Comparison of two-view versus single-view digital breast tomosynthesis and 2D-mammography in breast cancer surveillance imaging

Purpose Limited work has been performed for the implementation of digital breast tomosynthesis (DBT) in breast cancer surveillance imaging. The aim of this study was to investigate the differences between two different DBT implementations in breast cancer surveillance imaging, for patients with a personal history of breast cancer. Method The DBT implementations investigated were: (1) 2-view 2D digital mammography and 2-view DBT (2vDM&2vDBT) (2) 1-view (cranial-caudal) DM and 1-view (mediolateral-oblique) DBT (1vDM&1vDBT). Clinical performance of these two implementations was assessed retrospectively using observer studies with 118 sets of real patient images, from a single imaging centre, and six observers. Sensitivity, specificity and area under the curve (AUC) using the Jack-knife alternative free-response receiver operating characteristics (JAFROC) analysis were evaluated. Results Results suggest that the two DBT implementations are not significantly different in terms of sensitivity, specificity and AUC. When looking at the two main different lesion types, non-calcifications and calcifications, and two different density levels, no difference in the performance of the two DBT implementations was found. Conclusions Since 1vDM&1vDBT exposes the patient to half the dose of 2vDM&2vDBT, it might be worth considering 1vDM&1vDBT in breast cancer surveillance imaging. However, larger studies are required to conclude on this matter.

Automated summary

This study found no significant differences in sensitivity, specificity, and AUC between the 2-view 2D digital mammography and 2-view DBT implementation and the 1-view (cranial-caudal) DM and 1-view (mediolateral-oblique) DBT implementation in breast cancer surveillance imaging. Considering the radiation dose, using 1-view DM and 1-view DBT may be worth considering, but larger studies are needed to draw a final conclusion.