Rossano Girometti1, Ludmila Tomkova2, Lorenzo Cereser3, Chiara Zuiani4. 1. Institute of Radiology, Department of Medicine, University of Udine, University Hospital, S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100, Udine, UD, Italy. Electronic address: rgirometti@sirm.org. 2. Institute of Radiology, Department of Medicine, University of Udine, University Hospital, S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100, Udine, UD, Italy. Electronic address: ludmila.tomkova@yahoo.com. 3. Institute of Radiology, Department of Medicine, University of Udine, University Hospital, S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100, Udine, UD, Italy. Electronic address: lorenzo.cereser@asuiud.sanita.fvg.it. 4. Institute of Radiology, Department of Medicine, University of Udine, University Hospital, S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100, Udine, UD, Italy. Electronic address: chiara.zuiani@uniud.it.
Abstract
PURPOSE: To investigate whether combined Digital breast tomosynthesis and Automated breast volume scanner (DBT-ABVS) are comparable to Magnetic resonance imaging (MRI) in staging breast cancer. METHODS: We retrospectively included seventy-three patients with histologically proven breast cancer who underwent preoperative DBT, ABVS and 1.5 T MRI in the period July 2015-July 2016. Two radiologists in consensus recorded the number, site and Breast imaging-reporting and data system (BI-RADS) category of breast findings during two independent reading strategies, i.e. DBT-ABVS vs. MRI. Using histology or 1-year follow up as the standard of reference, we calculated the accuracy for cancer of both imaging strategies. Bland-Altman analysis was used to evaluate the agreement between MRI vs. DBT or ABVS in cancer size assessment. RESULTS: Patients showed a total of 160 lesions (108 malignant and 52 benign). Malignant lesions were unifocal, multifocal, multicentric and biltateral in 53, 15, 4 and 1 cases, respectively. Diagnostic accuracy of DBT-ABVS vs. MRI was comparable for all cancers (90.0% [95%C.I. 84.3-94.2] vs. 93.8% [95%C.I. 88.8-97.0], respectively). DBT-ABVS showed lower sensitivity and positive predictive values for additional disease (76.5% [95%C.I. 58.8-89.3] vs. 91.7% [95%C.I. 84.6-96.1], and 78.8% [95%C.I. 61.0-91.0] vs 93.4% [95%C.I. 86.9-97.3], respectively). Compared to MRI, ABVS + DBT missed 6 lesions, including two invasive cancers and one extensive intravascular invasion associated to ductal carcinoma in situ. Bland-Altman analysis showed ABVS to agree with MRI at a higher extent than DBT in assessing cancer size. CONCLUSIONS: Though less performing than MRI, DBT-ABVS showed acceptable diagnostic accuracy in staging breast cancer. This strategy might be used if MRI is unavailable or unfeasible.
PURPOSE: To investigate whether combined Digital breast tomosynthesis and Automated breast volume scanner (DBT-ABVS) are comparable to Magnetic resonance imaging (MRI) in staging breast cancer. METHODS: We retrospectively included seventy-three patients with histologically proven breast cancer who underwent preoperative DBT, ABVS and 1.5 T MRI in the period July 2015-July 2016. Two radiologists in consensus recorded the number, site and Breast imaging-reporting and data system (BI-RADS) category of breast findings during two independent reading strategies, i.e. DBT-ABVS vs. MRI. Using histology or 1-year follow up as the standard of reference, we calculated the accuracy for cancer of both imaging strategies. Bland-Altman analysis was used to evaluate the agreement between MRI vs. DBT or ABVS in cancer size assessment. RESULTS:Patients showed a total of 160 lesions (108 malignant and 52 benign). Malignant lesions were unifocal, multifocal, multicentric and biltateral in 53, 15, 4 and 1 cases, respectively. Diagnostic accuracy of DBT-ABVS vs. MRI was comparable for all cancers (90.0% [95%C.I. 84.3-94.2] vs. 93.8% [95%C.I. 88.8-97.0], respectively). DBT-ABVS showed lower sensitivity and positive predictive values for additional disease (76.5% [95%C.I. 58.8-89.3] vs. 91.7% [95%C.I. 84.6-96.1], and 78.8% [95%C.I. 61.0-91.0] vs 93.4% [95%C.I. 86.9-97.3], respectively). Compared to MRI, ABVS + DBT missed 6 lesions, including two invasive cancers and one extensive intravascular invasion associated to ductal carcinoma in situ. Bland-Altman analysis showed ABVS to agree with MRI at a higher extent than DBT in assessing cancer size. CONCLUSIONS: Though less performing than MRI, DBT-ABVS showed acceptable diagnostic accuracy in staging breast cancer. This strategy might be used if MRI is unavailable or unfeasible.
Authors: Anna D'Angelo; Gianluca Gatta; Graziella Di Grezia; Sara Mercogliano; Francesca Ferrara; Charlotte Marguerite Lucille Trombadori; Antonio Franco; Alessandro Cina; Paolo Belli; Riccardo Manfredi Journal: Tomography Date: 2022-08-12