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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(03): 678-688
DOI: 10.1055/s-0041-1734378
Pictorial Essay

Utility of Digital Breast Tomosynthesis with Two-Dimensional Synthesized Mammography Images: A Pictorial Essay

Pradipta C. Hande
1   Division of Radiology, Department of Imaging, Breach Candy Hospital Trust, Mumbai, Maharashtra, India
,
Sabita S. Desai
2   Department of Radiology, Breach Candy Hospital Trust, Mumbai, Maharashtra, India
,
Sarabjeet K. Arneja
3   Department of Surgical Pathology and Cytology, Breach Candy Hospital Trust, Mumbai, Maharashtra, India
,
Sreedevi Sathian
4   Department of Radiodiagnosis, Breach Candy Hospital Trust, Mumbai, Maharashtra, India
› Author Affiliations Financial Support and Sponsorship None.
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Abstract

Background Mammography has been established as the key modality in the detection and diagnosis of breast cancers. Digital breast tomosynthesis (DBT) has emerged as a mammographic technique which allows improved visualization of abnormalities by reducing the effect of overlapping breast tissue.

Purpose This article is a pictorial essay which highlights the advantages of DBT with two-dimensional (2D) synthesized mammography (2DSM) images, its clinical applications, and its role in breast imaging.

Materials and Methods Selenia Dimensions HD mammography machine performs DBT which acquires a series of low-dose digital mammographic images of the compressed breast followed by full-field digital mammography. Software using specialized algorithms helps to create a 2DSM image reconstructed from the DBT data set. The images are interpreted on a dedicated work station on high-resolution monitors by the radiologist. American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS) lexicon is used for reporting. High-resolution breast ultrasound which includes evaluation of the axilla is done for all cases.

Conclusion DBT improves detection and better characterization of lesions which thereby increases confidence of interpretation of mammograms and assigning BI-RADS categories for further management.

Keywords

2D synthesized mammography (2DSM) - ACR BI-RADS - digital breast tomosynthesis (DBT) - FFDM


