Objectives
To compare radiologists’ sensitivity, confidence level, and reading efficiency of
detecting microcalcifications in digital breast tomosynthesis (DBT) at two clinically
relevant dose levels.
Materials and Methods
Six 5-cm-thick heterogeneous breast phantoms embedded with a total of 144 simulated
microcalcification clusters of four speck sizes were imaged at two dose modes by a
clinical DBT system. The DBT volumes at the two dose levels were read independently
by six MQSA radiologists and one fellow with 1–33 years (median 12 years) of experience
in a fully-crossed counter-balanced manner. The radiologist located each potential
cluster and rated its conspicuity and his/her confidence that the marked location
contained a cluster. The differences in the results between the two dose modes were
analyzed by two-tailed paired t-test.
Results
Compared to the lower-dose mode, the average glandular dose in the higher-dose mode
for the 5-cm phantoms increased from 1.34 to 2.07 mGy. The detection sensitivity increased
for all speck sizes and significantly for the two smaller sizes (p <0.05). An average of 13.8% fewer false positive clusters was marked. The average
conspicuity rating and the radiologists’ confidence level were higher for all speck
sizes and reached significance (p <0.05) for the three larger sizes. The average reading time per detected cluster
reduced significantly (p <0.05) by an average of 13.2%.
Conclusion
For a 5-cm-thick breast, an increase in average glandular dose from 1.34 to 2.07 mGy
for DBT imaging increased the conspicuity of microcalcifications, improved the detection
sensitivity by radiologists, increased their confidence levels, reduced false positive
detections, and increased the reading efficiency.
Key Words
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Article info
Publication history
Published online: September 16, 2020
Accepted:
July 30,
2020
Received in revised form:
July 30,
2020
Received:
May 19,
2020
Footnotes
This work was supported by an institutional research grant from GE Healthcare. HPC has control of the study, the data and the analysis, and the information submitted for publication.
Identification
Copyright
© 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
