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DOI:10.2214/AJR.07.2841
AJR 2008; 190:865-869
© American Roentgen Ray Society

Original Research

Digital Breast Tomosynthesis: A Pilot Observer Study

Walter F. Good1, Gordon S. Abrams2, Victor J. Catullo2, Denise M. Chough2, Marie A. Ganott2, Christiane M. Hakim2 and David Gur1

1 Department of Radiology, Imaging Research, University of Pittsburgh, F.A.R.P. Bldg., 3362 Fifth Ave., Pittsburgh, PA 15213.
2 Department of Radiology, Magee-Women's Hospital, Pittsburgh, PA.

OBJECTIVE. The objective of our study was to assess ergonomic and diagnostic performance–related issues associated with the interpretation of digital breast tomosynthesis–generated examinations.

MATERIALS AND METHODS. Thirty selected cases were read under three different display conditions by nine experienced radiologists in a fully crossed, mode-balanced observer performance study. The reading modes included full-field digital mammography (FFDM) alone, the 11 low-dose projections acquired for the reconstruction of tomosynthesis images, and the reconstructed digital breast tomosynthesis examination. Observers rated cases under the free-response receiver operating characteristic, as well as a screening paradigm, and provided subjective assessments of the relative diagnostic value of the two digital breast tomosynthesis–based image sets as compared with FFDM. The time to review and diagnose each case was also evaluated.

RESULTS. Observer performance measures were not statistically significant (p > 0.05) primarily because of the small sample size in this pilot study, suggesting that showing significant improvements in diagnosis, if any, will require a larger study. Several radiologists did perceive the digital breast tomosynthesis image set and the projection series to be better than FFDM (p < 0.05) for diagnosing this specific case set. The time to review, interpret, and rate the examinations was significantly different for the techniques in question (p < 0.05).

CONCLUSION. Tomosynthesis-based breast imaging may have great potential, but much work is needed before its optimal role in the clinical environment is known.

Keywords: breast cancer • breast screening • digital breast tomosynthesis • full-field digital mammography • observer performance study • tomosynthesis






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