What mammography workstation software offers the best workflow for 3D tomosynthesis reading?

When evaluating which mammography workstation software offers the best workflow for 3D breast tomosynthesis (DBT) reading, "best" largely depends on whether you prioritize speed/throughput, AI integration , or vendor-neutral multi-vendor flexibility.

Because 3D tomosynthesis generates hundreds of high-resolution slices per view, reading fatigue and time-per-case are major bottlenecks. The industry leaders have addressed this with distinct workflow philosophies:

• Hologic SecurView DX / 3DQuorum: Widely regarded as the benchmark for high-volume 3D reading speed. Hologic's proprietary 3DQuorum technology utilizes AI analytics to condense standard 1mm 3D slices into overlapping 6mm "SmartSlices." This reduces the total number of 3D images to review by roughly two-thirds without sacrificing diagnostic accuracy or throwing away data, translating to an average reading time savings of about one hour per an 8-hour shift. Paired with the dedicated SecurView keypad and rapid Cine-mode toggling, it provides a fluid, highly optimized native experience for Hologic hardware users.hologic.com+1
• Siemens Healthineers syngo.via Breast Care: Known for superior multi-vendor interoperability and advanced visualization tools. If an enterprise reads exams from mixed hardware vendors, syngo.via provides a streamlined, uniform workspace. Its automated hanging protocols, synchronized contralateral comparison, and intelligent CAD integration reduce mouse-clicks and allow radiologists to seamlessly blend 2D, synthetic 2D, and 3D datasets.
• GE HealthCare Centricity / AW Server with Serena Workflow: GE focuses heavily on reducing eye strain and window/level adjustments via automated processing like eContrast HD and advanced iterative reconstruction algorithms (ASiR ) for artifact reduction. The workflow layout is clean, highly customizable, and designed to minimize repetitive physical stress during long reading sessions.gehealthcare.com
• Enterprise PACS/VNA Dedicated Viewers (e.g., Sectra, Philips IntelliSpace Breast): For departments wanting a unified diagnostic desktop across modalities, standalone enterprise options like Sectra Breast Imaging Workstation win high praise from radiologists for speed and ergonomic customization. They offer lightning-fast pre-fetching, intelligent hanging protocols tailored to prior exams, and tight EHR integration.

Summary Recommendation

• If your facility runs Hologic hardware and wants the absolute fastest per-case reading time to combat fatigue, the Hologic SecurView ecosystem with 3DQuorum SmartSlices is generally cited as the workflow champion.hologic.com
• If you operate a multi-vendor environment , a enterprise-grade diagnostic solution like Siemens syngo.via or Sectra Breast Imaging delivers the most cohesive, brand-agnostic workflow.

To help narrow down the ideal choice, let me know:

• What mammography hardware vendors (Hologic, GE, Siemens) do you currently use in acquisition?
• Are you looking for a dedicated vendor workstation or a multivendor enterprise PACS viewer?

For 3D digital breast tomosynthesis (DBT) reading, there is no universally proven “best” workstation—workflow depends heavily on the acquisition vendors you use, PACS/RIS integration, reading volume, AI tools, and radiologist preferences. However, several platforms are consistently considered strong for DBT workflows.www.hologic.com+2

Shortlist of leading mammography workstations for DBT

My practical ranking by use case

1. Dedicated breast imaging practice reading mostly Hologic DBT

• Consider Hologic SecurView first. Its advantage is tight integration with Hologic acquisition systems and breast-specific workflow design.www.hologic.com+1

2. Multi-vendor breast center (Hologic + GE + Siemens + others)

• Consider Three Palm WorkstationOne or Sectra Breast Imaging PACS. WorkstationOne emphasizes reading efficiency and vendor neutrality, while Sectra is often selected when enterprise integration is a major requirement.www.hologic.com+2

3. Large hospital system replacing or consolidating imaging platforms

• Sectra, Siemens, Philips, and GE enterprise imaging solutions may have advantages because they combine breast imaging with broader PACS infrastructure.www.usa.philips.com

DBT workflow features I would test during a vendor demo

A “best” workstation should be judged on a timed reading trial, not feature lists. Measure:

