Comparison of Imaging Quality between 2D Synthesised Mammograms Reconstructed from Digital Breast Tomosynthesis and 2D Full-field Digital Mammograms

Objectives: The aim of this study was to evaluate if 2D synthesised mammograms reconstructed from a digital breast tomosynthesis 3D data set are noninferior in imaging quality when compared to 2D full field digital mammograms.

Methods: A random sample of 100 mammograms was selected from a dedicated private breast imaging service in Australia. Selected cases were classified as normal, benign or malignant. Five breast radiologists retrospectively rated the overall imaging quality and lesion quality of 2D synthesised mammograms when compared with 2D full field digital mammograms. Cases with metal artefact were reassessed using metal artefact post processing software.

Results: Overall image quality for all cases before metal reduction post processing was 0.39 (CI 0.32, 0.45) and after post processing 0.40 (CI 0.33, 0.46). Overall lesion quality for all cases before metal reduction post processing was 0.46 (CI 0.28, 0.65) and after post processing 0.58 (CI 0.43, 0.72). Results confirm noninferiority of both overall image quality and overall lesion quality when comparing 2D synthesised mammograms to 2D full field digital mammograms. Metal artefact reduction had an impact on improving ratings for 2D synthesised mammograms.

Conclusions: 2D synthesised mammograms reconstructed from a digital breast tomosynthesis 3D data set are noninferior when compared to 2D full field digital mammograms. This results in reduction of radiation dose and time under compression.

Advances in Knowledge: 2D synthesised mammograms reconstructed from a digital breast tomosynthesis 3D data set can replace 2D full field digital mammograms. Metal artefact reduction software should be used routinely.