RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/21998048/ below:

Digital breast tomosynthesis is comparable to mammographic spot views for mass characterization

Comparative Study

doi: 10.1148/radiol.11101763. Epub 2011 Oct 13. Digital breast tomosynthesis is comparable to mammographic spot views for mass characterization

Affiliations

Affiliation

¹ Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, SPC 5326, Ann Arbor, MI 48109, USA. smitran@umich.edu

PMID: 21998048
PMCID: PMC3244671
DOI: 10.1148/radiol.11101763

Item in Clipboard

Comparative Study

Digital breast tomosynthesis is comparable to mammographic spot views for mass characterization

Mitra Noroozian et al. Radiology. 2012 Jan.

doi: 10.1148/radiol.11101763. Epub 2011 Oct 13. Affiliation

¹ Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, SPC 5326, Ann Arbor, MI 48109, USA. smitran@umich.edu

PMID: 21998048
PMCID: PMC3244671
DOI: 10.1148/radiol.11101763

Item in Clipboard

Abstract

Purpose: To determine if digital breast tomosynthesis (DBT) performs comparably to mammographic spot views (MSVs) in characterizing breast masses as benign or malignant.

Materials and methods: This IRB-approved, HIPAA-compliant reader study obtained informed consent from all subjects. Four blinded Mammography Quality Standards Act-certified academic radiologists individually evaluated DBT images and MSVs of 67 masses (30 malignant, 37 benign) in 67 women (age range, 34-88 years). Images were viewed in random order at separate counterbalanced sessions and were rated for visibility (10-point scale), likelihood of malignancy (12-point scale), and Breast Imaging Reporting and Data System (BI-RADS) classification. Differences in mass visibility were analyzed by using the Wilcoxon matched-pairs signed-ranks test. Reader performance was measured by calculating the area under the receiver operating characteristic curve (A(z)) and partial area index above a sensitivity threshold of 0.90 (A(z)(0.90)) by using likelihood of malignancy ratings. Masses categorized as BI-RADS 4 or 5 were compared with histopathologic analysis to determine true-positive results for each modality.

Results: Mean mass visibility ratings were slightly better with DBT (range, 3.2-4.4) than with MSV (range, 3.8-4.8) for all four readers, with one reader's improvement achieving statistical significance (P = .001). The A(z) ranged 0.89-0.93 for DBT and 0.88-0.93 for MSV (P ≥ .23). The A(z)((0.90)) ranged 0.36-0.52 for DBT and 0.25-0.40 for MSV (P ≥ .20). The readers characterized seven additional malignant masses as BI-RADS 4 or 5 with DBT than with MSV, at a cost of five false-positive biopsy recommendations, with a mean of 1.8 true-positive (range, 0-3) and 1.3 false-positive (range, -1 to 4) assessments per reader.

Conclusion: In this small study, mass characterization in terms of visibility ratings, reader performance, and BI-RADS assessment with DBT was similar to that with MSVs. Preliminary findings suggest that MSV might not be necessary for mass characterization when performing DBT.

PubMed Disclaimer

Figures
Figure 1a:

Images in 71-year-old woman with…

Figure 1a:

Images in 71-year-old woman with 1.9-cm invasive ductal carcinoma. (a) Cropped mediolateral oblique…

Figure 1a:

Images in 71-year-old woman with 1.9-cm invasive ductal carcinoma. (a) Cropped mediolateral oblique DBT image (arrow) displayed on the graphical user interface, which allowed readers to electronically enter their assessment of mass visibility, likelihood of malignancy, and BI-RADS category. This interface facilitated DBT image review by allowing readers to scroll through the image volume and adjust contrast and brightness as necessary. (b) MSV available on the graphical user interface to allow readers to electronically mark or reference the mass and (c) digital mediolateral oblique MSV (spot compression) reviewed by using a light-box or hot-light.

Figure 1b:

Images in 71-year-old woman with…

Figure 1b:

Images in 71-year-old woman with 1.9-cm invasive ductal carcinoma. (a) Cropped mediolateral oblique…

Figure 1b:

Figure 1c:

Images in 71-year-old woman with…

Figure 1c:

Images in 71-year-old woman with 1.9-cm invasive ductal carcinoma. (a) Cropped mediolateral oblique…

Figure 1c:

Figure 2:

Box plot of each reader’s…

Figure 2:

Box plot of each reader’s visibility ratings (1 = obvious; 10 = subtle)…

Figure 2:

Box plot of each reader’s visibility ratings (1 = obvious; 10 = subtle) for masses on MSVs and DBT images. The boundary of the box closest to zero indicates 25th percentile and the boundary of the box farthest from zero indicates 75th percentile. Dashed and solid lines within each box indicate mean and median ratings, respectively. For reader 3 (R3) DBT, the median line coincides with 25th percentile. Whiskers above and below each box indicate 95th and 5th percentiles, respectively. The dots represent outliers. The P values for readers 1 (R1), 2 (R2), 3, and 4 (R4) were .19, .53, .13, and .001, respectively.

Figure 3a:

Matched image set of 2.3-cm…

Figure 3a:

Matched image set of 2.3-cm invasive ductal carcinoma (arrow) in 56-year-old woman. (a)…

Figure 3a:

Matched image set of 2.3-cm invasive ductal carcinoma (arrow) in 56-year-old woman. (a) Craniocaudal DBT image (1-mm section from a volume of 20–30 sections) and (b) analog craniocaudal MSV (spot magnification). The images were viewed and assessed during separate reader sessions. Spiculated margins are visible on both images. The readers’ mean and median visibility ratings, respectively, were 3.5 and 4.0 on DBT image and 3.3 and 2.0 on MSV (1 = obvious, 10 = subtle).

Figure 3b:

Matched image set of 2.3-cm…

Figure 3b:

Matched image set of 2.3-cm invasive ductal carcinoma (arrow) in 56-year-old woman. (a)…

Figure 3b:

Figure 4a:

Matched image set of 1.2-cm…

Figure 4a:

Matched image set of 1.2-cm fibroadenoma (arrow) in 29-year-old woman. (a) Mediolateral oblique…

Figure 4a:

Matched image set of 1.2-cm fibroadenoma (arrow) in 29-year-old woman. (a) Mediolateral oblique DBT image (1-mm section from a volume of 20–30 sections) and (b) digital mediolateral oblique MSV (spot compression). The images were viewed and assessed during separate reader sessions. The readers’ mean and median visibility ratings, respectively, were 4.8 and 5.0 on DBT image and 5.5 and 4.5 on MSV (1 = obvious, 10 = subtle).

Figure 4b:

Matched image set of 1.2-cm…

Figure 4b:

Matched image set of 1.2-cm fibroadenoma (arrow) in 29-year-old woman. (a) Mediolateral oblique…

Figure 4b:

Figure 5:

ROC curves for all four…

Figure 5:

ROC curves for all four readers. The A _z and the A _z…

Figure 5:

ROC curves for all four readers. The A_z and the A_z^(0.90) show no significant difference in reader performance when interpreting DBT images versus MSVs (see Table 2) . R1 = reader 1, R2 = reader 2, R3 = reader 3, R4 = reader 4.