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Proceedings Paper

The role of digital tomosynthesis in reducing the number of equivocal breast reportings
Author(s): Maram Alakhras; Claudia Mello-Thoms; Mary Rickard; Roger Bourne; Patrick C. Brennan
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Paper Abstract


To compare radiologists’ confidence in assessing breast cancer using combined digital mammography (DM) and digital breast tomosynthesis (DBT) compared with DM alone as a function of previous experience with DBT.

Materials and Methods

Institutional ethics approval was obtained. Twenty-three experienced breast radiologists reviewed 50 cases in two modes, DM alone and DM+DBT. Twenty-seven cases presented with breast cancer. Each radiologist was asked to detect breast lesions and give a confidence score of 1-5 (1- Normal, 2- Benign, 3- Equivocal, 4- Suspicious, 5- Malignant). Radiologists were divided into three sub-groups according to their prior experience with DBT (none, workshop experience, and clinical experience). Confidence scores using DM+DBT were compared with DM alone for all readers combined and for each DBT experience subgroup. Statistical analyses, using GraphPad Prism 5, were carried out using the Wilcoxon signed-rank test with statistical significance set at p< 0.05.


Confidence scores were higher for true positive cancer cases using DM+DBT compared with DM alone for all readers (p < 0.0001). Confidence scores for normal cases were lower (indicating greater confidence in the non-cancer diagnosis) with DM+DBT compared with DM alone for all readers (p= 0.018) and readers with no prior DBT experience (p= 0.035).


Addition of DBT to DM increases the confidence level of radiologists in scoring cancer and normal/benign cases. This finding appears to apply across radiologists with varying levels of DBT experience, however further work involving greater numbers of radiologists is required.

Paper Details

Date Published: 17 March 2015
PDF: 6 pages
Proc. SPIE 9416, Medical Imaging 2015: Image Perception, Observer Performance, and Technology Assessment, 94161G (17 March 2015); doi: 10.1117/12.2081838
Show Author Affiliations
Maram Alakhras, The Univ. of Sydney (Australia)
Claudia Mello-Thoms, The Univ. of Sydney (Australia)
Univ. of Pittsburgh (United States)
Mary Rickard, The Univ. of Sydney (Australia)
Sydney Breast Clinic (Australia)
Roger Bourne, The Univ. of Sydney (Australia)
Patrick C. Brennan, The Univ. of Sydney (Australia)

Published in SPIE Proceedings Vol. 9416:
Medical Imaging 2015: Image Perception, Observer Performance, and Technology Assessment
Claudia R. Mello-Thoms; Matthew A. Kupinski, Editor(s)

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