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Tomosynthesis
Regina J. Hooley, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Digital breast tomosynthesis (DBT)
            • 2D full-field digital mammography (FFDM)
          • Synonyms

            • "3D" mammography (but is tomographic, not true 3D)
          • Definitions

            • Multiple low-dose digital-projection images across x-ray arc of ± 15-50°
              • Creation of thin tomographic breast reconstruction slices spaced at 0.5-1.0 mm
              • Positioning as for mammography
              • Magnification views not possible
            • Synthetic mammography: 2D views reconstructed from projection images
              • May eliminate need for standard FFDM, ↓ radiation dose and exposure time to ~ 1.3x standard FFDM

          IMAGING

          • General Features

            • DBT Technique

              • Indications

                • Imaging Findings

                  • Limitations

                    • Image-Guided Biopsy

                      PATHOLOGY

                      • Staging, Grading, & Classification

                        DIAGNOSTIC CHECKLIST

                        • Consider

                          Selected References

                          1. Skaane P et al: Digital Mammography versus Digital Mammography Plus Tomosynthesis in Breast Cancer Screening: The Oslo Tomosynthesis Screening Trial. Radiology. 182394, 2019
                          2. Bahl M et al: Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting. Eur Radiol. 29(2): 477-84, 2019
                          3. Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
                          4. Ambinder EB et al: Synthesized mammography: the new standard of care when screening for breast cancer with digital breast tomosynthesis? Acad Radiol. 25(8):973-6, 2018
                          5. Bahl M et al: Comparison of upright digital breast tomosynthesis-guided versus prone stereotactic vacuum-assisted breast biopsy. Radiology. 181788, 2018
                          6. Caumo F et al: Digital breast tomosynthesis with synthesized two-dimensional images versus full-field digital mammography for population screening: outcomes from the Verona screening program. Radiology. 287(1):37-46, 2018
                          7. Choudhery S et al: Masses in the Era of screening tomosynthesis: Is diagnostic ultrasound sufficient? Br J Radiol. 20180801, 2018
                          8. Cohen EO et al: Screening mammography findings from one standard projection only in the era of full-field digital mammography and digital breast tomosynthesis. AJR Am J Roentgenol. 211(2):445-51, 2018
                          9. Geiser WR et al: Artifacts in digital breast tomosynthesis. AJR Am J Roentgenol. 211(4):926-32, 2018
                          10. Lai YC et al: Microcalcifications detected at screening mammography: synthetic mammography and digital breast tomosynthesis versus digital mammography. Radiology. 289(3):630-8, 2018
                          11. Lamb LR et al: Pathologic upgrade rates of high-risk breast lesions on digital two-dimensional vs tomosynthesis mammography. J Am Coll Surg. 226(5):858-67, 2018
                          12. Marinovich ML et al: Agreement between digital breast tomosynthesis and pathologic tumour size for staging breast cancer, and comparison with standard mammography. Breast. 43:59-66, 2018
                          13. Marinovich ML et al: Breast cancer screening using tomosynthesis or mammography: a meta-analysis of cancer detection and recall. J Natl Cancer Inst. 110(9):942-9, 2018
                          14. Patel BK et al: Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions. AJR Am J Roentgenol. 210(6):1395-1400, 2018
                          15. Tagliafico AS et al: A prospective comparative trial of adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts (ASTOUND-2). Eur J Cancer. 104:39-46, 2018
                          16. Zackrisson S et al: One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol. 19(11):1493-1503, 2018
                          17. Hooley RJ et al: Advances in digital breast tomosynthesis. AJR Am J Roentgenol. 208(2):256-66, 2017
                          18. Rafferty EA et al: Breast cancer screening using tomosynthesis and digital mammography in dense and nondense breasts. JAMA. 315(16):1784-6, 2016
                          19. Raghu M et al: Tomosynthesis in the diagnostic setting: changing rates of BI-RADS final assessment over time. Radiology. 281(1):54-61, 2016
                          20. Tagliafico AS et al: Adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts: interim report of a prospective comparative trial. J Clin Oncol. 2016
                          21. Morra L et al: Breast cancer: computer-aided detection with digital breast tomosynthesis. Radiology. 141959, 2015
                          22. Schrading S et al: Digital breast tomosynthesis-guided vacuum-assisted breast biopsy: initial experiences and comparison with prone stereotactic vacuum-assisted biopsy. Radiology. 274(3):654-62, 2015
                          23. Shin SU et al: Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density. Eur Radiol. 25(1):1-8, 2015
                          24. Vedantham S et al: Digital breast tomosynthesis: state of the art. Radiology. 277(3):663-84, 2015
                          25. Friedewald SM et al: Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA. 311(24):2499-507, 2014
                          26. Brandt KR et al: Can digital breast tomosynthesis replace conventional diagnostic mammography views for screening recalls without calcifications? A comparison study in a simulated clinical setting. AJR Am J Roentgenol. 200(2):291-8, 2013
                          27. Ciatto S et al: Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol. 14(7):583-9, 2013
                          28. Houssami N et al: Overview of the evidence on digital breast tomosynthesis in breast cancer detection. Breast. 22(2):101-8, 2013
                          29. Rafferty EA et al: Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial. Radiology. 266(1):104-13, 2013
                          30. Rose SL et al: Implementation of breast tomosynthesis in a routine screening practice: an observational study. AJR Am J Roentgenol. 200(6):1401-8, 2013
                          31. Skaane P et al: Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program. Radiology. 267(1):47-56, 2013
                          32. Uematsu T: The emerging role of breast tomosynthesis. Breast Cancer. 20(3):204-12, 2013
                          33. Zuley ML et al: Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology. 266(1):89-95, 2013
                          34. Noroozian M et al: Digital breast tomosynthesis is comparable to mammographic spot views for mass characterization. Radiology. 262(1):61-8, 2012
                          35. Wallis MG et al: Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer study. Radiology. 262(3):788-96, 2012
                          36. Kopans D et al: Calcifications in the breast and digital breast tomosynthesis. Breast J. 17(6):638-44, 2011
                          37. Spangler ML et al: Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol. 196(2):320-4, 2011
                          Related Anatomy
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Terminology

