DBT spot compression views increase reader accuracy
The addition of digital breast tomosynthesis (DBT) spot compression views gives readers a clearer view of questionable DBT findings and could reduce the need for additional workup of benign abnormalities, new research suggests.
Previous studies have indicated that DBT alone could potentially replace the spot compression views used when digital mammography (DM) resulted in inconclusive findings. But there are still many instances in which those additional DM spot views deliver indeterminate results. Benign asymmetries, architectural distortion and increased breast density, even when captured with DBT, can create added concern for readers and frequently require additional workups.
But a new study published Feb. 16 in the American Journal of Roentgenology highlights a potential solution—a recently developed commercial system that allows for spot compression views to be obtained via DBT. The system uses a small paddle for localized compression while the DBT images are acquired, similar to DM spot views. Researchers hypothesized that the additional views would increase accuracy and potentially improve interreader and intrareader agreement.
"The diagnostic performance and supplemental dose delivered by this additional view have not been systematically investigated,” F. Deleau, MD, with the department of radiology at Institut Bergonié, Comprehensive Cancer Center, and coauthors explained. “We conducted this study to evaluate the impact on diagnostic performance of obtaining a DBT spot compression view for assessment of equivocal DBT findings.”
Their analysis of the new method included the DBT spot compression views of 102 women between 2018 to 2019. The images were reviewed by two fellowship-trained radiologists and one breast radiologist.
In line with the researchers’ theory, the DBT spot images increased intrareader agreement from .43 to .72, while interreader agreement improved to .45 from .21, respectively. Additionally, the accuracy of all three readers increased significantly (74% vs 90%, 73% vs 94%, 71% vs 94%), as did reader specificity (69% vs 90%, 75% vs 94%; 68% vs 93%).
“The findings indicate that the DBT spot compression view can be performed in routine clinical practice to improve characterization of subtle or ambiguous findings on DBT,” the doctors suggested.
The added views did come with a slight increase in radiation dose, but the doctors noted that it was small (1.97 mGy versus 1.78-1.81 mGy).
You can view the detailed research in the American Journal of Roentgenology.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.