Literature DB >> 25253902

Use of Tomosynthesis in Intraoperative Digital Specimen Radiography - Is a Reduction of Breast Re-excision Rates Possible?

R Schulz-Wendtland1, G Dilbat2, M R Bani3, M P Lux3, M Meier-Meitinger1, E Wenkel1, S Schwab4, M W Beckmann3, M Uder4, B Adamietz1.   

Abstract

Aim: A prospective clinical study was done to see whether it is possible to reduce the rate of re-excisions using digital breast tomosynthesis (DBT) compared commercial FFDM. Material and Method: Between 1/2011 and 5/2011 we diagnosed an invasive breast cancer (BI-RADS 5) in 100 patients. After histological verification we performed breast-conserving therapy with intraoperative imaging using one of 2 different systems: 1. Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, Tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm, range: 50°, 25 projections, time for scanning > 20 s, geometry: same scanning scope, reconstruction: filtered back projection; or 2. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm as the standard. The 100 radiograms obtained with both systems were prospectively shown on a monitor to 3 radiologists.
Results: Out of a total of 100 patients with histologically proven breast cancer (BI-RADS 6) no re-excision was necessary in 78 patients. A retrospective analysis (n = 22) demonstrated an increase in sensitivity of tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e., in 8 patients re-excision would not have been necessary with tomosynthesis.
Conclusion: Tomosynthesis has a significant higher sensitivity (p < 0.05) compared with a commercial FFDM system. Studies with higher numbers of patients will be necessary to evaluate this method.

Entities:  

Keywords:  breast; mammary gland tumor; mammographic density

Year:  2011        PMID: 25253902      PMCID: PMC4166918          DOI: 10.1055/s-0031-1280427

Source DB:  PubMed          Journal:  Geburtshilfe Frauenheilkd        ISSN: 0016-5751            Impact factor:   2.915


  25 in total

1.  Quality assurance in the diagnosis of breast disease. EUSOMA Working Party.

Authors:  N M Perry
Journal:  Eur J Cancer       Date:  2001-01       Impact factor: 9.162

2.  [Compression-free biplanar radiography of the breast specimen with a specimen device].

Authors:  J-H Grunert; U Wiechmann; E Gmelin
Journal:  Rofo       Date:  2003-03

3.  Experimental phantom lesion detectability study using a digital breast tomosynthesis prototype system.

Authors:  R Schulz-Wendtland; E Wenkel; M Lell; C Böhner; W A Bautz; T Mertelmeier
Journal:  Rofo       Date:  2006-12

4.  Digital breast tomosynthesis: a pilot observer study.

Authors:  Walter F Good; Gordon S Abrams; Victor J Catullo; Denise M Chough; Marie A Ganott; Christiane M Hakim; David Gur
Journal:  AJR Am J Roentgenol       Date:  2008-04       Impact factor: 3.959

5.  Zurich Consensus: German Expert Opinion on the St. Gallen Votes on 15 March 2009 (11th International Conference at St. Gallen: Primary Therapy of Early Breast Cancer).

Authors:  Matthias W Beckmann; Jens-Uwe Blohmer; Serban-Dan Costa; Klaus Diedrich; Ingo Diel; Wolfgang Eiermann; Klaus Friese; Bernd Gerber; Nadia Harbeck; Joern Hilfrich; Wolfgang Janni; Fritz Jaenicke; Walter Jonat; Manfred Kaufmann; Marion Kiechle; Uwe Koehler; Rolf Kreienberg; Gunter von Minckwitz; Volker Moebus; Ulrike Nitz; Andreas Schneeweiss; Christoph Thomssen; Diethelm Wallwiener
Journal:  Breast Care (Basel)       Date:  2009-04-24       Impact factor: 2.860

6.  Digital breast tomosynthesis: observer performance study.

Authors:  David Gur; Gordon S Abrams; Denise M Chough; Marie A Ganott; Christiane M Hakim; Ronald L Perrin; Grace Y Rathfon; Jules H Sumkin; Margarita L Zuley; Andriy I Bandos
Journal:  AJR Am J Roentgenol       Date:  2009-08       Impact factor: 3.959

Review 7.  Management of the breast specimen.

Authors:  C J D'Orsi
Journal:  Radiology       Date:  1995-02       Impact factor: 11.105

8.  Factors correlating with reexcision after breast-conserving therapy.

Authors:  M R Bani; M P Lux; K Heusinger; E Wenkel; A Magener; R Schulz-Wendtland; M W Beckmann; P A Fasching
Journal:  Eur J Surg Oncol       Date:  2008-06-09       Impact factor: 4.424

9.  Parenchymal texture analysis in digital breast tomosynthesis for breast cancer risk estimation: a preliminary study.

Authors:  Despina Kontos; Predrag R Bakic; Ann-Katherine Carton; Andrea B Troxel; Emily F Conant; Andrew D A Maidment
Journal:  Acad Radiol       Date:  2009-03       Impact factor: 3.173

Review 10.  Guidelines from the European Society of Breast Imaging for diagnostic interventional breast procedures.

Authors:  Matthew Wallis; Anne Tardivon; Anne Tarvidon; Thomas Helbich; Ingrid Schreer
Journal:  Eur Radiol       Date:  2007-02       Impact factor: 7.034

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  4 in total

1.  Full Field Digital Mammography (FFDM) versus CMOS Technology versus Tomosynthesis (DBT) - Which System Increases the Quality of Intraoperative Imaging?

Authors:  R Schulz-Wendtland; G Dilbat; M Bani; P A Fasching; M P Lux; E Wenkel; S Schwab; C R Loehberg; S M Jud; C Rauh; C M Bayer; M W Beckmann; M Uder; M Meier-Meitinger
Journal:  Geburtshilfe Frauenheilkd       Date:  2012-06       Impact factor: 2.915

2.  Re-excision Rates and Local Recurrence in Breast Cancer Patients Undergoing Breast Conserving Therapy.

Authors:  M Dieterich; H Dieterich; H Moch; C Rosso
Journal:  Geburtshilfe Frauenheilkd       Date:  2012-11       Impact factor: 2.915

3.  Full Field Digital Mammography (FFDM) versus CMOS Technology, Specimen Radiography System (SRS) and Tomosynthesis (DBT) - Which System Can Optimise Surgical Therapy?

Authors:  R Schulz-Wendtland; G Dilbat; M Bani; P A Fasching; K Heusinger; M P Lux; C R Loehberg; B Brehm; M Hammon; M Saake; P Dankerl; S M Jud; C Rauh; C M Bayer; M W Beckmann; M Uder; M Meier-Meitinger
Journal:  Geburtshilfe Frauenheilkd       Date:  2013-05       Impact factor: 2.915

4.  Mammographic Density and Prediction of Nodal Status in Breast Cancer Patients.

Authors:  C C Hack; L Häberle; K Geisler; R Schulz-Wendtland; A Hartmann; P A Fasching; M Uder; D L Wachter; S M Jud; C R Loehberg; M P Lux; C Rauh; M W Beckmann; K Heusinger
Journal:  Geburtshilfe Frauenheilkd       Date:  2013-02       Impact factor: 2.915

  4 in total

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