Comparison of visibility of circumscribed masses on Digital Breast Tomosynthesis (DBT) and 2D mammography: are circumscribed masses better visualized and assured of being benign on DBT?

• Published in: European radiology 2017-02, Vol.27 (2), p.570-577
• Main Authors: Nakashima, Kazuaki, Uematsu, Takayoshi, Itoh, Takahiro, Takahashi, Kaoru, Nishimura, Seiichirou, Hayashi, Tomomi, Sugino, Takashi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Breast; Breast - diagnostic imaging; Breast - pathology; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Diagnostic Radiology; Female; Humans; Imaging; Imaging, Three-Dimensional - methods; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Mammography; Mammography - methods; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Radiographic Image Enhancement - methods; Radiology; Reproducibility of Results; Retrospective Studies; Tumors; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-016-4420-5

Objective To compare the visibility of circumscribed masses on digital breast tomosynthesis (DBT) images and 2D mammograms and determine the usefulness of DBT for differentiation between benign and malignant circumscribed masses. Methods Seventy-one (19 malignant and 52 benign) mammographic well-circumscribed masses were included. Visibility of the masses and halo signs on DBT images were retrospectively compared with 2D mammograms. The effects of mammographic breast density on mass visibility were also evaluated. Results For DBT, 83% were superior and 17% were equivalent in visibility of the masses to that of 2D, and superiority of DBT was significantly enhanced in the high breast density group compared with the low breast density group (91% vs 68%, respectively, p = 0.016). Three lesions were only detected on DBT. There was no significant difference in the superiority of DBT for lesion visibility between malignant and benign masses. The halo sign was detected in 58% lesions on DBT and in 4% on 2D ( p < 0.001). Conclusion Circumscribed masses were better visualized on DBT than on 2D mammograms, particularly in high-density breasts. The halo sign often appeared on DBT and gave a clearer mass margin. However, circumscribed masses on DBT are not assured of being benign. Key Points • Circumscribed masses were better visualized on breast tomosynthesis than on 2D mammography. • Tomosynthesis visualized circumscribed masses better than 2D for all breast density categories. • Halo signs often appeared on tomosynthesis and contributed to detect circumscribed margins. • Circumscribed masses on tomosynthesis images are not assured of being benign lesions.