Can Digital Breast Tomosynthesis Replace Full-Field Digital Mammography? A Multireader, Multicase Study of Wide-Angle Tomosynthesis.

Authors:
Dianne Georgian-Smith
Dianne Georgian-Smith
Massachusetts General Hospital
United States
Nancy A Obuchowski
Nancy A Obuchowski
Cleveland Clinic
United States
Joseph Y Lo
Joseph Y Lo
Duke University Medical Center
United States
Rachel F Brem
Rachel F Brem
The George Washington University
United States
Jay A Baker
Jay A Baker
Duke University Medical Center
Paul R Fisher
Paul R Fisher
La Trobe University
Australia
Alice Rim
Alice Rim
Cleveland Clinic
United States
Wei Zhao
Wei Zhao
School of Public Health
New Haven | United States

AJR Am J Roentgenol 2019 Apr 1:1-7. Epub 2019 Apr 1.

9 Diagnostic Imaging, X-Ray Products, Siemens Healthcare GmbH, Forchheim, Germany.

Objective: The purpose of this study was to test the hypothesis whether two-view wide-angle digital breast tomosynthesis (DBT) can replace full-field digital mammography (FFDM) for breast cancer detection.

Subjects And Methods: In a multireader multicase study, bilateral two-view FFDM and bilateral two-view wide-angle DBT images were independently viewed for breast cancer detection in two reading sessions separated by more than 1 month. From a pool of 764 patients undergoing screening and diagnostic mammography, 330 patient-cases were selected. The endpoints were the mean ROC AUC for the reader per breast (breast level), ROC AUC per patient (subject level), noncancer recall rates, sensitivity, and specificity.

Results: Twenty-nine of 31 readers performed better with DBT than FFDM regardless of breast density. There was a statistically significant improvement in readers' mean diagnostic accuracy with DBT. The subject-level AUC increased from 0.765 (standard error [SE], 0.027) for FFDM to 0.835 (SE, 0.027) for DBT (p = 0.002). Breast-level AUC increased from 0.818 (SE, 0.019) for FFDM to 0.861 (SE, 0.019) for DBT (p = 0.011). The noncancer recall rate per patient was reduced by 19% with DBT (p < 0.001). Masses and architectural distortions were detected more with DBT (p < 0.001); calcifications trended lower (p = 0.136). Accuracy for detection of invasive cancers was significantly greater with DBT (p < 0.001).

Conclusion: Reader performance in breast cancer detection is significantly higher with wide-angle two-view DBT independent of FFDM, verifying the robustness of DBT as a sole view. However, results of perception studies in the vision sciences support the inclusion of an overview image.

Download full-text PDF

Source
https://www.ajronline.org/doi/10.2214/AJR.18.20294
Publisher Site
http://dx.doi.org/10.2214/AJR.18.20294DOI Listing
April 2019
13 Reads

Article Mentions


Provided by Crossref Event Data
twitter
Twitter:
April 23, 2019, 6:02 am EST
twitter
Twitter:
April 23, 2019, 1:27 am EST
twitter
Twitter:
April 22, 2019, 3:30 pm EST

Publication Analysis

Top Keywords

breast cancer
12
dbt
11
ffdm breast
8
two-view wide-angle
8
multicase study
8
dbt 0001
8
noncancer recall
8
roc auc
8
auc increased
8
cancer detection
8
multireader multicase
8
bilateral two-view
8
replace full-field
8
full-field digital
8
digital breast
8
breast tomosynthesis
8
breast
7
ffdm
6
[se] 0027
4
0027 ffdm
4

Similar Publications