Skip to main content

Advertisement

SpringerLink
Log in

Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine the performance of combined single-view mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus single-view cranio-caudal (CC) mammography (MX) compared with that of standard two-view digital mammography.

Methods

A multi-reader multi-case (MRMC) receiver-operating characteristic (ROC) study was conducted, involving six breast radiologists. Two hundred fifty patients underwent bilateral MX and DBT imaging. MX and DBT images with the adjunct of the CC-MX view from 469 breasts were evaluated and rated independently by six readers. Differences in mean areas under the ROC curves (AUCs), mean sensitivity and mean specificity were analysed by analysis of variance (ANOVA) to assess clinical performance.

Results

The combined technique was found to be non-inferior to standard two-view mammography (MX(CC+MLO)) in mean AUC (difference: +0.021;95 % LCL = −0.011), but was not statistically significant for superiority (P = 0.197). The combined technique had equivalent sensitivity to standard mammography (76.2 % vs. 72.8 %, P = 0.269) and equivalent specificity (84.9 % vs. 83.0 %, P = 0.130). Specificity for benign lesions was significantly higher with the combination of techniques versus mammography (45.6 % vs. 36.8 %, P = 0.002).

Conclusion

In this enriched study population, the combination of single-view MLO tomosynthesis plus single-view CC mammography was non-inferior to that of standard two-view digital mammography in terms of ROC curve area, sensitivity and specificity.

Key Points

• Breast tomosynthesis (DBT) has emerged as a valuable adjunct to mammography (MX).

• Combination DBT/MX demonstrated non-inferior clinical performance to standard two-view MX.

• Combination DBT/MX was superior to two-view MX in recognising benign lesions.

• Combination DBT/MX reduced variability compared with two-view MX.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Niklason LT, Christian BT, Niklason LE et al (1997) Digital tomosynthesis in breast imaging. Radiology 205:399–406

    PubMed  CAS  Google Scholar 

  2. Park JM, Franken EA Jr, Garg M, Fajardo LL, Niklason LT (2007) Breast tomosynthesis: present considerations and future applications. Radiographics 27:S231–S240

    Article  PubMed  Google Scholar 

  3. Rafferty E (2007) Digital mammography: novel applications. Radiol Clin N Am 45:831–843

    Article  PubMed  Google Scholar 

  4. Good WF, Abrams GS, Catullo VJ et al (2008) Digital breast tomosynthesis: a pilot observer study. AJR Am J Roentgenol 190:865–869

    Article  PubMed  Google Scholar 

  5. Andersson I, Ikeda DM, Zackrisson S et al (2008) Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings. Eur Radiol 18:2817–2825

    Article  PubMed  Google Scholar 

  6. Gur D, Abrams GS, Chough DM et al (2009) Digital breast tomosynthesis: observer performance study. AJR Am J Roentgenol 193:586–591

    Article  PubMed  Google Scholar 

  7. Teertstra HJ, Loo CE, van den Bosch MAAJ et al (2010) Breast tomosynthesis in clinical practice. Eur Radiol 20:16–24

    Article  PubMed  Google Scholar 

  8. Gennaro G, Toledano A, di Maggio C et al (2010) Digital breast tomosynthesis versus digital mammography: a clinical performance study. Eur Radiol 20:1545–1553

    Article  PubMed  Google Scholar 

  9. Svahn TM, Chakraborty DP, Ikeda D, Zackrisson S, Do Y, Mattsson S, Andersson I. Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy. Br J Radiol. 2012 Jun 6. [Epub ahead of print] PubMed PMID: 22674710

  10. Wallis MG, Moa E, Zanca F, Leifland K, Danielsson M (2012) Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution x-ray imaging observer study. Radiology 262:788–796

    Article  PubMed  Google Scholar 

  11. Gur D, Bandos AI, Rockette HE et al (2011) Localized detection and classification of abnormalities on FFDM and tomosynthesis examinations rated under an FROC paradigm. Am J Roentgenol 196:737–741

    Article  Google Scholar 

  12. Svahn T, Andersson I, Chakraborty D et al (2010) The diagnostic accuracy of dual-view digital mammography, single-view tomosynthesis and a dual-view combination of breast tomosynthesis and digital mammography in a free-response observer performance study. Radiat Prot Dosim 139:113–117

    Article  CAS  Google Scholar 

  13. Michell MJ, Iqbal A, Wasan RK, Evans DR, Peacock C, Lawinski CP, Douiri A, Wilson R, Whelehan P. A comparison of the accuracy of film-screen mammography, full-field digital mammography and digital breast tomosynthesis. Clin Radiol. 2012 May 23. [Epub ahead of print] PubMed PMID: 22625656

  14. Wu T, Liu B, Moore R, Kopans D (2006) Optimal acquisition techniques for digital breast tomosynthesis screening. In: Flynn MJ, Hsieh J (ed) Medical imaging 2006: physics of medical imaging. Proceedings of SPIE 2006;6142:61425-E

