Briefly review the method of acquisition of digital breast tomosynthesis images, practical issues around implementation and radiation dose. Review the current implementation and indications for digital breast tomosynthesis. Appreciate the benefits of DBT over standard mammography in the assessment of breast lesions. Review common imaging appearances and pitfalls in digital breast tomosynthesis assessment.

Standard 2D mammography remains the current standard of care for breast cancer screening. Together with ultrasound, standard mammography is invaluable in the assessment of symptomatic women aged 35 years or older1. However standard mammography is not without its limitations, chief among these being the superimposition of breast tissue. Digital breast tomosynthesis (DBT or 3D mammography) is a technique which attempts to address some of the inherent limitations in standard 2D mammography by using multiple, rapidly acquired mammograms to construct a 3-dimensional image of the breast....

Technique: While the concept of tomosynthesis in radiology is not new by any means, its first application to breast imaging came in the 1990s6. In DBT image acquisition the x-ray tube performs a series of low-dose exposures as it moves over an arc of variable range. The acquired images are converted into a stack of thin slices using a variety of reconstruction algorithms including back projection, filtered back projection and maximum likelihood algorithms7. A detailed discussion of reconstruction techniques is beyond the scope of this...

Digital breast tomosynthesis is superior to 2D mammography in the assessment and detection ofmasses, asymmetric densities and architectural distortion. Whichcan reduce the need for both further assessment views and ultrasound. There are several non-trivial technical considerations associated with the implementation of thistechnology. DBT results in an increased radiation dose to the breast, though the implications of this in both the screening and diagnostic settings are not yet clear. DBT is rapidly gaining prominence, particularly in the diagnostic breast setting but also in the assessment of...

For correspondence please contact: Dr. Suraindra Rajadurai Radiology Registrar Austin Health & Breastscreen Victoria, St. Vincent's Hospital Email: [email protected] Twitter: surainr ResearchGate: Suraindra Rajadurai Dr. Numan Kutaiba Breast Fellow Breastscreen Victoria,St. Vincent's Hospital Dr. Shalini Bigwood Breast Fellow Breastscreen Victoria, St. Vincent's Hospital Dr. Kirti Mehta Radiologist Breastscreen Victoria, St. Vincent's Hospital A/Prof. Jennifer Cawson Radiologist Breastscreen Victoria, St. Vincent's Hospital

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