207 - Interpretation of Reconstructed 2D Mammography
Friday, April 3, 2020
1:00 PM – 1:30 PM
Location: LinQ - Social C
Why DBT? • Tissue superimposition hides pathologies in 2D • Tissue superimposition mimics pathologies in 2D DBT in the US Today DBT Advantages • Improved cancer detection • Decreases recall rates Radiation Dose • Additional effective dose of 3D is equivalent to about 2 months of annual natural background radiation in the United States • MQSA- 3 mGy • 2D FFDM ~1.2 mGy • DBT ~1.45 mGy • Combo ~2.65 mGy • DBT view ~1.2x radiation dose as 2D
Introduction of Synthetic 2D Imaging Hologic Synthesized 2D Image • How does it work? Synthetic View • GE and Siemens • Each vendor has pros and cons to their method
Synthetic View Algorithm • Enhances structures i.e. architectural distortions and spiculations; high-contrast features (calcifications)
Do we need a 2D image? • Provides a way to globally assess the breast Gauge breast density, evaluate symmetry, interval changes from prior non-tomosynthesis exams • Provides better evaluation of calcifications – often distributed over several DBT slices Dose with Synthesized View • Incorporating synthetic view in place of FFDM reduces the dose by nearly half • Substantially less dose than imaging combination mode Synthetic View Performance Architectural Distortion • Synthesized mammography algorithm enhances appearance of AD
Masses • Mass shape, margin, and density can often be better depicted on DBT
Are calcifications detected as well on synthetic imaging as on FFDM? • FFDM and SM performed similarly in evaluation of microcalcifications, high sensitivity, modest specificity
Limitations of Synthesized Mammography • Artifacts • Difficulty in assessing motion
Where are we now? • Implementing synthesized mammography into practice around the world • Gao et al. – majority of survey respondents reported still utilizing FFDM
Verona Screening Outcomes
Use of Synthesized View in Practice: Hofvind (Radiology 2018) • Performance of DBT and synthetic mammography (SM) with digital mammography (DM) in a population-based mammographic screening program
Summary • The better mammogram for screening and diagnostic evaluation Reducing recall rates Increasing cancer detection rates Useful for diagnostic imaging and for screening Benefits are sustainable over time
Learning Objectives:
Upon completion, participant will be able to describe available methods of synthesized view image reconstruction.
Upon completion, participant will be able to discuss current synthesized imaging literature.
Upon completion, participant will be able to understand the benefits and drawbacks of implementing synthetic imaging in practice.
