Diagnostic performances of radiology trainees in reading digital breast tomosynthesis and the synthesized view

Current literature has described the usefulness of the DBT in addition to FFDM because of the increase in cancer detection and decrease in recall rates. The primary limitations of using FFDM plus DBT for screening are the rise in radiation dose, which approximately doubles if both modalities are used. Subsequently, synthesized two-dimensional views can be reconstructed from DBT slices with the ideal to replace FFDM. Although many studies have explored the value of DBT in addition to FFDM, little attention is given to the effectiveness that synthesized views might bring to the radiologists as a supplement view for DBT. The aim of this study is to investigate the diagnostic accuracy of radiology trainees with DBT only compared with DBT plus the synthesized view (C-View). Twenty radiology trainees were asked to report a set of 35 two-projection DBT images of left and right breasts (15 were cancer cases). Another group of 8 trainees read the same DBT set with the addition of the C-View. Participants searched for the presence of lesions within the cases using the Tabar RANZCR system where 2 represented a benign lesion; 3-5 represented the suspicion of a malignancy with a higher value indicating a higher malignant possibility. The readers' performances were evaluated via specificity, sensitivity, lesion sensitivity, ROC and JAFROC between two reading modes. The results demonstrated diagnostic metrics of participants were not significantly different in reading DBT only compared with the group reading DBT plus synthesized view (P>0.05). This finding implies that viewing DBT only could be equivalent to DBT plus C-View for radiology trainees.