Accuracy of Synthetic 2D Mammography Compared With Conventional 2D Digital Mammography Obtained With 3D Tomosynthesis

Leesburg, VA, June 3, 2019—Comparing the diagnostic performance of synthetic 2D imaging generated from 3D digital breast tomosynthesis (DBT) with traditional 2D full-field digital mammography (FFDM) via the most current commercial algorithm in an urban academic radiology practice, Katherine Simon et al. of Weill Cornell Medicine in New York City concluded that DBT plus synthetic 2D mammography performs as well as and not worse than DBT plus FFDM. 

As a retrospective study with three readers, all patients who presented for routine screening mammography between August 13, 2014 and January 31, 2016 and underwent DBT, synthetic 2D mammography, and FFDM were considered eligible, according to an Original Research article in the American Journal of Roentgenology

The cohort included all consecutively registered patients with biopsy-proven ductal carcinoma in situ and invasive mammary carcinoma during the study period (n = 89) and 100 cases of negative or benign (BI-RADS 1 or 2) findings with at least 365-day negative mammographic and clinical follow-up. 

Altogether, DBT and synthetic 2D mammography evidenced sensitivity of 0.83, specificity of 0.96, and a positive predictive value of 0.93. 

Meanwhile, DBT and FFDM had a sensitivity of 0.84, specificity of 0.94, and a positive predictive value of 0.95. 

Furthermore, McNemar tests showed no statistically significant differences in sensitivity, specificity, positive predictive value, or negative predictive value. 

Because the radiation dose of DBT plus FFDM is almost twice that of FFDM alone—but still within allowable Mammography Quality Standards Act levels—Simon and colleagues also determined that DBT in conjunction with synthetic 2D mammography may be a practicable alternative for decreasing radiation dose without sacrificing diagnostic accuracy.  

Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiology society in the North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, topical symposia and AJR Live Webinars, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.