Return to Course LibraryCE InformationPrint Course MaterialsBibliographyRegister Now

Release Date
June 23, 2016

Expiration Date
July 1, 2021



Emily F. Conant, MD
Division Chief, Breast Imaging
Vice Chair, Faculty Development, Radiology
Professor of Radiology
   at the Hospital of the University of Pennsylvania





Equipment Requirements
PC: Win7/Win8, Pentium processor or faster, at least 2GB RAM, Internet Explorer version 10/11, Mozilla FireFox version 33.0.

MAC: OS version 10.8/10.9, Intel processor, at least 2GB RAM, Safari version 6.2, FireFox 33.0


5103-401A Synthetic 2D Mammography
       + Breast Tomosynthesis

Update and Tips for Clinical Implementation

Recorded on Thursday, June 9, 2016

A certified one-hour live webinar for radiologists, radiologic technologists, and other healthcare professionals who care for patients with breast disease

Format: Archived Webinar
Credit: 1.0 AMA PRA Category 1
Credit: 1.0 ARRT Category A
Tuition:  none

This activity qualifies for 1.0 hour of training for the Hologic Selenia® Dimensions® 3D Mammography™ System

Course Overview
In February 2011, the FDA approved 3D digital breast tomosynthesis (DBT) technology in combination with standard 2D full-field digital mammography (DM) for breast cancer screening. DM/DBT has been shown to improve sensitivity, substantially reduce recall rates, and increase visualization of breast cancers compared to DM alone. [1-3] DBT has also demonstrated utility in imaging dense breast tissue, which by nature can be challenging to adequately image and interpret using DM alone given the propensity for tissue overlap. [4] However, the combination of DM/DBT exposes patients to approximately two times the radiation dose of DM alone, although the amount of exposure remains well below FDA-defined limits. [1]

To address radiation dose concerns, the FDA has approved the use of synthesized 2D images (sDM) that are generated from the 3D data set. Synthetic 2D images by definition are produced without the need for the additional radiation required for standard DM images. [4] Recent studies have found that sDM/DBT performed similarly to DM/DBT, concluding that sDM “may eliminate the need for DM as part of a routine clinical study,” while reducing radiation dose. [5, 6]

  1. Friedewald SM, Rafferty EA, Rose SL. Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA. 2014;311(24):2499-2507.
  2. American College of Radiology website. ACR Statement on Breast Tomosynthesis. Accessed April 11, 2016.
  3. McDonald ES, Oustimov A, Weinstein SP, Synnestvedt MB, Schnall M, Conant EF. Effectiveness of Digital Breast Tomosynthesis Compared With Digital Mammography: Outcomes Analysis From 3 Years of Breast Cancer Screening. JAMA Oncol. 2016 Feb 18. [Epub ahead of print]
  4. FDA approval OI8003/S001. Accessed April 20, 2016.
  5.   Zuley ML, Guo B, Catullo VJ, et al. Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images. Radiology. 2014;271(3):664-671
  6. Choi JS, Han BK, Ko EY, et al. Comparision between two-dimensional synthetic mammography reconstructed from digital breast  tomosynthesis and full-field digital mammography for the detection of T1 breast cancer. Eur Radiol. 2015 Dec 1. [Epub ahead of print]

Educational Objectives
After completing this activity, the participant should be better able to:

  • Evaluate the role of traditional 2D full field digital mammography (DM) in combination with digital breast tomosynthesis (DBT) for breast cancer screening
  • Assess the quality and diagnostic value of traditional DM and synthetic 2D images (sDM) used in combination with DBT
  • Discuss strategies for implementing sDM/DBT into clinical practice

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine and International Center for Postgraduate Medical Education. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

SA-CME: This activity meets the criteria for self-assessment toward the purpose of fulfilling requirements in the American Board of Radiology (ABR) Maintenance of Certification Program.

The European Accreditation Council for CME (EACCME®)
The UEMS-EACCME® has mutual recognition agreements with the American Medical Association (AMA) for live events and e-learning materials. For more information go to

Radiologic Technologists
This program has been approved by the American Society of Radiologic Technologists (ASRT) for 1.0 hour of ARRT Category A continuing education credit.

How to Enroll and Participate
There are no fees or prerequisites to participate in this program. Estimated time to complete this activity is one hour.

  • Click on the blue link. Complete the precourse questions and SUBMIT.
  • Click on the blue link again to view the recording.

How to Receive a Credit Certificate
Your certificate of credit will remain in your account at as a permanent record of your participation.

  • Log-in to your account at
  • View the entire educational activity session. At the conclusion of the lecture, close the Vimeo window.
  • Return to the course in your account at
  • From the COURSE HOME page, click the button for POSTTEST and for EVALUATION.
  • A passing grade of at least 75% is required to receive credit. You may take the test up to three times.
  • Upon receipt of a passing grade, you will be able to print a certificate of credit from your account at

Your certificate of credit will remain in your account at as a permanent record of your participation.


Emily F. Conant, MD
Division Chief, Breast Imaging
Vice Chair, Faculty Development, Radiology
Professor of Radiology at the Hospital of the University of Pennsylvania


After attending medical school at the University of Pennsylvania School of Medicine, Dr. Conant went on to complete her residency and fellowship in thoracic and breast imaging at Penn. She began her career at Thomas Jefferson University Hospital and nine years later returned to Penn as Chief of Breast Imaging.

Dr. Conant, a pioneer in the development of digital mammography, is a leader in research on the use and benefits of early mammography screening and on the role of multimodality breast imaging. As an internationally known clinician and researcher, Dr. Conant has received grants from the National Institutes of Health to compare standard surgical biopsy with digital mammography and stereotactic core breast biopsy. She has published more than 150 peer-reviewed articles on topics ranging from novel imaging technologies; the assessment of disparities in access to imaging; and quantitative analysis of multimodality breast images to guide personalized screening. In addition to her clinical and research responsibilities, Dr. Conant continues to guide faculty governance and organizational change at the Perelman School of Medicine at Penn.

 Dr. Conant is a fellow of the Society of Breast Imaging and a member of a multitude of professional organizations, including the American Roentgen Ray Society, National Association of University Radiologists, International Digital Mammography Development Group, and the Radiological Society of North America.

Dr. Conant has also been recognized for her outstanding contributions to the field of breast imaging by Philadelphia Magazine, America’s Top Doctors, and Best Doctors in America. She has been a featured expert in the national media, including appearances on Good Morning America, CBS News, USA Today, The New York Times, and Redbook.

Disclosure Information
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. The existence or absence of COI for anyone in a position to control content will be disclosed to participants prior to the start of each activity.

Emily F. Conant, MD, has received fees for non-CME services from Hologic, Inc., and fees for readers’ studies from Siemens Healthcare

The following planners and managers have reported NO financial relationships or relationships to products or devices

Trace Hutchison, PharmD
Samantha Mattiucci, PharmD, CCMEP
Linda McLean, MS 
Victoria Phoenix, BS           
Jan Schultz, RN, MSN, CCMEP
Judi Smelker-Mitchek, RN, BSN                        

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

For questions regarding this program, please contact ICPME:

Jointly provided by


This activity is supported by an independent grant from Hologic, Inc.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.