The Morphology of Microcalcifications in 2D Digital Mammography and Breast Tomosynthesis: Is It Different?

The development of new 3D imaging systems in the mammographic field is raising questions on its superiority of performance over 2D digital mammography in all aspects. Researchers are currently investigating the performance of digital breast tomosynthesis (DBT) compared to 2D digital mammography in terms of detectability of lesions (masses and microcalcifications) and diagnostic accuracy. Since a morphological description of the shape of microcalcifications is a determining factor for recalling the patient or not, we have investigated the efficiency of DBT in describing the morphology of microcalcifications within clusters compared to digital mammography. Four radiologists participated in the study and have described the shapes of microcalcifications in 71 clusters in 2D images and DBT series that were read in separate blinded sessions. An agreement test based on the kappa statistic was applied to evaluate the consistency of each reader's evaluation in 2D and DBT. An inter-rater variability test was also applied for each modality. Results have shown that there is good agreement between the observers' evaluations in these two modalities. The inter-rater test also revealed good agreement between the observers performance of assessment. In conclusion, this preliminary study has shown that the morphology of microcalcification clusters does not differ substantially in 2D versus DBT.