment: digital mammography versus digital breast tomosynthesis. Radiology 2019; 291 (02) 320-327
    CrossrefPubMedSuche in Google Scholar
  • 21 Skaane P, Bandos AI, Eben EB. et al. Two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images. Radiology 2014; 271 (03) 655-663
    CrossrefPubMedSuche in Google Scholar
  • 22 Abdullah P, Alabousi M, Ramadan S. et al. Synthetic 2D mammography versus standard 2D digital mammography: a diagnostic test accuracy systematic review and meta-analysis. Am J Roentgenol 2021; 217 (02) 314-325
    CrossrefPubMedSuche in Google Scholar
  • 23 Svahn T, Andersson I, Chakraborty D. et al. The diagnostic accuracy of dual-view digital mammography, single-view breast tomosynthesis and a dual-view combination of breast tomosynthesis and digital mammography in a free-response observer performance study. Radiat Prot Dosimetry 2010; 139 (1-3): 113-117
    CrossrefPubMedSuche in Google Scholar
  • 24 Gur D, Zuley ML, Anello MI. et al. Dose reduction in digital breast tomosynthesis (DBT) screening using synthetically reconstructed projection images: an observer performance study. Acad Radiol 2012; 19 (02) 166-171
    CrossrefPubMedSuche in Google Scholar
  • 25 Gulati S, Dhamija E, Anand R. Imaging artifacts on synthesized mammogram: what a radiologist should know!. Indian J Radiol Imaging 2022; 32 (04) 555-561
    Thieme ConnectPubMedSuche in Google Scholar
  • 26 Tirada N, Li G, Dreizin D. et al. Digital breast tomosynthesis: physics, artifacts, and quality control considerations. Radiographics 2019; 39 (02) 413-426
    CrossrefPubMedSuche in Google Scholar
  • 27 Popli MB, Teotia R, Narang M, Krishna H. Breast positioning during mammography: mistakes to be avoided. Breast Cancer (Auckl) 2014; 8: 119-124
    PubMedSuche in Google Scholar
  • 28 Svahn TM, Houssami N, Sechopoulos I, Mattsson S. Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full-field digital mammography. Breast 2015; 24 (02) 93-99
    CrossrefPubMedSuche in Google Scholar
  • 29 Feng SSJ, Sechopoulos I. Clinical digital breast tomosynthesis system: dosimetric characterization. Radiology 2012; 263 (01) 35-42
    CrossrefPubMedSuche in Google Scholar