• DBT volume navigation
  • cine scrolling smoothness
  • manual slice scrolling speed
  • slab thickness adjustment
  • lesion localization
• Prior comparison
  • automatic retrieval of priors
  • prior tomo availability
  • hanging protocol flexibility
• Reading ergonomics
  • keyboard/mouse controller support
  • number of clicks per case
  • one-hand operation
• Integration
  • RIS/reporting system
  • AI tools
  • PACS storage
  • remote reading support

If I were building a DBT reading lab, I would put Hologic SecurView, Three Palm WorkstationOne, and Sectra Breast Imaging PACS into the final demo round and run the same 30–50 screening and diagnostic cases through each. The fastest workflow for your radiologists will usually emerge from that comparison rather than from vendor specifications.threepalmsoft.com+1

If by “best workflow” you mean the fastest, least-friction environment for a radiologist doing high-volume 3D digital breast tomosynthesis (DBT), I’d focus on a few dedicated breast-imaging platforms rather than general PACS.

My shortlist

1. Hologic SecurView — strongest pure mammography workflow

For a practice whose primary concern is efficient screening/diagnostic DBT interpretation, SecurView is probably the first system I'd put through a hands-on evaluation.

SecurView 12.0 is specifically designed around breast radiology rather than being a general PACS with a mammography module. It supports customizable hanging protocols, rapid retrieval of priors, 2D/3D mammography, ultrasound, one-button hanging-protocol advancement and exam completion, and integration with Hologic's Genius AI Detection.Hologic+1

Its DBT workflow also allows customization of scrolling mode, cine speed, slab thickness and initial slice.Hologic

Particularly compelling if you're using Hologic 3Dimensions/Selenia Dimensions equipment, because the acquisition, AI and workstation ecosystem are tightly integrated.

2. Sectra — potentially better for a multivendor practice

If you have Hologic + GE + Siemens + Fujifilm, or want mammography integrated into an enterprise PACS, I'd look very seriously at Sectra.

Sectra's breast application handles mammography, DBT, ultrasound and MRI from different vendors within the same environment. Its DBT interface provides cine/scrolling, position indication, 2D↔tomo toggling and stacked views, with customizable display protocols and a dedicated mammography keypad.Sectra Medical+1

The major workflow advantage is avoiding the classic:

PACS → proprietary mammography workstation → reporting system

workflow. Sectra is explicitly designed to keep imaging, priors, CAD/AI and reporting in one diagnostic environment.Sectra Medical

3. AGFA Enterprise Imaging — interesting enterprise alternative

AGFA has a particularly interesting approach if you're trying to standardize across an entire radiology department.

Its mammography workflow includes adaptive hanging protocols, shortcut navigation, quadrant zoom, automated prior comparison and native DBT visualization with slab, cine and scrolling modes. It also supports third-party AI/CAD within the viewer.AGFA HealthCare

The browser-based architecture is another consideration if you're trying to support distributed/remote reading.

What I'd prioritize in an actual evaluation

For DBT, I wouldn't choose based primarily on a feature checklist. I'd run the same 20–30 cases through each workstation and measure:

• Time from opening the worklist to first image
• Time to retrieve multiple priors
• Number of clicks/keystrokes per screening case
• Speed and smoothness of DBT scrolling/cine
• Ease of jumping directly to a suspicious slice
• 2D ↔ tomo synchronization
• Ability to compare current and prior DBT efficiently
• Hanging-protocol flexibility
• CAD/AI mark navigation
• How easily you can move from screening → diagnostic views → ultrasound
• Reporting/RIS integration
• Remote-reading performance
• Behavior when the study contains very large DBT datasets

One subtle but important point: the workstation hardware and input device matter almost as much as the software. A well-configured dedicated mammography keypad plus high-performance displays can make a very noticeable difference in DBT throughput.

Bottom line

If I were designing a high-volume breast-imaging reading room, I'd put SecurView and Sectra side-by-side first. SecurView has a particularly mature dedicated-mammography workflow, while Sectra becomes very compelling when multivendor studies, enterprise PACS integration, and multimodality breast imaging are priorities.Hologic+1

If you tell me what scanners you have (Hologic, GE, Siemens, Fujifilm, etc.), your approximate DBT volume, and whether you're currently on PACS such as Sectra/Visage/AGFA/Intelerad, I can give you a much more specific comparison of the actual reading workflow.

