Stereoscopic versus monoscopic detection of masses on breast tomosynthesis projection images

The goal of this study was to assess if stereoscopic viewing of breast tomosynthesis projection images impacted mass detection performance when compared to monoscopic viewing. The dataset for this study, provided by Hologic, Inc., contained 47 craniocaudal cases (23 biopsy proven malignant masses and 24 normals). Two projection images that were separated by 8 degrees were chosen to form a stereoscopic pair. The images were preprocessed to enhance their contrast and were presented on a stereoscopic display. Three experienced breast imagers participated in a blinded observer study as readers. Each case was shown twice to each reader - once in the stereoscopic mode, and once in the monoscopic mode in a random order. The readers were asked to make a binary decision on whether they saw a mass for which they would initiate a diagnostic workup or not, and also report the location of the mass and provide a confidence score in the range of 0-100. The binary decisions were analyzed using the sensitivity-specificity measure, while the confidence scores were analyzed using the Receiver Operating Characteristic curve (ROC). We also report a statistical analysis of the difference in partial AUC values greater than 95% sensitivity between the stereoscopic and monoscopic modes.