Image quality comparison of synthesized two‐dimensional images and digital mammography in breast tomosynthesis: A quantitative analysis

BACKGROUND: Breast cancer remains a leading cause of cancer-related morbidity and mortality worldwide. Early detection of breast cancer using high-quality mammography is essential for improving prognosis and treatment outcomes. Digital breast tomosynthesis with synthesized two-dimensional mammography (SM) reduces dose and tissue overlap; however, its comprehensive physical evaluations remain limited. PURPOSE: This study quantitatively compared the image quality of conventional digital mammography (DM) and SM acquired using the AMULET Innovality System. METHODS: Polymethyl methacrylate, American College of Radiology, and contrast-detail (CD) mammography phantoms were imaged 10 times in both DM and SM modes. Image quality metrics, including signal-to-noise ratio (SNR) maps, noise power spectrum (NPS), contrast-to-noise ratio (CNR), modulation transfer function (MTF), and CD curves, were evaluated. RESULTS: values of 134.9 for DM and 56.7 for SM. CONCLUSIONS: Quantitative phantom-based evaluation demonstrated that DM showed superior performance to SM in several physical image quality metrics, including SNR uniformity, noise characteristics, spatial resolution, and contrast-detail detectability. These findings indicate systematic differences in physical image quality between DM and SM; however, further observer and clinical studies are required to clarify how these differences translate to diagnostic performance in clinical practice.