                            • Imaging

                              • Pathology

                                • Diagnostic Checklist

                                  TERMINOLOGY

                                  • Abbreviations

                                    • Digital breast tomosynthesis (DBT)
                                    • 2D full-field digital mammography (FFDM)
                                  • Synonyms

                                    • "3D" mammography (but is tomographic, not true 3D)
                                  • Definitions

                                    • Multiple low-dose digital-projection images across x-ray arc of ± 15-50°
                                      • Creation of thin tomographic breast reconstruction slices spaced at 0.5-1.0 mm
                                      • Positioning as for mammography
                                      • Magnification views not possible
                                    • Synthetic mammography: 2D views reconstructed from projection images
                                      • May eliminate need for standard FFDM, ↓ radiation dose and exposure time to ~ 1.3x standard FFDM

                                  IMAGING

                                  • General Features

                                    • DBT Technique

                                      • Indications

                                        • Imaging Findings

                                          • Limitations

                                            • Image-Guided Biopsy

                                              PATHOLOGY

                                              • Staging, Grading, & Classification

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  Selected References

                                                  1. Skaane P et al: Digital Mammography versus Digital Mammography Plus Tomosynthesis in Breast Cancer Screening: The Oslo Tomosynthesis Screening Trial. Radiology. 182394, 2019
                                                  2. Bahl M et al: Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting. Eur Radiol. 29(2): 477-84, 2019
                                                  3. Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
                                                  4. Ambinder EB et al: Synthesized mammography: the new standard of care when screening for breast cancer with digital breast tomosynthesis? Acad Radiol. 25(8):973-6, 2018
                                                  5. Bahl M et al: Comparison of upright digital breast tomosynthesis-guided versus prone stereotactic vacuum-assisted breast biopsy. Radiology. 181788, 2018
                                                  6. Caumo F et al: Digital breast tomosynthesis with synthesized two-dimensional images versus full-field digital mammography for population screening: outcomes from the Verona screening program. Radiology. 287(1):37-46, 2018
                                                  7. Choudhery S et al: Masses in the Era of screening tomosynthesis: Is diagnostic ultrasound sufficient? Br J Radiol. 20180801, 2018
                                                  8. Cohen EO et al: Screening mammography findings from one standard projection only in the era of full-field digital mammography and digital breast tomosynthesis. AJR Am J Roentgenol. 211(2):445-51, 2018
                                                  9. Geiser WR et al: Artifacts in digital breast tomosynthesis. AJR Am J Roentgenol. 211(4):926-32, 2018
                                                  10. Lai YC et al: Microcalcifications detected at screening mammography: synthetic mammography and digital breast tomosynthesis versus digital mammography. Radiology. 289(3):630-8, 2018
                                                  11. Lamb LR et al: Pathologic upgrade rates of high-risk breast lesions on digital two-dimensional vs tomosynthesis mammography. J Am Coll Surg. 226(5):858-67, 2018
                                                  12. Marinovich ML et al: Agreement between digital breast tomosynthesis and pathologic tumour size for staging breast cancer, and comparison with standard mammography. Breast. 43:59-66, 2018
                                                  13. Marinovich ML et al: Breast cancer screening using tomosynthesis or mammography: a meta-analysis of cancer detection and recall. J Natl Cancer Inst. 110(9):942-9, 2018
