Yueh Z Lee1, Connor Puett2, Christina R Inscoe3, Beilin Jia4, Connie Kim5, Ruth Walsh5, Sora Yoon5, Suk Jung Kim6, Cherie M Kuzmiak7, Donglin Zeng4, Jianping Lu8, Otto Zhou8. 1. Department of Radiology, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 152 MacNider Hall CB7575, Chapel Hill, NC 27599. Electronic address: leey@med.unc.edu. 2. Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 152 MacNider Hall CB7575, Chapel Hill, NC 27599. 3. Department of Applied Physical Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 5. Department of Radiology, Duke University, Durham, North Carolina. 6. Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan,South Korea. 7. Department of Radiology, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514. 8. Department of Physics and Astronomy, University of North Carolina at Chapel Hill,Chapel Hill, North Carolina.
Abstract
RATIONALE AND OBJECTIVES: A linear array of carbon nanotube-enabled x-ray sources allows for stationary digital breast tomosynthesis (sDBT), during which projection views are collected without the need to move the x-ray tube. This work presents our initial clinical experience with a first-generation sDBT device. MATERIALS AND METHODS: Following informed consent, women with a "suspicious abnormality" (Breast Imaging Reporting and Data System 4), discovered by digital mammography and awaiting biopsy, were also imaged by the first generation sDBT. Four radiologists participated in this paired-image study, completing questionnaires while interpreting the mammograms and sDBT image stacks. Areas under the receiver operating characteristic curve were used to measure reader performance (likelihood of correctly identifying malignancy based on pathology as ground truth), while a multivariate analysis assessed preference, as readers compared one modality to the next when interpreting diagnostically important image features. RESULTS: Findings from 43 women were available for analysis, in whom 12 cases of malignancy were identified by pathology. The mean areas under the receiver operating characteristic curve was significantly higher (p < 0.05) for sDBT than mammography for all breast density categories and breast thicknesses. Additionally, readers preferred sDBT over mammography when evaluating mass margins and shape, architectural distortion, and asymmetry, but preferred mammography when characterizing microcalcifications. CONCLUSION: Readers preferred sDBT over mammography when interpreting soft-tissue breast features and were diagnostically more accurate using images generated by sDBT in a Breast Imaging Reporting and Data System 4 population. However, the findings also demonstrated the need to improve microcalcification conspicuity, which is guiding both technological and image-processing design changes in future sDBT devices.
RATIONALE AND OBJECTIVES: A linear array of carbon nanotube-enabled x-ray sources allows for stationary digital breast tomosynthesis (sDBT), during which projection views are collected without the need to move the x-ray tube. This work presents our initial clinical experience with a first-generation sDBT device. MATERIALS AND METHODS: Following informed consent, women with a "suspicious abnormality" (Breast Imaging Reporting and Data System 4), discovered by digital mammography and awaiting biopsy, were also imaged by the first generation sDBT. Four radiologists participated in this paired-image study, completing questionnaires while interpreting the mammograms and sDBT image stacks. Areas under the receiver operating characteristic curve were used to measure reader performance (likelihood of correctly identifying malignancy based on pathology as ground truth), while a multivariate analysis assessed preference, as readers compared one modality to the next when interpreting diagnostically important image features. RESULTS: Findings from 43 women were available for analysis, in whom 12 cases of malignancy were identified by pathology. The mean areas under the receiver operating characteristic curve was significantly higher (p < 0.05) for sDBT than mammography for all breast density categories and breast thicknesses. Additionally, readers preferred sDBT over mammography when evaluating mass margins and shape, architectural distortion, and asymmetry, but preferred mammography when characterizing microcalcifications. CONCLUSION: Readers preferred sDBT over mammography when interpreting soft-tissue breast features and were diagnostically more accurate using images generated by sDBT in a Breast Imaging Reporting and Data System 4 population. However, the findings also demonstrated the need to improve microcalcification conspicuity, which is guiding both technological and image-processing design changes in future sDBT devices.
Authors: Norman F Boyd; Helen Guo; Lisa J Martin; Limei Sun; Jennifer Stone; Eve Fishell; Roberta A Jong; Greg Hislop; Anna Chiarelli; Salomon Minkin; Martin J Yaffe Journal: N Engl J Med Date: 2007-01-18 Impact factor: 91.245
Authors: M Lee Spangler; Margarita L Zuley; Jules H Sumkin; Gordan Abrams; Marie A Ganott; Christiane Hakim; Ronald Perrin; Denise M Chough; Ratan Shah; David Gur Journal: AJR Am J Roentgenol Date: 2011-02 Impact factor: 3.959