Clinical Performance of Synthesized Two-dimensional Mammography Combined with Tomosynthesis in a Large Screening Population

Purpose To compare the clinical performance of synthesized two-dimensional (s2D) mammography combined with digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) alone and FFDM combined with DBT in a large community-based screening population by analyzing recall rate, positive predictive value, and cancer detection rate. Materials and Methods This was a retrospective study approved by the institutional review board and was HIPAA compliant with waiver of informed consent. A total of 78 810 screening mammograms from October 11, 2011, to June 30, 2016, were retrospectively collected. Of these, 32 076 were FFDM, 30 561 were DBT-FFDM, and 16 173 were DBT-s2D mammograms. Diagnostic performance of FFDM, DBT-FFDM, and DBT-s2D mammography was compared. Statistical significance was determined by using the Pearson χ