Alberto Stefano Tagliafico1,2, Massimo Calabrese3, Bianca Bignotti4, Alessio Signori4, Erica Fisci4, Federica Rossi4, Francesca Valdora5, Nehmat Houssami6. 1. Department of Health Sciences (DISSAL), Radiology Section, University of Genoa and Emergency Radiology, IRCCS AOU San Martino-IST, Genoa, Italy. alberto.tagliafico@unige.it. 2. Emergency Radiology, Policlinico San Martino, Genoa, Italy. alberto.tagliafico@unige.it. 3. Breast Radiology, Policlinico San Martino, Genoa, Italy. 4. Department of Health Sciences (DISSAL), Radiology Section, University of Genoa and Emergency Radiology, IRCCS AOU San Martino-IST, Genoa, Italy. 5. Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy. 6. Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Abstract
OBJECTIVE: To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. MATERIALS AND METHODS: This is a substudy of the 'ASTOUND' trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D. RESULTS:The median age of the patients was 53 years (range, 36-88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (p<0.001) and a mean reading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other. CONCLUSION: Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time. KEY POINTS: • Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images • Double reading using S-2D plus tomosynthesis had the highest global accuracy (p<0.001). • Double reading of S-2D plus tomosynthesis increased reading time.
RCT Entities:
OBJECTIVE: To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. MATERIALS AND METHODS: This is a substudy of the 'ASTOUND' trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D. RESULTS: The median age of the patients was 53 years (range, 36-88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (p<0.001) and a mean reading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other. CONCLUSION: Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time. KEY POINTS: • Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images • Double reading using S-2D plus tomosynthesis had the highest global accuracy (p<0.001). • Double reading of S-2D plus tomosynthesis increased reading time.
Entities:
Keywords:
Accuracy; Breast density; Dense breasts; Digital Breast Tomosynthesis; Reading time
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