Dustler Magnus, Hellgren Gustav, Timberg Pontus
Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden.
Lund University, Department of Translational Medicine, Medical Radiation Physics, Malmö, Sweden.
J Med Imaging (Bellingham). 2025 Jan;12(Suppl 1):S13011. doi: 10.1117/1.JMI.12.S1.S13011. Epub 2025 Jan 20.
We aim to investigate the characteristics and evaluate the performance of synthetic mammograms (SMs) based on wide-angle digital breast tomosynthesis (DBT) compared with digital mammography (DM).
Fifty cases with both synthetic and digital mammograms were selected from the Malmö Breast Tomosynthesis Screening Trial. They were categorized into five groups consisting of normal cases and recalled cases with false-positive and true-positive findings from DM and DBT only. The DBT system used was a wide-angle (WA) system from Siemens, and the SM images were reconstructed from the DBT images. Visual grading, detection, and recall were evaluated by experienced breast radiologists in both SM and DM images.
Some image quality criteria of the SM images were rated as qualitatively inferior to DM images. However, reader-averaged diagnostic accuracy (0.57 versus 0.55), sensitivity (0.46 versus 0.50), and specificity (0.64 versus 0.58) were not significantly different between SM and DM, respectively.
Synthetic mammography plays a promising role to complement or even replace DM. The study could not find any indications of substantial differences in the sensitivity or specificity of SM for WA DBT systems compared with DM. However, certain image quality criteria of SM fall slightly short compared with DM images. Next-generation DBT systems could address such limitations through improved reconstruction algorithms and system design, and their performance should be the focus of future research studies.
我们旨在研究基于广角数字乳腺断层合成（DBT）的合成乳腺X线摄影（SM）的特征，并与数字乳腺X线摄影（DM）相比较评估其性能。
从马尔默乳腺断层合成筛查试验中选取了50例同时有合成乳腺X线摄影和数字乳腺X线摄影的病例。它们被分为五组，包括正常病例以及仅从DM和DBT中有假阳性和真阳性结果的召回病例。所使用的DBT系统是西门子的广角（WA）系统，SM图像由DBT图像重建而来。经验丰富的乳腺放射科医生对SM和DM图像进行视觉分级、检测和召回评估。
SM图像的一些图像质量标准在定性上被评为低于DM图像。然而，SM和DM之间读者平均诊断准确性（分别为0.57对0.55）、敏感性（分别为0.46对0.50）和特异性（分别为0.64对0.58）并无显著差异。
合成乳腺X线摄影在补充甚至替代DM方面发挥着有前景的作用。该研究未发现与DM相比，WA DBT系统的SM在敏感性或特异性上存在实质性差异的任何迹象。然而，SM的某些图像质量标准与DM图像相比略逊一筹。下一代DBT系统可通过改进重建算法和系统设计来解决此类限制，其性能应成为未来研究的重点。
