To explore the diagnostic efficacy of tomosynthesis spot compression (TSC) compared with conventional spot compression (CSC) for ambiguous findings on full-field digital mammography (FFDM). In this retrospective study, 122 patients (including 108 patients with dense breasts) with ambiguous FFDM findings were imaged with both CSC and TSC. Two radiologists independently reviewed the images and evaluated lesions using the Breast Imaging Reporting and Data System. Pathology or at least a 1-year follow-up imaging was used as the reference standard. Diagnostic efficacies of CSC and TSC were compared, including area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The mean glandular dose was recorded and compared for TSC and CSC. Of the 122 patients, 63 had benign lesions and 59 had malignant lesions. For Reader 1, the following diagnostic efficacies of TSC were significantly higher than those of CSC: AUC (0.988 vs. 0.906, P = 0.001), accuracy (93.4% vs. 77.8%, P = 0.001), specificity (87.3% vs. 63.5%, P = 0.002), PPV (88.1% vs. 70.5%, P = 0.010), and NPV (100% vs. 90.9%, P = 0.029). For Reader 2, TSC showed higher AUC (0.949 vs. 0.909, P = 0.011) and accuracy (83.6% vs. 71.3%, P = 0.022) than CSC. The mean glandular dose of TSC was higher than that of CSC (1.85 ± 0.53 vs. 1.47 ± 0.58 mGy, P < 0.001) but remained within the safety limit. TSC provides better diagnostic efficacy with a slightly higher but tolerable radiation dose than CSC. Therefore, TSC may be a candidate modality for patients with ambiguous findings on FFDM.

探讨断层合成点压缩 (TSC) 与传统点压缩 (CSC) 相比对全视野数字乳腺 X 线摄影 (FFDM) 模糊结果的诊断效果。在这项回顾性研究中，对 122 名 FFDM 结果不明确的患者（包括 108 名致密乳腺患者）进行了 CSC 和 TSC 成像。两名放射科医生独立审查图像并使用乳腺成像报告和数据系统评估病变。病理学或至少1年的随访影像学作为参考标准。比较CSC和TSC的诊断效能，包括曲线下面积（AUC）、准确性、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。记录并比较 TSC 和 CSC 的平均腺体剂量。 122例患者中，63例为良性病变，59例为恶性病变。对于读者 1，TSC 的以下诊断效能显着高于 CSC：AUC（0.988 vs. 0.906， P = 0.001）、准确度（93.4% vs. 77.8%， P = 0.001）、特异性（87.3% vs. 0.001）。 63.5%， P = 0.002）、PPV（88.1% vs. 70.5%，P = 0.010）和 NPV（100% vs. 90.9%， P = 0.029）。对于 Reader 2，TSC 显示出比 CSC 更高的 AUC（0.949 vs. 0.909， P = 0.011）和准确度（83.6% vs. 71.3%， P = 0.022）。 TSC 的平均腺体剂量高于 CSC（1.85 ± 0.53 vs. 1.47 ± 0.58 mGy， P < 0.001），但仍处于安全限度内。 TSC 的诊断效果比 CSC 稍高但可耐受。因此，对于 FFDM 发现不明确的患者，TSC 可能是一种候选治疗方式。