Comparison of screening full-field digital mammography and digital breast tomosynthesis technical recalls

Lonie R Salkowski; Mai Elezaby; Amy M Fowler; Elizabeth Burnside; Ryan W Woods; Roberta M Strigel

doi:10.1117/1.JMI.6.3.031403

Comparison of screening full-field digital mammography and digital breast tomosynthesis technical recalls

J Med Imaging (Bellingham). 2019 Jul;6(3):031403. doi: 10.1117/1.JMI.6.3.031403. Epub 2018 Dec 22.

Authors

Lonie R Salkowski^{1

2}, Mai Elezaby¹, Amy M Fowler^{1

2

3}, Elizabeth Burnside^{1

3

4}, Ryan W Woods¹, Roberta M Strigel^{1

2

3}

Affiliations

¹ University of Wisconsin Madison, Department of Radiology, Madison, Wisconsin, United States.
² University of Wisconsin Madison, Department of Medical Physics, Madison, Wisconsin, United States.
³ University of Wisconsin, Carbone Cancer Center, Madison, Wisconsin, United States.
⁴ University of Wisconsin School of Medicine and Public Health Institute of Clinical Translational Science, Madison, Wisconsin, United States.

Abstract

Enhancing quality using the inspection program (EQUIP) augments the FDA/MQSA program ensuring image quality review and implementation of corrective processes. We compared technical recalls between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). Prospectively recorded technical recalls of consecutive screening mammograms (10/2013 - 12/2017) were compared for imaging modality [FFDM, DBT + FFDM, DBT + synthesized mammography (SynM)], images requested, and indication(s) (motion, positioning, technical/artifact). Chi-squared tests evaluated statistical significance between proportions. Of 48,324 screening mammograms, 277 (0.57%) patients were recalled for 360 indications with 371 repeated views. DBT exams had significantly less recalls compared to FFDM ( $X^{2} = 25.239$ ; $p = 0 < 0.001$ ). 98 (27.2%) recalls were for motion, 192 (53.3%) positioning, and 70 (19.4%) technique/artifacts. Theses indications for technical recall were compared for FFDM, DBT + FFDM, and DBT + SynM. There were significant differences in the indications for technical recall prior to and after implementing DBT + SynM ( $X^{2} = 18.719$ ; $p < 0.001$ ). Technical recalls declined significantly with the inclusion of DBT (SynM/FFDM) compared to FFDM alone. Recalls for motion demonstrated the greatest decrease. Positioning remains a dominant factor for technical recall regardless of modality, supporting the opportunity for continued technologist education in positioning to decrease technical recalls.

Keywords: EQUIP; FFDM; breast imaging; digital mammography; technical recall; tomosynthesis.