                                                  14. Patel BK et al: Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions. AJR Am J Roentgenol. 210(6):1395-1400, 2018
                                                  15. Tagliafico AS et al: A prospective comparative trial of adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts (ASTOUND-2). Eur J Cancer. 104:39-46, 2018
                                                  16. Zackrisson S et al: One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol. 19(11):1493-1503, 2018
                                                  17. Hooley RJ et al: Advances in digital breast tomosynthesis. AJR Am J Roentgenol. 208(2):256-66, 2017
                                                  18. Rafferty EA et al: Breast cancer screening using tomosynthesis and digital mammography in dense and nondense breasts. JAMA. 315(16):1784-6, 2016
                                                  19. Raghu M et al: Tomosynthesis in the diagnostic setting: changing rates of BI-RADS final assessment over time. Radiology. 281(1):54-61, 2016
                                                  20. Tagliafico AS et al: Adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts: interim report of a prospective comparative trial. J Clin Oncol. 2016
                                                  21. Morra L et al: Breast cancer: computer-aided detection with digital breast tomosynthesis. Radiology. 141959, 2015
                                                  22. Schrading S et al: Digital breast tomosynthesis-guided vacuum-assisted breast biopsy: initial experiences and comparison with prone stereotactic vacuum-assisted biopsy. Radiology. 274(3):654-62, 2015
                                                  23. Shin SU et al: Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density. Eur Radiol. 25(1):1-8, 2015
                                                  24. Vedantham S et al: Digital breast tomosynthesis: state of the art. Radiology. 277(3):663-84, 2015
                                                  25. Friedewald SM et al: Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA. 311(24):2499-507, 2014
                                                  26. Brandt KR et al: Can digital breast tomosynthesis replace conventional diagnostic mammography views for screening recalls without calcifications? A comparison study in a simulated clinical setting. AJR Am J Roentgenol. 200(2):291-8, 2013
                                                  27. Ciatto S et al: Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol. 14(7):583-9, 2013
                                                  28. Houssami N et al: Overview of the evidence on digital breast tomosynthesis in breast cancer detection. Breast. 22(2):101-8, 2013
                                                  29. Rafferty EA et al: Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial. Radiology. 266(1):104-13, 2013
                                                  30. Rose SL et al: Implementation of breast tomosynthesis in a routine screening practice: an observational study. AJR Am J Roentgenol. 200(6):1401-8, 2013
                                                  31. Skaane P et al: Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program. Radiology. 267(1):47-56, 2013
                                                  32. Uematsu T: The emerging role of breast tomosynthesis. Breast Cancer. 20(3):204-12, 2013
                                                  33. Zuley ML et al: Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology. 266(1):89-95, 2013
                                                  34. Noroozian M et al: Digital breast tomosynthesis is comparable to mammographic spot views for mass characterization. Radiology. 262(1):61-8, 2012
                                                  35. Wallis MG et al: Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer study. Radiology. 262(3):788-96, 2012
                                                  36. Kopans D et al: Calcifications in the breast and digital breast tomosynthesis. Breast J. 17(6):638-44, 2011
                                                  37. Spangler ML et al: Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol. 196(2):320-4, 2011