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Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images

Comparative Study

. 2014 Jun;271(3):664-71. doi: 10.1148/radiol.13131530. Epub 2014 Jan 21. Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images

Affiliations

Affiliation

¹ From the Department of Radiology, Magee Womens Hospital, University of Pittsburgh Medical Center, 300 Halket St, Pittsburgh, PA 15213 (M.L.Z., V.J.C., D.M.C., A.E.K., A.H.L., G.Y.R., M.L.S., J.H.S., L.P.W.); Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (M.L.Z., V.J.C., D.M.C., A.E.K., A.H.L., G.Y.R., M.L.S., J.H.S., L.P.W.); and Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pa (B.G., A.I.B.).

PMID: 24475859
PMCID: PMC4263638
DOI: 10.1148/radiol.13131530

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Comparative Study

Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images

Margarita L Zuley et al. Radiology. 2014 Jun.

. 2014 Jun;271(3):664-71. doi: 10.1148/radiol.13131530. Epub 2014 Jan 21. Authors Margarita L Zuley¹, Ben Guo, Victor J Catullo, Denise M Chough, Amy E Kelly, Amy H Lu, Grace Y Rathfon, Marion Lee Spangler, Jules H Sumkin, Luisa P Wallace, Andriy I Bandos Affiliation

¹ From the Department of Radiology, Magee Womens Hospital, University of Pittsburgh Medical Center, 300 Halket St, Pittsburgh, PA 15213 (M.L.Z., V.J.C., D.M.C., A.E.K., A.H.L., G.Y.R., M.L.S., J.H.S., L.P.W.); Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (M.L.Z., V.J.C., D.M.C., A.E.K., A.H.L., G.Y.R., M.L.S., J.H.S., L.P.W.); and Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pa (B.G., A.I.B.).

PMID: 24475859
PMCID: PMC4263638
DOI: 10.1148/radiol.13131530

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Abstract

Purpose: To assess interpretation performance and radiation dose when two-dimensional synthesized mammography (SM) images versus standard full-field digital mammography (FFDM) images are used alone or in combination with digital breast tomosynthesis images.

Materials and methods: A fully crossed, mode-balanced multicase (n = 123), multireader (n = 8), retrospective observer performance study was performed by using deidentified images acquired between 2008 and 2011 with institutional review board approved, HIPAA-compliant protocols, during which each patient signed informed consent. The cohort included 36 cases of biopsy-proven cancer, 35 cases of biopsy-proven benign lesions, and 52 normal or benign cases (Breast Imaging Reporting and Data System [BI-RADS] score of 1 or 2) with negative 1-year follow-up results. Accuracy of sequentially reported probability of malignancy ratings and seven-category forced BI-RADS ratings was evaluated by using areas under the receiver operating characteristic curve (AUCs) in the random-reader analysis.

Results: Probability of malignancy-based mean AUCs for SM and FFDM images alone was 0.894 and 0.889, respectively (difference, -0.005; 95% confidence interval [CI]: -0.062, 0.054; P = .85). Mean AUC for SM with tomosynthesis and FFDM with tomosynthesis was 0.916 and 0.939, respectively (difference, 0.023; 95% CI: -0.011, 0.057; P = .19). In terms of the reader-specific AUCs, five readers performed better with SM alone versus FFDM alone, and all eight readers performed better with combined FFDM and tomosynthesis (absolute differences from 0.003 to 0.052). Similar results were obtained by using a nonparametric analysis of forced BI-RADS ratings.

Conclusion: SM alone or in combination with tomosynthesis is comparable in performance to FFDM alone or in combination with tomosynthesis and may eliminate the need for FFDM as part of a routine clinical study.

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Figures
Figure 1:

Overall ROC curves based on…

Figure 1:

Overall ROC curves based on probability of malignancy ratings for individual breasts. FPF…

Figure 1:

Overall ROC curves based on probability of malignancy ratings for individual breasts. FPF = false-positive fraction, TOMO = tomosynthesis, TPF = true-positive fraction.

Figure 1:

Overall ROC curves based on…

Figure 1:

Overall ROC curves based on probability of malignancy ratings for individual breasts. FPF…

Figure 1:

Overall ROC curves based on probability of malignancy ratings for individual breasts. FPF = false-positive fraction, TOMO = tomosynthesis, TPF = true-positive fraction.

Figure 2:

Overall breast-based ROC curves for…

Figure 2:

Overall breast-based ROC curves for forced BI-RADs ratings. FPF = false-positive finding, TOMO…

Figure 2:

Overall breast-based ROC curves for forced BI-RADs ratings. FPF = false-positive finding, TOMO = tomosynthesis, TPF = true-positive finding.

Figure 2:

Overall breast-based ROC curves for…

Figure 2:

Overall breast-based ROC curves for forced BI-RADs ratings. FPF = false-positive finding, TOMO…

Figure 2:

Overall breast-based ROC curves for forced BI-RADs ratings. FPF = false-positive finding, TOMO = tomosynthesis, TPF = true-positive finding.

Figure 3a:

(a) FFDM and (b) SM…

Figure 3a:

(a) FFDM and (b) SM craniocaudal images demonstrate a spiculated mass in a…

Figure 3a:

(a) FFDM and (b) SM craniocaudal images demonstrate a spiculated mass in a 58-year-old woman that proved to be invasive ductal carcinoma at biopsy.

Figure 3b:

(a) FFDM and (b) SM…

Figure 3b:

(a) FFDM and (b) SM craniocaudal images demonstrate a spiculated mass in a…

Figure 3b:

(a) FFDM and (b) SM craniocaudal images demonstrate a spiculated mass in a 58-year-old woman that proved to be invasive ductal carcinoma at biopsy.

Figure 4a:

(a) FFDM and (b) SM…

Figure 4a:

(a) FFDM and (b) SM craniocaudal images demonstrate segmental distribution of fine pleomorphic…

Figure 4a:

(a) FFDM and (b) SM craniocaudal images demonstrate segmental distribution of fine pleomorphic calcifications in a 55-year-old woman that were due to DCIS.

Figure 4b:

(a) FFDM and (b) SM…

Figure 4b:

(a) FFDM and (b) SM craniocaudal images demonstrate segmental distribution of fine pleomorphic…

Figure 4b:

(a) FFDM and (b) SM craniocaudal images demonstrate segmental distribution of fine pleomorphic calcifications in a 55-year-old woman that were due to DCIS.