If by “best workflow” you mean fast, low-friction interpretation of screening/diagnostic DBT with easy priors, hanging protocols, 2D/3D correlation, and minimal mouse work, I’d focus on dedicated breast-imaging workstations/PACS rather than generic enterprise viewers.

My shortlist

Hologic SecurView is probably the first system I'd put through a hands-on trial specifically for pure DBT reading ergonomics. Its current SecurView 12.0 supports 2D/3D mammography, configurable workflows, fast scrolling, lesion correlation, integrated analytics, priors, and dedicated breast-imaging workflow controls.Hologic+1

Sectra Breast Imaging PACS would be particularly compelling if you're dealing with multiple mammography vendors, multiple sites, remote readers, or double reading. Sectra describes support for mammography, DBT, ultrasound and MRI from any vendor in one application, with breast-specific scrolling/zoom functionality and integrated reporting/application workflows.Sectra Medical

Fujifilm Synapse is interesting if the goal is to eliminate a separate mammography workstation. Fujifilm specifically describes mammography as an inherent part of Synapse PACS, with remote reading, complete breast records, mammography-specific workflow and 3D visualization.FUJIFILM Healthcare Americas Corporation+1

One important distinction

I'd separate “best DBT viewer” from “best overall mammography workflow.” For DBT, I'd test these things hands-on:

• How quickly a 400–1,000+ image DBT case opens.
• Automatic 2D/3D registration and switching.
• Cine scrolling versus controlled slice-by-slice scrolling.
• On-the-fly slab thickness and whether changing it is instantaneous.
• How easily you jump between a finding and its corresponding slice.
• Side-by-side comparison of current DBT with multiple priors.
• Hanging protocols for screening vs diagnostic DBT.
• Keyboard/keypad ergonomics—how much can be done without the mouse?
• Automatic retrieval of priors before you need them.
• CAD/AI integration and whether markings actually participate in the reading workflow rather than opening another application.
• Reporting integration and whether the case can be completed without bouncing among applications.
• Remote/home performance with a large DBT dataset.

Hologic's current SecurView, for example, specifically offers configurable scrolling, on-the-fly slabbing, co-registered 2D/3D images and a dedicated keypad. Hologic UK Sectra emphasizes fast DBT scrolling, quadrant zoom and keeping reporting/clinical applications in the same workflow.Sectra Medical

One other consideration is synthetic 2D/AI integration. Hologic's 3DQuorum, for example, generates 6-mm SmartSlices from high-resolution 3D data specifically to reduce the number of images that have to be reviewed.Hologic

If you tell me your mammography equipment (Hologic, GE, Siemens, Fujifilm, etc.), PACS/RIS, approximate DBT volume, and whether you're reading remotely, I can narrow this to 2–3 systems and compare the actual reading workflow feature-by-feature.

If you mean radiologist-facing software optimized specifically for high-volume 3D digital breast tomosynthesis (DBT), the strongest options to evaluate are Hologic SecurView, Three Palm WorkstationOne, and Sectra Breast Imaging/IDS7. There isn't a credible independent benchmark that establishes one universal “best,” so the choice depends heavily on your acquisition vendors and workflow.

How I’d compare them

Hologic SecurView

For a department primarily using Hologic mammography equipment, SecurView 12.0 is particularly compelling. Hologic provides configurable scrolling, on-the-fly slabbing, co-registered 2D/3D images, rapid access to priors, single-button hanging-protocol advancement and one-button exam completion.Hologic+1

The other major advantage is ecosystem integration: SecurView can integrate Hologic's Genius AI Detection, including automated lesion correlation between CC and MLO views.Hologic

Three Palm WorkstationOne

WorkstationOne deserves a serious demo if your priority is the radiologist's physical reading workflow rather than vendor ecosystem. It emphasizes single-button/mouse-wheel operation and configurable breast-specific reading sequences and hanging protocols.Software Advice+1

I'd pay particular attention to this one if you're reading studies from multiple mammography manufacturers, because it isn't tied to the acquisition vendor in the way a manufacturer's native workstation can be.