Publication History

Article published online:
23 August 2021

© 2021. 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 Tabár L, Yen AM-F, Wu WY-Y. et al. Insights from the breast cancer screening trials: how screening affects the natural history of breast cancer and implications for evaluating service screening programs. Breast J 2015; 21 (01) 13-20
    CrossrefPubMedGoogle Scholar
  • 2 Hooley RJ, Durand MA, Philpotts LE. Advances in digital breast tomosynthesis. AJR Am J Roentgenol 2017; 208 (02) 256-266
    CrossrefPubMedGoogle Scholar
  • 3 Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 2002; 225 (01) 165-175
    CrossrefPubMedGoogle Scholar
  • 4 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
    CrossrefPubMedGoogle Scholar
  • 5 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
    CrossrefPubMedGoogle Scholar
  • 6 Zuley ML, Guo B, Catullo VJ, Chough DM, Kelly AE, Lu AH, et al. Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images. Radiology 2014;271:664–677
  • 7 Peppard HR, Nicholson BE, Rochman CM. Merchant JK, Mayo RC III, Harvey JA. Digital breast tomosynthesis in the diagnostic setting: indications and clinical applications. Radiographics 2015; 35 (04) 975-990
    CrossrefPubMedGoogle Scholar
  • 8 Choi JS, Han BK, Ko EY. et al. Comparison between two-dimensional synthetic mammography reconstructed from digital breast tomosynthesis and full-field digital mammography for the detection of T1 breast cancer. Eur Radiol 2016; 26 (08) 2538-2546
    CrossrefPubMedGoogle Scholar
  • 9 Sickles EA, D’Orsi CJ, Bassett LW. et al. ACR BI-RADS mammography. In: D’Orsi C, Sickles EA, Mendelson EB, Morris EA, eds. ACR BI-RADS Atlas Breast Imaging Reporting and Data System 2013. 5th ed. Reston, VA: American College of Radiology; 2013:1–175
  • 10 Zuley ML, Bandos AI, Ganott MA. et al. Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology 2013; 266 (01) 89-95
    CrossrefPubMedGoogle Scholar
  • 11 Dang PA, Freer PE, Humphrey KL, Halpern EF, Rafferty EA. Addition of tomosynthesis to conventional digital mammography: effect on image interpretation time of screening examinations. Radiology 2014; 270 (01) 49-56
    CrossrefPubMedGoogle Scholar
  • 12 Freer PE, Wang JL, Rafferty EA. Digital breast tomosynthesis in the analysis of fat-containing lesions. Radiographics 2014; 34 (02) 343-358
    CrossrefPubMedGoogle Scholar
  • 13 Mun HS, Kim HH, Shin HJ. et al. Assessment of extent of breast cancer: comparison between digital breast tomosynthesis and full-field digital mammography. Clin Radiol 2013; 68 (12) 1254-1259
    CrossrefPubMedGoogle Scholar
  • 14 Luparia A, Mariscotti G, Durando M. et al. Accuracy of tumour size assessment in the preoperative staging of breast cancer: comparison of digital mammography, tomosynthesis, ultrasound and MRI. Radiol Med (Torino 2013; 118 (07) 1119-1136
    CrossrefPubMedGoogle Scholar
  • 15 Rominger M, Wisgickl C, Timmesfeld N. Breast microcalcifications as type descriptors to stratify risk of malignancy: a systematic review and meta-analysis of 10665 cases with special focus on round/punctate microcalcifications. Röfo Fortschr Geb Röntgenstr Nuklearmed 2012; 184 (12) 1144-1152
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A pictorial review of changes in the BI-RADS: fifth edition. Radiographics 2016; 36: 623-639
    PubMed
  • 17 Destounis SV, Arieno AL, Morgan RC. Preliminary clinical experience with digital breast tomosynthesis in the visualization of breast microcalcifications. J Clin Imaging Sci 2013; 3: 65
    CrossrefPubMedGoogle Scholar
  • 18 Spangler ML, Zuley ML, Sumkin JH. et al. Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol 2011; 196 (02) 320-324
    CrossrefPubMedGoogle Scholar
  • 19 Kopans D, Gavenonis S, Halpern E, Moore R. Calcifications in the breast and digital breast tomosynthesis. Breast J 2011; 17 (06) 638-644
    CrossrefPubMedGoogle Scholar
  • 20 Chesebro AL, Winkler NS, Birdwell RL, Giess CS. Developing asymmetries at mammography: a multimodality approach to assessment and management. Radiographics 2016; 36 (02) 322-334
    CrossrefPubMedGoogle Scholar
  • 21 Price ER, Joe BN, Sickles EA. The developing asymmetry: revisiting a perceptual and diagnostic challenge. Radiology 2015; 274 (03) 642-651
    CrossrefPubMedGoogle Scholar
  • 22 Durand MA, Wang S, Hooley RJ, Raghu M, Philpotts LE. Tomosynthesis-detected architectural distortion: management algorithm with radiologic-pathologic correlation. Radiographics 2016; 36 (02) 311-321
    CrossrefPubMedGoogle Scholar
  • 23 Harvey JA, March DE. Making the Diagnosis: A Practical Guide to Breast Imaging. Philadelphia, PA: Elsevier Saunders 2013
  • 24 Geiser WR, Einstein SA, Yang W-T. Artifacts in digital breast tomosynthesis. AJR Am J Roentgenol 2018; 211 (04) 926-932
    CrossrefPubMedGoogle Scholar
  • 25 Gennaro G, Bernardi D, Houssami N. Radiation dose with digital breast tomosynthesis compared to digital mammography: per-view analysis. Eur Radiol 2018; 28 (02) 573-581
    CrossrefPubMedGoogle Scholar
  • 26 Choi Y, Woo O-H, Shin H-S, Cho KR, Seo BK, Choi G-Y. Quantitative analysis of radiation dosage and image quality between digital breast tomosynthesis (DBT) with two-dimensional synthetic mammography and full-field digital mammography (FFDM. Clin Imaging 2019; 55: 12-17
    CrossrefPubMedGoogle Scholar