A study of the feasibility of using slabbing to reduce tomosynthesis review time

This study aimed to investigate whether decreasing the amount of slices in breast tomosynthesis (BT) image volumes reduce reading time. BT slices were combined into so-called slabs, by reconstructing thin slices and merging them into thicker slabs. Sets of slabs where created from 35 clinical BT volumes with malignant or benignant findings and from 50 BT volumes drawn from screening sets (without any prior review). The image sets were reviewed in two separate sessions while the review time was recorded. A total of five experienced radiologists were employed for the image review. Additionally a VGA study was performed to compare slabbed images with the originals in order to ensure that the image quality was not significantly degraded. One set of 27 pathological cases (13 masses and 14 microcalcification clusters) and one of 22 subtle lesions that had been missed on digital mammography but detected on BT were presented to an experienced radiologist and 2 medical physicists who rated the quality of the slabbed versions relative to the originals. The study could find no significant degradation in image quality when using 2 mm slabs instead of 1 mm slices. There was no significant decrease in reading time on clinical cases (P = .133), but on screening images there was a significant decrease of 7.7 ± 9.6 s from an average level of 32.2 ± 14.5 s (P < .0001). This suggests that increasing slab thickness can reduce the time radiologists spend studying normal images by 20%.