K Lång1, I Andersson, S Zackrisson. 1. Medical Radiology, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
Abstract
OBJECTIVE: To analyse discrepant breast cancer detection in digital breast tomosynthesis (DBT) and digital mammography (DM). METHODS: From a previous detection study comparing DBT and DM, 26 discrepant cases were extracted, 19 detected by DBT only and 7 by DM only. An expert panel of three radiologists reviewed these cases and documented the level of discrepancy, lesion visibility, radiographic pattern and lesion conspicuity and assessed the reason for non-detection. Differences between groups were tested using the Wilcoxon rank sum test, the Kruskal-Wallis test and visual grading characteristics. RESULTS: The proportion of lesion periphery in fatty tissue was statistically significantly larger, and there were significantly more spiculated masses in DBT compared with DM in the DBT only group (p = 0.018; p = 0.015). The main reasons for missing a lesion were poor lesion visibility when using DM and interpretative error when using DBT. CONCLUSION: Lesion visualization is superior with DBT, particularly of spiculated tumours. A major reason for non-detection in DBT seems to be interpretative error, which may be due to lack of experience. ADVANCES IN KNOWLEDGE: Our findings suggest that DBT is better than DM in visualizing breast cancer and that non-detection when using DBT is related to interpretative error regarding clearly visible lesions.
OBJECTIVE: To analyse discrepant breast cancer detection in digital breast tomosynthesis (DBT) and digital mammography (DM). METHODS: From a previous detection study comparing DBT and DM, 26 discrepant cases were extracted, 19 detected by DBT only and 7 by DM only. An expert panel of three radiologists reviewed these cases and documented the level of discrepancy, lesion visibility, radiographic pattern and lesion conspicuity and assessed the reason for non-detection. Differences between groups were tested using the Wilcoxon rank sum test, the Kruskal-Wallis test and visual grading characteristics. RESULTS: The proportion of lesion periphery in fatty tissue was statistically significantly larger, and there were significantly more spiculated masses in DBT compared with DM in the DBT only group (p = 0.018; p = 0.015). The main reasons for missing a lesion were poor lesion visibility when using DM and interpretative error when using DBT. CONCLUSION: Lesion visualization is superior with DBT, particularly of spiculated tumours. A major reason for non-detection in DBT seems to be interpretative error, which may be due to lack of experience. ADVANCES IN KNOWLEDGE: Our findings suggest that DBT is better than DM in visualizing breast cancer and that non-detection when using DBT is related to interpretative error regarding clearly visible lesions.
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