Digital X-Ray Tomosynthesis Current State Of The Art Essay Of College Election

Digital Breast Tomosynthesis (DBT) is an X-ray mammography technique where multiple low-dose projection images of the breast are reconstructed in multiple tomographic images creating a semi-3D mammogram.This enables the visualization of a sequential set of thin sections of the breast, overcoming the masking effect of overlying fibroglandular breast tissue, then improving carcinoma detection and reducing false-positive cases.However, evidence suggests that 15-30% of breast cancers are missed by standard screening mammography, and this rate can be even higher in women under 50 years [8] and in women with dense breast [9-12].In fact, the primary limitation of mammography is the overlapping of dense fibroglandular breast tissue that can decrease the visibility or hide underlying malignant lesion [13-16].Moreover, the overlay of normal fibroglandular breast tissue may mimic the appearance of carcinoma, leading to a reduction in specificity and increase in false-positive recalls [16].In the early 2000s, mammography has transitioned from film-screen system to digital detectors [17, 18], with an improved diagnostic performance, especially in women with dense breasts [19].This review aims at describing current DBT technique, analyzing DBT in clinical practice and providing an overview of published studies on clinical experience with DBT in the screening and diagnostic settings.

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To overcome the dose issue, manufacturers have developed a synthesized mammography (SM) that provides the benefits of a combined FFDM plus DBT examination with a reduced radiation exposure; this is a synthesized 2D image generated from the DBT data.

SM is now considered a valid alternative for FFDM: its aim is to provide the 2D component of the DBT examination, particularly useful when comparing with previous [44].

In SM, algorithms preserve imaging characteristics such as microcalcifications and spiculations but with poorer overall resolution and increased image noise [45].

DBT images require a large amount of storage space, especially in screening programs, due to the high numbers of participating women and considering that storage requirements will increase with time as more patients will have previous DBT studies for comparison.

DBT image files size are 10–20 times that of 2D conventional mammography; the number of slices for each DBT set depends on the breast thickness, but an average combined DBT/FFDM study is about 1GB of data, which could be reduced to approximately 250 MB if the DBT images are stored with a 4:1 reversible (lossless) compression [40, 55].

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