Digital Breast Tomosynthesis Indications and Applications

A review of the potential uses, benefits, and limitations of digital breast tomosynthesis in the diagnostic setting.

Course ID: Q00500 Category:


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 17, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 0.50
Patient Care: 0.50
Patient Interactions and Management: 0.50

Mammography: 2.00
Image Production: 0.50
Image Acquisition and Quality Assurance: 0.50
Procedures: 1.50
Anatomy, Physiology, and Pathology: 0.75
Mammographic Positioning, Special Needs, and Imaging Procedures: 0.75

Registered Radiologist Assistant: 0.50
Procedures: 0.50
Thoracic Section: 0.50

Radiation Therapy: 0.50
Patient Care: 0.50
Patient and Medical Record Management: 0.50


  1. Introduction
  2. DBT Technology
  3. Indications for DBT
    1. Lesion Visibility
    2. Reader Performance and Preferences
    3. Replacement for Traditional Supplemental Imaging
  4. Contraindications for DBT
  5. Practical Use of DBT in Diagnostic Workup
    1. Assessment of Noncalcified Cancers
      1. Architectural Distortion
      2. Focal Asymetry
      3. Masses
    2. Localization of Single-View Findings
    3. Breast Cancer Staging
      1. Tumor Size
      2. Number of Tumor Lesions or Satellite Lesions
      3. Evaluation of the Contralateral Breast
  6. Potential Limitations and Drawbacks
  7. Conclusion


Upon completion of this course, students will:

  1. list the reasons for performing diagnostic mammography
  2. relate alternate terminology for pseudolesions
  3. describe the x-ray tube movement during digital breast tomosynthesis
  4. state what DBTCANNOT be used for
  5. recall the thickness of reconstructed DBT post-acquisition images
  6. define combination acquisition mode
  7. list the advantages of combination acquisition mode imaging
  8. compare outcomes for the Dang et al. study
  9. state recommended number of views for diagnostic DBT
  10. describe how infiltrating invasive lobular carcinoma presents at mammogram
  11. compare DBT vs. conventional diagnostic mammography in reader studies
  12. discuss study findings relative to the potential of DBT to replace other imaging modalities
  13. determine which study examined diagnostic workflow
  14. list the outcomes of the Philpotts et al. study
  15. state workflow improvements as readers become more familiar with DBT technology
  16. describe the relative bell curve for DBT accuracy
  17. state the effect of DBT in regard to number of lesions classified at BI-RADS category 3
  18. explain the compression time needed for combination-mode DBT
  19. compare the imaging features of breast cancer for DBT versus conventional mammography
  20. relate the importance of identifying architectural distortion at diagnostic mammography
  21. describe architectural distortion as it presents at mammography
  22. list factors associated with the appearance of architectural distortion
  23. state the types of scars that manifest as architectural distortion
  24. describe focal asymmetry
  25. define asymmetry
  26. list how DBT can be utilized for the evaluation of focal asymmetry
  27. list how breast masses are characterized
  28. compare mass margins, shape, and density between DBT and FFDM
  29. name the tissue that comprises the majority of the breast
  30. state how breast masses should be evaluated
  31. describe the angle used for MLO views of the breast
  32. describe how image sets are arranged for DBT
  33. state how known or suspected lesions are examined at mammogram
  34. note the prevalence of contralateral breast disease for women with newly diagnosed breast cancer
  35. state the desired compression breast thickness for DBT