Assessment of task-based performance from five clinical DBT systems using an anthropomorphic breast phantom

Purpose: There are currently five FDA approved commercial digital breast tomosynthesis (DBT) systems, all of which have varying geometry and exposure techniques. The aim of this work was to determine if an anthropomorphic breast phantom could be used to systematically compare performance of DBT, full field digital mammography (FFDM) and synthetic mammography (SM) across the systems. Methods: An anthropomorphic breast phantom was created through inkjet printing containing printed masses. The phantom was imaged using automatic exposure control (AEC) settings for that system. Thus, all phantom acquisition settings, and subsequent radiation dose levels, were dictated from the manufacturer settings. A four alternative forced choice reader study was conducted to assess reader performance. Results: Performance in detecting masses was higher with DBT than with FFDM or SM. The difference in proportion correct (PC) was statistically significant for most cases. Additionally, PC of the DBT systems trended with increased gantry span with lowest PC from Hologic and Fuji (both 15°), then both GE systems (25°), and highest for Siemens (50°). Conclusions: A phantom containing masses was imaged on five commercially available DBT systems across 3 states. A 4AFC study was performed to assess performance with FFDM, DBT, and SM across all systems. Overall detection was highest using DBT, with improvement as the gantry span increased. This study is the first of its kind to use an inkjet based physical anthropomorphic phantom to assess performance of all five commercially available breast imaging systems.