G Mariscotti1, M Durando2, N Houssami3, C Zuiani4, L Martincich5, V Londero4, E Caramia2, P Clauser4, P P Campanino6, E Regini2, A Luparia7, I Castellano8, L Bergamasco9, A Sapino8, P Fonio2, M Bazzocchi4, G Gandini2. 1. Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Cittá della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126 Torino, Italy. Electronic address: giovanna.mariscotti@libero.it. 2. Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Cittá della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126 Torino, Italy. 3. Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney 2006, NSW, Australia. 4. Department of Medical and Biological Sciences, Institute of Diagnostic Radiology, University of Udine, 33100 Udine, Italy. 5. Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, 10060 Candiolo, Torino, Italy. 6. Breast Imaging Service, Ospedale Koelliker, C.so Galileo Ferraris 256, 10100 Torino, Italy. 7. U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Azienda Provinciale Servizi Sanitari (APSS), 38100 Trento, Italy. 8. Department of Biomedical Sciences and Human Oncology, A. O. U. Città della Salute e della Scienza of Turin, University of Turin, Via Santena,7, Torino, Italy. 9. Department of Surgical Sciences, University of Torino, Azienda Ospedaliera Città della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, 10126 Torino, Italy.
Abstract
AIM: To examine the interpretive performance of digital breast tomosynthesis (DBT) as an adjunct to digital mammography (DM) compared to DM alone in a series of invasive lobular carcinomas (ILCs) and to assess whether DBT can be used to characterise ILC. MATERIALS AND METHODS: A retrospective, multi-reader study was conducted of 83 mammographic examinations of women with 107 newly diagnosed ILCs ascertained at histology. Consenting women underwent both DM and DBT acquisitions. Twelve radiologists, with varying mammography experience, interpreted DM images alone, reporting lesion location, mammographic features, and malignancy probability using the Breast Imaging-Reporting and Data System (BI-RADS) categories 1-5; they then reviewed DBT images in addition to DM, and reported the same parameters. Statistical analyses compared sensitivity, false-positive rates (FPR), and interpretive performance using the receiver operating characteristics (ROC) curve and the area under the curve (AUC), for reading with DM versus DM plus DBT. RESULTS: Multi-reader pooled ROC analysis for DM plus DBT yielded AUC=0.89 (95% confidence interval [CI]: 0.88-0.91), which was significantly higher (p<0.0001) than DM alone with AUC=0.84 (95% CI: 0.82-0.86). DBT plus DM significantly increased pooled sensitivity (85%) compared to DM alone (70%; p<0.0001). FPR did not vary significantly with the addition of DBT to DM. Interpreting with DBT (compared to DM alone) increased the correct identification of ILCs depicted as architectural distortions (84% versus 65%, respectively) or as masses (89% versus 70%), increasing interpretive performance for both experienced and less-experienced readers; larger gains in AUC were shown for less-experienced radiologists. Multifocal and/or multicentric and bilateral disease was more frequently identified on DM with DBT. CONCLUSION: Adding DBT to DM significantly improved the accuracy of mammographic interpretation for ILCs and contributed to characterising disease extent.
AIM: To examine the interpretive performance of digital breast tomosynthesis (DBT) as an adjunct to digital mammography (DM) compared to DM alone in a series of invasive lobular carcinomas (ILCs) and to assess whether DBT can be used to characterise ILC. MATERIALS AND METHODS: A retrospective, multi-reader study was conducted of 83 mammographic examinations of women with 107 newly diagnosed ILCs ascertained at histology. Consenting women underwent both DM and DBT acquisitions. Twelve radiologists, with varying mammography experience, interpreted DM images alone, reporting lesion location, mammographic features, and malignancy probability using the Breast Imaging-Reporting and Data System (BI-RADS) categories 1-5; they then reviewed DBT images in addition to DM, and reported the same parameters. Statistical analyses compared sensitivity, false-positive rates (FPR), and interpretive performance using the receiver operating characteristics (ROC) curve and the area under the curve (AUC), for reading with DM versus DM plus DBT. RESULTS: Multi-reader pooled ROC analysis for DM plus DBT yielded AUC=0.89 (95% confidence interval [CI]: 0.88-0.91), which was significantly higher (p<0.0001) than DM alone with AUC=0.84 (95% CI: 0.82-0.86). DBT plus DM significantly increased pooled sensitivity (85%) compared to DM alone (70%; p<0.0001). FPR did not vary significantly with the addition of DBT to DM. Interpreting with DBT (compared to DM alone) increased the correct identification of ILCs depicted as architectural distortions (84% versus 65%, respectively) or as masses (89% versus 70%), increasing interpretive performance for both experienced and less-experienced readers; larger gains in AUC were shown for less-experienced radiologists. Multifocal and/or multicentric and bilateral disease was more frequently identified on DM with DBT. CONCLUSION: Adding DBT to DM significantly improved the accuracy of mammographic interpretation for ILCs and contributed to characterising disease extent.
Authors: Heang-Ping Chan; Mark A Helvie; Lubomir Hadjiiski; Deborah O Jeffries; Katherine A Klein; Colleen H Neal; Mitra Noroozian; Chintana Paramagul; Marilyn A Roubidoux Journal: Acad Radiol Date: 2017-06-21 Impact factor: 3.173