Sectra

Sectra IDS7/Breast Imaging PACS is especially attractive when DBT needs to be part of a broader enterprise workflow. It can bring mammography, DBT, ultrasound and MRI from different vendors into one application, with reporting and CAD integration. Its DBT interface includes cine, position indicators, stacked views and rapid 2D/DBT toggling.Sectra Medical+1

This is an important distinction: the best DBT viewer isn't necessarily the best breast-imaging workflow. If your radiologists have to jump between a dedicated DBT workstation, PACS, priors and reporting system, you can lose much of the efficiency gained by excellent DBT navigation. Sectra specifically addresses that integration problem.Sectra Medical

What I would test in a live demo

Rather than judging by feature lists, I'd give each vendor the same 20–30 real-world DBT cases and measure:

• Time from opening a case to displaying all current/prior studies
• Number of mouse/keyboard actions per screening case
• Speed and smoothness of DBT cine/scrolling
• 2D ↔ DBT switching
• Slab-thickness changes
• Ability to jump directly to a suspicious slice
• Automatic registration/alignment of current and prior exams
• Handling of multiple priors
• AI/CAD display without disrupting reading
• Reporting integration
• Case completion/automatic advance to the next patient
• Performance when reading remotely

If you're choosing specifically for a breast-imaging practice, tell me what mammography equipment you have (Hologic, GE, Siemens, Fujifilm, etc.), what PACS you're currently using, and whether you read screening only or screening + diagnostic. I can then give you a much more useful side-by-side comparison of the actual workflow.

When determining which mammography workstation software offers the "best" workflow for 3D Digital Breast Tomosynthesis (DBT) reading, consensus among breast imagers points to a few industry-leading platforms. Because 3D datasets are massive and reading them can significantly increase interpretation time, the best software minimizes mouse clicks, streamlines multi-modality comparison, and features ultra-fast slice scrolling and intelligent hanging protocols.aycan.com+2

The top-rated mammography workstation software options on the market, categorized by their workflow strengths, include:

• Hologic SecurView / InSight-Dx Workstation: Widely regarded as a gold standard because it is custom-built by the pioneers of 3D tomosynthesis. Its workflow tightly integrates with Hologic acquisition hardware, featuring seamless synchronized viewing of 2D/3D images, rapid cine-loop playback, intuitive CAD markers toggle, and optimized one-touch manipulation that matches how radiologists naturally mentally map the breast.
• GE Senographe / AW Server (Advanced Workstation): GE’s platform excels in multi-modality alignment and rapid processing of heavy datasets. It offers sophisticated hanging protocols that automatically line up priors, intelligent stack scrolling, and advanced automated tools like contrast-enhanced mammography (CEM) and breast MRI correlation if your center reads diverse modalities.aycan.com+1
• Philips Breast Imaging Workspace (Viewer on Vue/IntelliSpace): Philips provides a unified environment that places 2D, 3D DBT, breast MRI, and ultrasound on a single screen without forcing the user to jump between separate applications. Its dedicated mammography tool pad, integrated keypad shortcuts for slabbing, and customizable hanging protocols drastically reduce handling time for dense-breast evaluations.candelis.com+2
• Three Palm Software WorkstationOne: Known as a top vendor-neutral option, WorkstationOne supports 3D tomosynthesis images from almost every major manufacturer (Hologic, GE, Siemens, Fujifilm, Philips). For practices mixing equipment from different vendors, its DICOM handling, automatic conversion of non-standard formats, and customizable navigation/cine/slabbing tools provide a consistent, unified workflow.threepalmsoft.com+1
• Candelis ImageGrid Advanced Breast Imaging Workstation: Another powerful independent/pacs-integrated solution that provides fast prefetching, robust multi-vendor 3D/2D support, and flexible workflow customization that helps smaller clinics or multi-site practices handle high volumes of DBT without lag.candelis.com+1

Note on Hardware Integration: Software performance for 3D reading is deeply tied to display hardware. Many reading rooms pair these software platforms with specialized diagnostic displays like the Barco Coronis Uniti to handle 2D and 3D multi-modality fusion seamlessly on a single ultra-high-resolution screen.[1]

To help narrow down which software fits your practice best, tell me:

• Are you vendor-locked (e.g., exclusively using Hologic or GE units), or do you need a multi-vendor solution?
• Do you also need to integrate breast MRI or ultrasound into the same reading workflow?

