News | June 01, 2015

ECRI Institute Says 3-D Mammography May Provide Deeper, More Detailed Scans

Emerging technology brief details benefits, adoption and coverage of digital breast tomosynthesis

digital breast tomosynthesis, ECRI Institute, technology forecast report

June 1, 2015 — ECRI Institute’s health technology assessment service released an emerging technology brief concerning digital breast tomosynthesis (3-D mammography). The information is based on ECRI’s technology forecast report, "Digital Breast Tomosynthesis for Screening and Diagnosis of Breast Cancer."

Digital breast tomosynthesis is a 3-D breast imaging technique based on full-field digital mammography (FFDM) technology. Unlike conventional mammography units, a tomosynthesis system's X-ray tube sweeps in an arc around the breast to acquire between 50 and 100 two-dimensional (2-D) projections from slightly different angles in about 10 to 20 seconds. The resulting 2-D images are digitally manipulated to create tomograms (i.e., slices) in any plane, thus allowing for 3-D reconstruction that reveals depth. The slices can be displayed individually or in a dynamic "movie" mode.

Providing a 3-D reconstruction of the breast eliminates the problem of overlying tissue that might be mistaken for lesions or that might obscure small cancers, according to technology developers. 

Developers contend that the 3-D images offered by digital breast tomosynthesis might overcome the shortcomings of digital mammography, which produces 2-D images that can mask some small lesions or mistakenly identify dense breast tissue as tumors, potentially missing some cancers or increasing false positives. Some studies suggest that digital breast tomosynthesis may reduce recall rates and increase the number of breast cancers detected compared with digital mammography alone.

Initial diffusion appears to be slow, but its uptake is increasing, with three manufacturers having systems on the market as of April 2015. In recent years, most providers have invested heavily in upgrading to digital mammography, with digital systems representing more than 95 percent of all U.S. mammography units in service as of early 2015.

The U.S. Centers for Medicare and Medicaid Services (CMS) now covers for digital breast tomosynthesis, but several private third-party payers consider the technology investigational and deny coverage. Others consider the technology integral to digital mammography and thus, not separately reimbursable. Without additional reimbursement to recoup acquisition costs, some providers are unlikely to upgrade to digital breast tomosynthesis until they replace their existing digital mammography units.

Some providers appear to be investing in the technology to gain a marketing advantage in competitive markets for women's health services. Manufacturers are also supporting provider marketing efforts with direct-to-consumer campaigns positioning it as being clinically superior to standard digital mammography.

The ECRI Institute is an independent nonprofit organization that conducts research into the most effective approaches for improving patient care.

For more information:

Related Content

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Women Prefer Getting Mammograms Every Year
News | Mammography | January 09, 2018
Women prefer to get their mammograms every year, instead of every two years, according to a new study presented at the...
Planmed Clarity 2-D Digital Mammography System Receives FDA Approval
Technology | Mammography | January 08, 2018
The U.S. Food and Drug Administration (FDA) issued an approval letter for the Planmed Clarity 2-D full-field digital...
Overweight Women May Need More Frequent Mammograms
News | Mammography | January 04, 2018
Women with higher body mass index (BMI) face an increased risk of not detecting their breast tumor until it has become...
About 25 percent of screening patients and 60 percent of diagnostic patients do not have prior mammograms available for comparison at the time of their examinations due to the lack of interoperability or other restrictions preventing clinicians from accessing prior exams.

About 25 percent of screening patients and 60 percent of diagnostic patients do not have prior mammograms available for comparison at the time of their examinations due to the lack of interoperability or other restrictions preventing clinicians from accessing prior exams.

Feature | Breast Imaging | January 02, 2018 | Kathryn Pearson Peyton, M.D.
Sixty million women undergo regular screening mammography in the United States, but even in the digital age, it is di
Imagio Opto-Acoustic Breast Imaging System Helps Differentiate Tumor Subtypes
News | Oncology Diagnostics | January 02, 2018
Seno Medical Instruments Inc. (Seno Medical) recently reported data from their clinical study demonstrating that its...
Study Finds Link Between Breast Cancer Treatments and Cellular Aging Markers
News | Women's Health | January 02, 2018
January 2, 2018 — A new study found women who had received chemotherapy and/or...
ACR Appropriateness Criteria Adds and Revises Topics for December 2017
News | Clinical Decision Support | December 29, 2017
December 29, 2017 — Radiologists can enhance the quality and effectiveness of care with the newest release of the ACR
Double Black Announces Gemini Series Monitors for Multimodality and Digital Breast Imaging
Technology | Flat Panel Displays | December 28, 2017
December 28, 2017 — Double Black Imaging and their Image Systems Division are releasing their Gemini Series 6MP and 8
Overlay Init