Background: Synthesized 2D mammography (SM) has been invented to help lower the radiation dose by circumventing the need for acquiring full-field digital mammography (FFDM) when digital breast tomosynthesis (DBT) is performed. Prior studies have compared microcalcifications detection and characterization in FFDM with SM or with DBT alone. Only few studies have compared DBT plus SM and DBT plus FFDM.

Objective: To determine the performance of DBT with SM versus DBT with FFDM in detection and characterization of microcalcifications.

Materials and Methods: Three hundred three paired examinations of 2D plus DBT images in the same session were performed. Fifty-five biopsyproven malignancy, 198 biopsy-proven benign microcalcifications, and 50 randomly selected negative screening studies were retrospectively reviewed by two radiologists. Comparison of sensitivity and specificity between the two modalities were performed.

Results: From the 55 malignant microcalcifications, three cases were missed by DBT with FFDM but detected and correctly categorized as malignant by DBT with SM. Only one case of malignant microcalcifications was not detected by DBT with SM, and the present case was also miscategorized as benign by DBT with FFDM. There were no statistically significant differences in both detections (p=0.42), and characterization (p=0.65) of microcalcification between both modalities. In DBT with SM, the sensitivity was higher, and the specificity was lower for both detection and characterization of microcalcification when compared to DBT with FFDM.

Conclusion: DBT in combination with SM is comparable to DBT in combination with FFDM for detection and characterization of microcalcifications.

Keywords: Synthesized 2D mammography; Full-field digital mammography; Digital breast tomosynthesis; Microcalcifications detection and characterization

DOI: doi.org/10.35755/jmedassocthai.2021.09.12882

Received 6 May 2021 | Revised 27 July 2021 | Accepted 30 July 2021