Comparison of breast density assessments between synthesized C-View™ & intelligent 2D™ mammography

Objective To compare breast density assessments between C-View^™ and Intelligent 2D^™, different genera-tions of synthesized mammography (SM) from Hologic. Methods: In this retrospective study, we identified a subset of females between March 2017 and December 2019 who underwent screening digital breast tomo-synthesis (DBT) with C-View followed by DBT with Intelligent 2D. Clinical Breast Imaging Reporting and Database System breast density was obtained along with volumetric breast density measures (including density grade, breast volume, percentage volumetric density, dense volume) using Volpara™. Differences in density measures by type of synthesized image were calculated using the pairwise t-test or McNemar’s test, as appropriate. Results 67 patients (avg age 62.7; range 40–84) were included with an average of 13.3 months between the two exams. No difference was found in Breast Imaging Reporting and Database System density between the SM reconstructions (p = 0.74). Similarly, there was no difference in Volpara™ mean density grade (p = 0.71), mean breast volume (p = 0.48), mean dense volume (p = 0.43) or mean percent volumetric density (p = 0.12) between the exams. Conclusion We found no significant differences in clinical and automated breast density assessments between these two versions of SM. Advances in knowledge Lack of differences in density estimates between the two SM reconstructions is impor-tant as density assignment impacts risk stratification and adjunct screening recommendations.