Dianne Georgian-Smith1, Nancy A Obuchowski2, Joseph Y Lo3, Rachel F Brem4, Jay A Baker3, Paul R Fisher5, Alice Rim6, Wei Zhao7, Laurie L Fajardo8, Thomas Mertelmeier9. 1. 1 Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. 2. 2 Quantitative Health Science, Cleveland Clinic Foundation, Cleveland, OH. 3. 3 Department of Radiology, Duke University School of Medicine, Durham, NC. 4. 4 The George Washington Cancer Center, George Washington University, Washington, DC. 5. 5 Departments of Radiology and Surgery, State University of New York at Stony Brook Health Science Center, Stony Brook, NY. 6. 6 Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH. 7. 7 Department of Radiology, Stony Brook Medicine, Stony Brook, NY. 8. 8 Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT. 9. 9 Diagnostic Imaging, X-Ray Products, Siemens Healthcare GmbH, Forchheim, Germany.
Abstract
OBJECTIVE: The purpose of this study was to test the hypothesis whether two-view wide-angle digital breast tomosynthesis (DBT) can replace full-field digital mammography (FFDM) for breast cancer detection. SUBJECTS AND METHODS: In a multireader multicase study, bilateral two-view FFDM and bilateral two-view wide-angle DBT images were independently viewed for breast cancer detection in two reading sessions separated by more than 1 month. From a pool of 764 patients undergoing screening and diagnostic mammography, 330 patient-cases were selected. The endpoints were the mean ROC AUC for the reader per breast (breast level), ROC AUC per patient (subject level), noncancer recall rates, sensitivity, and specificity. RESULTS: Twenty-nine of 31 readers performed better with DBT than FFDM regardless of breast density. There was a statistically significant improvement in readers' mean diagnostic accuracy with DBT. The subject-level AUC increased from 0.765 (standard error [SE], 0.027) for FFDM to 0.835 (SE, 0.027) for DBT (p = 0.002). Breast-level AUC increased from 0.818 (SE, 0.019) for FFDM to 0.861 (SE, 0.019) for DBT (p = 0.011). The noncancer recall rate per patient was reduced by 19% with DBT (p < 0.001). Masses and architectural distortions were detected more with DBT (p < 0.001); calcifications trended lower (p = 0.136). Accuracy for detection of invasive cancers was significantly greater with DBT (p < 0.001). CONCLUSION: Reader performance in breast cancer detection is significantly higher with wide-angle two-view DBT independent of FFDM, verifying the robustness of DBT as a sole view. However, results of perception studies in the vision sciences support the inclusion of an overview image.
OBJECTIVE: The purpose of this study was to test the hypothesis whether two-view wide-angle digital breast tomosynthesis (DBT) can replace full-field digital mammography (FFDM) for breast cancer detection. SUBJECTS AND METHODS: In a multireader multicase study, bilateral two-view FFDM and bilateral two-view wide-angle DBT images were independently viewed for breast cancer detection in two reading sessions separated by more than 1 month. From a pool of 764 patients undergoing screening and diagnostic mammography, 330 patient-cases were selected. The endpoints were the mean ROC AUC for the reader per breast (breast level), ROC AUC per patient (subject level), noncancer recall rates, sensitivity, and specificity. RESULTS: Twenty-nine of 31 readers performed better with DBT than FFDM regardless of breast density. There was a statistically significant improvement in readers' mean diagnostic accuracy with DBT. The subject-level AUC increased from 0.765 (standard error [SE], 0.027) for FFDM to 0.835 (SE, 0.027) for DBT (p = 0.002). Breast-level AUC increased from 0.818 (SE, 0.019) for FFDM to 0.861 (SE, 0.019) for DBT (p = 0.011). The noncancer recall rate per patient was reduced by 19% with DBT (p < 0.001). Masses and architectural distortions were detected more with DBT (p < 0.001); calcifications trended lower (p = 0.136). Accuracy for detection of invasive cancers was significantly greater with DBT (p < 0.001). CONCLUSION: Reader performance in breast cancer detection is significantly higher with wide-angle two-view DBT independent of FFDM, verifying the robustness of DBT as a sole view. However, results of perception studies in the vision sciences support the inclusion of an overview image.
Authors: Miguel A Lago; Aditya Jonnalagadda; Craig K Abbey; Bruno B Barufaldi; Predrag R Bakic; Andrew D A Maidment; Winifred K Leung; Susan P Weinstein; Brian S Englander; Miguel P Eckstein Journal: Curr Biol Date: 2021-01-19 Impact factor: 10.834
Authors: Suzanne L van Winkel; Alejandro Rodríguez-Ruiz; Linda Appelman; Albert Gubern-Mérida; Nico Karssemeijer; Jonas Teuwen; Alexander J T Wanders; Ioannis Sechopoulos; Ritse M Mann Journal: Eur Radiol Date: 2021-05-04 Impact factor: 5.315