DISCUSSION
The aim of our study was to compare the diagnostic performance of conventional Digital Mammography (2D-DM) and Synthesized Digital Mammography.
Currently,
digital breast tomosynthesis must be interpreted in conjunction with digital mammography for several reasons.
First of all,
2D-DM offers a global view of the breast and allows comparative study with previous exams.
In the other hand,
it facilitates the detection and interpretation of microcalcifications.
However,
the use of digital mammography with tomosynthesis is not without limitations. The main limitation of the combo mode is the increase of the radiation dose.
Although it can be within acceptable limits,
any new technological advance should try to keep the radiation dose as low as possible.
One option is synthesized image,
that is generated from the information obtained from the tomosynthesis.
So it is important to demonstrate if Synthesized image is as good as conventional 2D-DM,
in order to avoid the need of a double exposure (2D-DM + DBT).
In our enriched sample we have found that the SE and SP were: 61.4% and 64.05% for 2D-DM; 70.2% and 59.48% for Synthesized-DM,
respectively.
Significant differences were found regarding SE between Synthesized-DM and 2D-DM.
We found no significant differences between the specificity or the ROC curves.
In this context,
several studies as the study led by Zuley et al,
have been published.
They concluded that there were no significant differences to conventional mammography and synthesized.
The Skaane group also concluded that the use of synthesized image and tomosynthesis was comparable to conventional mammography and tomosynthesis.
LIMITATIONS
Our study has some limitations.
It was a retrospective study,
with a small number of cases (210 patients) and with only one reader that reviewed both techniques.
CONCLUSION
1- Synthesized-DM demonstrated a higher sensitivity than conventional 2D-DM.
2- Similar Specificity and AUC values were seen in this enriched sample.
3- So,
according to our results,
synthesized-DM could be used instead of 2D-DM,
reducing the radiation dose.