The impact on lesion detection via a multi‐vendor study: A phantom‐based comparison of digital mammography, digital breast tomosynthesis, and synthetic mammography

Abstract

The aim of this study is to perform a test object-based comparison of the imaging performance of digital mammography (DM), digital breast tomosynthesis (DBT), and synthetic mammography (SM). Methods: Two test objects were used, the CDMAM and the L1-structured phantom. Small-detail detectability was assessed using CDMAM and the microcalcification simulating specks in the L1-structured background. Detection of spiculated and non-spiculated mass-like objects was assessed using the L1 phantom. Six different systems were included: Amulet Innovality (Fujifilm), Senographe Pristina (GEHC), 3Dimensions (Hologic), Giotto Class (IMS), Clarity 2D/3D (Planmed), and Mammomat Revelation (Siemens). Images were acquired under automatic exposure control (AEC) and at adjusted levels of AEC/2 and 2 × AEC level. Threshold gold thickness (T tr ) was established for the 0.13-mm-diameter CDMAM discs. Threshold diameters for the calcifications (d tr_c ), the spiculated masses (d tr_sm ), and for the non-spiculated masses (d tr_nsm ) were established. The threshold condition was defined as the thickness or diameter for a 62.5% correct score. Results: T tr for DM was generally superior to DBT, which in turn was superior to SM, but for most systems, these differences between modes were not significant. For L1, no significant differences in d tr_c were found between DM and DBT. The increase in d tr_c from DM to SM at AEC dose was 1%, 19%, 11%, 14%, 46%, and 27% for the Fujifilm, GEHC, Hologic, IMS, Planmed, and Siemens, respectively, indicating significantly poorer performance for all vendors except for Fujifilm, Hologic, and IMS. For both mass types, DBT performed better than SM, while SM showed no significant difference with DM (except for Fujifilm spiculated masses). The dose had an impact on small-detail detectability for both phantoms but did not influence the detection of either mass type. Conclusions: Both phantoms indicated potentially reduced small-detail detectability for SM versus DM and DBT and should therefore not be used in stand-alone mode. The L1 phantom demonstrated no significant difference in microcalcification detection between DM and DBT and also demonstrated the superiority of DBT, compared to DM for mass detection, for all six systems.

Task-based detectability in anatomical background in digital mammography, digital breast tomosynthesis and synthetic mammography

“…An additional acquisition of the 50 mm NPWE phantom placed side by side with a structured phantom (the 'L1 phantom') was made. The L1 phantom is a 48 mm thick semi-cylindrical PMMA box filled with water and acrylic beads of different diameters that generates images containing structured noise similar to DM and DBT images of breasts (Cockmartin et al 2017, Vancoillie et al 2021.…”

Comparison of lesion detection and conspicuity between narrow-angle and wide-angle digital breast tomosynthesis for dense and non-dense breasts

“…Other studies have compared the imaging performance of commercial DBT systems and mainly focused on the characteristics of physical properties for different systems [40][41][42][43][44] and detection performance of test objects in physical phantom. [45][46][47] There has been a lack of direct comparison of the clinical performance between DBT systems with different AR for various lesion types and breast densities. 5 Fajardo et al conducted a pilot clinical study with 61 cases and 3 readers to compare the lesion conspicuity and characterization between DBT with 15-deg and 30-deg AR acquired using a modified Hologic Selenia Dimensions DBT system, and found a higher preference for 15-deg AR for MCs and no difference for masses or architectural distortions (ADs).…”

“…Other studies have compared the imaging performance of commercial DBT systems and mainly focused on the characteristics of physical properties for different systems 40 – 44 and detection performance of test objects in physical phantom 45 – 47 There has been a lack of direct comparison of the clinical performance between DBT systems with different AR for various lesion types and breast densities 5 . Fajardo et al.…”

Technical note: Realization and uncertainty analysis for an adjustable 3D structured breast phantom in digital breast tomosynthesis

“…The Leuven Phantom (Lepha, L1) developed by Cockmartin et al overcomes this problem by using a variable background that retains its statistical properties while the concrete arrangement of the background can be changed by shaking. 13 The variable background is achieved by PMMA spheres with different diameters surrounded by water and has been proven to be able to represent anatomical backgrounds with respect to its fractal dimension. 14 Groups of micro-calcifications as well as spiculated and non-spiculated masses served as test inserts.…”

“…14 Groups of micro-calcifications as well as spiculated and non-spiculated masses served as test inserts. Although the phantom has successfully been used for various studies, 13,14 it became apparent that there was still room for further improvement. The way the objects were incorporated into the phantom was not as reproducible as would be required for mass production and subsequent use with computerized reading where exact position of test inserts is crucial.…”