  15. Sechopoulos I, Suryanarayanan S, Vedhantam S, D'Orsi C, Karellas A (2007) Computation of the glandular radiation dose in digital tomosynthesis of the breast. Med Phys 34:232–331

    Google Scholar 

  16. Dance DR, Young KC, van Engen RE (2011) Estimation of mean glandular dose for breast tomosynthesis: factors for use with the UK, European and IAEA breast dosimetry protocols. Phys Med Biol 56:453–471

    Article  PubMed  CAS  Google Scholar 

  17. American College of Radiology (ACR) (2003) Breast imaging reporting and data system Atlas (BI-RADS® Atlas). © American College of Radiology, Reston

    Google Scholar 

  18. Pesce LL, Metz CE (2007) Reliable and computationally efficient maximum likelihood estimation of “proper” binormal ROC curves. Acad Radiol 14:814–829

    Article  PubMed  Google Scholar 

  19. Obuchowski NA (2007) New methodological tools for multiple-reader ROC studies. Radiology 243:10–12

    Article  PubMed  Google Scholar 

  20. Obuchowski NA (1995) Multireader, multimodality receiver operating characteristic curve studies: hypothesis testing and sample size estimation using an analysis of variance approach with dependent observations. Acad Radiol 2:S22–S29

    Article  PubMed  Google Scholar 

  21. Obuchowski NA (1997) Testing for equivalence of diagnostic tests. AJR Am J Roentgenol 168:13–17

    PubMed  CAS  Google Scholar 

  22. Hillis SL (2007) A comparison of denominator degrees of freedom methods for multiple observer ROC analysis. Stat Med 26:596–619

    Article  PubMed  Google Scholar 

  23. Pater C (2004) Equivalence and noninferiority trials–are they viable alternatives for registration of new drugs ? (III). Curr Control Trials Cardiovasc Med 5:8–14

    Article  PubMed  Google Scholar 

  24. Vecchio S, Albanese A, Vignoli P, Taibi A (2011) A novel approach to digital breast tomosynthesis for simultaneous acquisition of 2D and 3D images. Eur Radiol 21:1207–1213

    Article  PubMed  Google Scholar 

  25. Spangler ML, Zuley ML, Sumkin JH et al (2010) Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol 196:320–324

    Article  Google Scholar 

  26. Kopans D, Gavenonis S, Halpern E, Moore R (2011) Calcifications in the breast and digital breast tomosynthesis. Breast J 6:638–644

    Article  Google Scholar 

  27. Chakrabarti K, Ochs R, Pennello G, Samuelson F. P080003 Hologic Selenia dimension 3D system. FDA executive summary September 2010, http://www.fda.gov.downloads.AdvisoryCommittees/CommitteesMeetingMaterial/MedicalDevices/MedicalDevicesAdvisoryCommittee/RadiologicalDevicesPanel/UCM226757.pdf. Accessed July 3, 2011

  28. Gur D, Bandos AI, Cohen CS et al (2008) The “laboratory” effect: comparing radiologists’ performance and variability during prospective clinical and laboratory mammography interpretations. Radiology 249:47–53

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank L. Katz, F. Braga, L. Hernandez, H. Souchay, R. Iordache, A. Talaverano and Sylvain Bernard from GE Healthcare for helpful discussion and scientific debate. They are also grateful to Andrea Azzalini for his help in figure preparation.

R. Edward Hendrick and Patricia Ruppel are consultants to GE Healthcare.

Author information

Authors and Affiliations

  1. Veneto Institute of Oncology (IOV)–IRCCS, via Gattamelata 64, 35128, Padua, Italy

    Gisella Gennaro, Luigi Pescarini, Ilaria Polico, Alessandro Proietti, Enrica Baldan, Elisabetta Bezzon, Fabio Pomerri & Pier Carlo Muzzio

  2. Department of Radiology, University of Colorado-Denver, School of Medicine, 12700 E. 19th Avenue, Mail Stop C278, Aurora, CO, 80045, USA

    R. Edward Hendrick

  3. Innovative Analytics, 161 E. Michigan Ave, Kalamazoo, MI, 49007, USA

    Patricia Ruppel

  4. Private Clinical Practice, Gorizia, Italy

    Roberta Chersevani

  5. Private Clinical Practice, Padua, Italy

    Cosimo di Maggio

  6. Oncological Reference Center (CRO)–IRCCS, Aviano, (Pordenone), Italy

    Manuela La Grassa

Authors
  1. Gisella Gennaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Edward Hendrick
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patricia Ruppel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roberta Chersevani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cosimo di Maggio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manuela La Grassa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Luigi Pescarini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ilaria Polico
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alessandro Proietti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Enrica Baldan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Elisabetta Bezzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Fabio Pomerri
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Pier Carlo Muzzio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gisella Gennaro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gennaro, G., Hendrick, R.E., Ruppel, P. et al. Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography. Eur Radiol 23, 664–672 (2013). https://doi.org/10.1007/s00330-012-2649-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-012-2649-1

Keywords

Search

Navigation