Zuckerman S, et al. - Via an institutional review board exempt, researchers evaluated utilization and attitudes regarding synthesized digital mammography (SM) in digital breast tomosynthesis (DBT) screening. Overall, 312 of 2,600 Society of Breast Imaging members responded to the survey. Of respondents, 96% and 83% reported DBT capability and SM capability, respectively. The most quoted reasons were cost or administration and image quality concerns of those without SM. Moreover, 40% and 52%, respectively, reported combined SM and digital mammography (DM) use in DBT screens and SM use without DM in the majority of DBT screens. In all, satisfaction with SM was 3.4 of 5. Reduced dose and increased lesion conspicuity were the most quoted SM benefits. Calcification characterization and reduced image quality were the most cited SM disadvantages. Most respondents were uncertain if cancer detection and recall rates varied with few reporting adverse outcomes. Most radiologists screening with DBT had SM, but only half had displaced DM with SM. Radiologists had concerns about image quality, particularly calcification characterization, regardless of a few reported adverse screening outcomes with SM–DBT.