Tomosynthesis boosts accuracy of digital mammography

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Adding tomosynthesis to standard digital mammography increases diagnostic accuracy while reducing false positive recall rates, according to a study recently published in the journal Radiology.

The study included 1,192 women, of whom 997 (780 screening cases and 217 women who had pre-biopsy imaging) had complete data sets. Two enriched reader studies were performed comparing digital mammography against digital mammography with tomosynthesis.

"This is the first major advance in breast imaging and breast cancer screening since the development of breast MRI," lead researcher Elizabeth Rafferty, director of breast imaging at the Avon Comprehensive Breast Center at Massachusetts General Hospital said in an announcement. "The beauty of tomosynthesis is that it addresses two major concerns with screening mammography: missed cancers and false positive rates."

Of the eligible cases, 312 (with 48 cancer cases) were read by 12 radiologists in the first study, and 310 (with 51 cancer cases) were read by 15 radiologists in the second study.

The researchers found that the use of standard mammography and tomosynthesis increased diagnostic accuracy for all 27 radiologists. Diagnostic sensitivity increased by close to 11 percent for the radiologists in the first study, and 16 percent in the second study.

"Almost all of the gains in diagnostic sensitivity with the combined modality were attributable to the improved detection and characterization of invasive cancers, which are the cancers we are most concerned about because of their potential to metastasize," Rafferty said. 

Additionally, the addition of tomosynthesis to standard digital mammography reduced false positive recall rates by 38.6 percent in the first study and 17.1 percent in the second study, which means, Rafferty said, a "substantial number of unnecessary diagnostic tests can be avoided" by using this technique in a clinical setting.

For more information:
- here's the study in Radiology
- read the announcement

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