Potential impact of tomosynthesis on the detection and diagnosis of breast lesions

ObjectiveThe aim of this study was to evaluate the clinical performance of 3D tomosynthesis in comparison with Full Field Digital Mammography (FFDM) in the detection and diagnosis of breast lesions.Material and methods132 patients underwent standard digital mammography and tomosynthesis and the likelihood of malignancy was categorized according to (ACR) BI-RADS.ResultsTomosynthesis images had significantly increased the number of cases with BI-RAD 1 or 2 (normal/benign) to 62 (42.7%) compared to 39 (26.8%) at mammogram (p < 0.005). Tomosynthesis helped also in more clarification of benign characters. Tomosynthesis images had significantly decreased the number of indeterminate/suspicious lesions (BI-RADS 3 and 4) from 90 (62%) cases to 39 (26.8%) (p < 0.005). In a total of 40 lesions (27.5%) assigned to BI-RADS 5 at tomosynthesis, the tomosynthesis showed better performance in assessment of tumor extension and higher level in detection of clusters of micro-calcifications.The accuracy, specificity, sensitivity and positive and negative predictive values (%) of mammography alone versus when combined with the tomosynthesis were as follows: 59.3, 62.8, 55.2, 56 and 62 versus 91.7, 92.3, 91, 91, and 92.3 respectively (Table 4).Tomosynthesis significantly improved the detection of the breast lesions on mammography images especially in the dense breast with significantly higher accurate BI-RADS scoring (P value <0.005).ConclusionBreast tomosynthesis is a promising technology that offers improved diagnostic and screening accuracy, fewer recalls as well as 3D lesion localization. Lesion conspicuity is improved using DBT compared with FFDM with a more confidence in making clinical decisions.