Radiologists make similar breast density assessments using synthesized mammography, FFDM

Radiologists make similar breast density assessments using synthesized mammography (SM) and standard or full-field digital mammography (FFDM), according to a new study published by the Journal of the American College of Radiology. This finding, the authors noted, suggests SM could potentially replace FFDM to provide additional value during the screening process.

“As technological advances have paved the way from analog screen films to digital mammography and now tomosynthesis, SM provides a unique value proposition to evolve mammographic screening further,” wrote lead author Irfanullah Haider, MD, MBA, of Brigham & Women’s Hospital in Boston, and colleagues.

The authors studied breast density assessments for 200 patients obtained from June 1 to November 30, 2016. Seven radiologists assigned a breast density to each patient using FFDM alone. The same group of readers then repeated the process using only SM images reconstructed from low-dose images acquired during digital breast tomosynthesis. The radiologists were blinded to each other’s work in both instances.

Overall, 87.5 percent of patients had the same BI-RADS density when radiologists used SM compared to when they used FFDM. For 7.5 percent of patients, the density based on SM was higher than the density based on FFDM—in each instance, it was one BI-RADS category higher. For 5 percent of patients, the density based on SM was lower than the density based on FFDM.

“Subjective breast density assessment by radiologists is similar for SM and FFDM,” the authors concluded. “This study contributes to emerging research supporting the replacement of FFDM with SM in an effort to reduce radiation dose and image acquisition time.”