Comparison of synthetic and digital mammography with digital breast tomosynthesis or alone for the detection and classification of microcalcifications
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To compare the performance of synthetic mammography (SM) and digital mammography (DM) with digital breast tomosynthesis (DBT) or alone for the evaluation of microcalcifications.
This retrospective study includes 198 mammography cases, all with DM, SM, and DBT images, from January to October 2013. Three radiologists interpreted images and recorded the presence of microcalcifications and their conspicuity scores and final BI-RADS categories (1, 2, 3, 4a, 4b, 4c, 5). Readers' area under the ROC curves (AUCs) were analyzed for SM plus DBT vs. DM plus DBT and SM alone vs. DM alone using the BI-RADS categories for the overall group and dense breast subgroup.
Conspicuity scores of detected microcalcifications were neither significantly different between SM and DM with DBT nor alone (p>0.05). In predicting malignancy of detected microcalcifications, no significant difference was found between readers' AUCs for SM and DM with DBT or alone in the overall group or dense breast subgroup (p>0.05).
Diagnostic performances of SM and DM for the evaluation of microcalcifications are not significantly different, whether performed with DBT or alone.
• In DBT-imaging, SM and DM show comparable performances when evaluating microcalcifications.
• For BI-RADS classification of microcalcifications, SM and DM show similar AUCs.
• DBT with SM may be sufficient for diagnosing microcalcifications, without DM.
KeywordsMicrocalcification Digital breast tomosynthesis Digital mammography Synthetic image Diagnosis
Area under the receiver operating characteristic curve
Breast Imaging Reporting and Data System
Digital breast tomosynthesis
Intraclass correlation coefficient
The authors are grateful to Seonwoo Kim, Ph.D and Min-Ji Kim, MS from Samsung Biomedical Research Institute, Samsung Medical Centre, for help in the statistical analyses.
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Boo-Kyung Han.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
Seonwoo Kim, Ph.D, Samsung Biomedical Research Institute, Samsung Medical Center helped the statistical analyses of the study.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
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