Comparison of synthetic and digital mammography with digital breast tomosynthesis or alone for the detection and classification of microcalcifications

ObjectiveTo compare the performance of synthetic mammography (SM) and digital mammography (DM) with digital breast tomosynthesis (DBT) or alone for the evaluation of microcalcifications.MethodsThis retrospective study includes 198 mammography cases, all with DM, SM, and DBT images, from January to October 2013. Three radiologists interpreted images and recorded the presence of microcalcifications and their conspicuity scores and final BI-RADS categories (1, 2, 3, 4a, 4b, 4c, 5). Readers' area under the ROC curves (AUCs) were analyzed for SM plus DBT vs. DM plus DBT and SM alone vs. DM alone using the BI-RADS categories for the overall group and dense breast subgroup.ResultsConspicuity scores of detected microcalcifications were neither significantly different between SM and DM with DBT nor alone (p>0.05). In predicting malignancy of detected microcalcifications, no significant difference was found between readers' AUCs for SM and DM with DBT or alone in the overall group or dense breast subgroup (p>0.05).ConclusionsDiagnostic performances of SM and DM for the evaluation of microcalcifications are not significantly different, whether performed with DBT or alone.Key Points center dot In DBT-imaging, SM and DM show comparable performances when evaluating microcalcifications.center dot For BI-RADS classification of microcalcifications, SM and DM show similar AUCs.center dot DBT with SM may be sufficient for diagnosing microcalcifications, without DM.