Chikarmane Sona
Brigham and Women's Hospital, Department of Radiology, Boston, MA, USA.
J Breast Imaging. 2022 Apr 15;4(2):124-134. doi: 10.1093/jbi/wbac008.
Digital breast tomosynthesis (DBT) has been widely adopted as a breast cancer screening tool, demonstrating decreased recall rates and other improved screening performance metrics when compared to digital mammography (DM) alone. Drawbacks of DBT when added to 2D DM include the increased radiation dose and longer examination time. Synthetic mammography (SM), a 2D reconstruction from the tomosynthesis slices, has been introduced to eliminate the need for a separate acquisition of 2D DM. Data show that the replacement of 2D DM by SM, when used with DBT, maintains the benefits of DBT, such as decreased recall rates, improved cancer detection rates, and similar positive predictive values. Key differences between SM and 2D DM include how the image is acquired, assessment of breast density, and visualization of mammographic findings, such as calcifications. Although SM is approved by the Food and Drug Administration and has been shown to be non-inferior when used with DBT, concerns surrounding SM include image quality and artifacts. The purpose of this review article is to review the benefits, drawbacks, and screening performance metrics of SM versus DBT.
数字乳腺断层合成（DBT）已被广泛用作乳腺癌筛查工具，与单纯数字乳腺X线摄影（DM）相比，其召回率降低，其他筛查性能指标也有所改善。DBT与二维DM联合使用时的缺点包括辐射剂量增加和检查时间延长。合成乳腺X线摄影（SM）是一种从断层合成切片进行的二维重建技术，已被引入以消除单独采集二维DM的需求。数据表明，SM与DBT联合使用时替代二维DM，可保持DBT的优势，如降低召回率、提高癌症检出率以及类似的阳性预测值。SM与二维DM之间的关键区别包括图像采集方式、乳腺密度评估以及乳腺X线摄影表现（如钙化）的可视化。尽管SM已获得美国食品药品监督管理局的批准，并且已证明与DBT联合使用时非劣效，但对SM的担忧包括图像质量和伪影。本文综述的目的是回顾SM与DBT的优缺点及筛查性能指标。