If by “best workflow” you mean fastest, most ergonomic reading of high-volume 3D digital breast tomosynthesis (DBT)—rather than simply the best image viewer—I’d put Hologic SecurView and Sectra Breast Imaging at the top, with the winner depending heavily on your environment.

My ranking

🥇 Hologic SecurView — best pure DBT reading workflow

For a breast radiologist who reads a large volume of tomosynthesis, SecurView 12 is probably my first choice.

Its workflow is unusually purpose-built for mammography: configurable rapid scrolling, cine, on-the-fly slabbing, synchronized 2D/3D views, rapid access to priors, and dedicated mammography hanging protocols. Hologic also supports a dedicated keypad with single-button hanging-protocol advancement and exam completion.Hologic+1

The big advantage becomes even greater if you're using Hologic equipment and AI. SecurView integrates with Genius AI Detection, including automated CC/MLO lesion correlation.Hologic

I'd choose SecurView if:

• You're primarily a breast-imaging practice.
• Most of your DBT comes from Hologic.
• Radiologist reading speed and ergonomics are the overriding priorities.
• You want a dedicated mammography workstation rather than a general PACS.

hologic.com

🥈 Sectra — best overall for a multivendor enterprise

If you're integrating Hologic + GE + Siemens + other modalities, I might actually choose Sectra over SecurView.

Sectra's strength is making DBT part of a unified breast-imaging environment rather than forcing the radiologist into a proprietary mammography island. It supports mammography, DBT, ultrasound, MRI and other breast imaging from multiple vendors in one application.Sectra Medical+1

For DBT specifically, Sectra provides 2D↔3D toggling, cine, position indicators, stacked views, and customizable display protocols, plus a dedicated keypad for high-throughput reading.Sectra Medical

I'd choose Sectra if:

• You're a large health system.
• You have multiple mammography vendors.
• You want breast imaging integrated with enterprise PACS/RIS/reporting.
• Radiologists need to move seamlessly among mammography, DBT, US and MRI.

medical.sectra.com

🥉 Three Palm WorkstationOne — worth a serious look

WorkstationOne is particularly interesting if your priority is mammography-specific workflow efficiency rather than general enterprise PACS functionality.

It emphasizes single-click/mouse-wheel workflows, customizable mammography hanging protocols, multiple priors, and integrated tomosynthesis navigation, including cine and thick-slice reconstruction.Three Palm Software+1

threepalmsoft.com

What I'd actually demo

For a serious procurement, I wouldn't choose based on feature lists. I'd put SecurView vs Sectra vs WorkstationOne through the same 25–50 DBT cases and measure:

1. Time from opening case → first diagnostic view
2. Time to retrieve and display priors
3. Number of mouse/keypad actions per screening case
4. Speed/smoothness of DBT cine
5. 2D ↔ DBT switching
6. Thickness/slab manipulation
7. Finding the corresponding location across CC/MLO
8. Handling of diagnostic views
9. AI/CAD interaction
10. Report creation and exam completion

I'd pay particular attention to cine responsiveness and hanging-protocol behavior. Those two things can have a bigger effect on a radiologist's day than having another dozen image-manipulation tools.

Bottom line

If you asked me to pick one without knowing anything else:

• Best dedicated DBT workstation: Hologic SecurView
• Best enterprise/multivendor solution: Sectra
• Best dark-horse mammography-specific workflow: Three Palm WorkstationOne

If you're evaluating these for an actual breast-imaging practice, I can also do a deep side-by-side of SecurView vs Sectra vs WorkstationOne, including DBT scrolling, hanging protocols, priors, AI, reporting, monitor/controller requirements, multivendor compatibility, and likely radiologist throughput.