Stereoscopic Interpretation of Low-Dose Breast Tomosynthesis Projection Images

Abstract

The purpose of this study was to evaluate stereoscopic perception of low-dose breast tomosynthesis projection images. In this Institutional Review Board exempt study, craniocaudal breast tomosynthesis cases (N = 47), consisting of 23 biopsy-proven malignant mass cases and 24 normal cases, were retrospectively reviewed. A stereoscopic pair comprised of two projection images that were ±4° apart from the zero angle projection was displayed on a Planar PL2010M stereoscopic display (Planar Systems, Inc., Beaverton, OR, USA). An experienced breast imager verified the truth for each case stereoscopically. A two-phase blinded observer study was conducted. In the first phase, two experienced breast imagers rated their ability to perceive 3D information using a scale of 1-3 and described the most suspicious lesion using the BI-RADS® descriptors. In the second phase, four experienced breast imagers were asked to make a binary decision on whether they saw a mass for which they would initiate a diagnostic workup or not and also report the location of the mass and provide a confidence score in the range of 0-100. The sensitivity and the specificity of the lesion detection task were evaluated. The results from our study suggest that radiologists who can perceive stereo can reliably interpret breast tomosynthesis projection images using stereoscopic viewing.

Progress in diagnosis of breast cancer: Advances in radiology technology

“…[15] The original research involved obtaining images at different angles that could be used to produce slices of breast tissue. [15] At the time, there were no digital detectors and computer processing speeds were slow by today's standards. This limited further development of DBT until the 1990s when digital detectors became available.…”

“…The first useable unit was developed in 2000 at Massachusetts General Hospital. [15] Numerous other systems were developed that varied the image capture angles and algorithms used to process the images.…”

“…Each method produces some image artifact, but one study concluded that iterative reconstruction provides the best image quality. [15] Structures in the same plane are combined by the images taken at different angles, thereby allowing them to become more apparent. [15] Images from different depths can be reconstructed in different slice thicknesses or combined together without additional exposure to the patient.…”

“…Although the radiation dose is higher, it is still under the dose limit prescribed by the MQSA. [15]…”

“…Many studies have shown that DBT has a higher sensitivity and specificity than digital mammography alone. [15212223] As a result, it can rule out many false-positives and reduce the high number of recall rates and associated patient anxiety. Even though the overall dose rate is higher when compared with a two view screening mammogram, DBT can reduce the need for some additional exposures when suspicious areas are found on screening exams.…”