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Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density

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Abstract

Objectives

To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density.

Methods

MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method.

Results

The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD.

Conclusions

MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD.

Key Points

• DBT has higher diagnostic performance and potential to overcome limitations of DM.

• Dose differences (DBT-DM, ΔAGD) were inversely correlated with breast thickness and density.

• Figure of merit of MLO-DBT/CC-DM was higher than that of two-view DM.

• In dense breasts, MLO-DBT/CC-DM provides better diagnostic performance with a small AGD increase.

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Abbreviations

AGD:

Average glandular dose

CC:

Cranio-caudal

DBT:

Digital breast tomosynthesis

DM:

Digital mammography

FOM:

Figure of merit

JAFROC:

Jack-knife alternative free-response receiver operating characteristic

MLO:

Mediolateral oblique

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Acknowledgments

The scientific guarantor of this publication is Woo Kyung Moon. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This research was supported by the Seoul National University Hospital Research Fund (grant 06-2012-0780), and the Core Medical Device R & D Program (10043122) funded by the Ministry of Trade, Industry & Energy (MOTIE), Korea. The authors would also like to thank Chris Woo, B.A. for his kind assistance in editing this manuscript and appreciate the statistical advice given by the Medical Research Collaborating Centre at Seoul National University Hospital and the Seoul National University College of Medicine. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. This study is retrospective diagnostic study performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul, 100-744, Korea

    Sung Ui Shin, Jung Min Chang, Min Sun Bae, Su Hyun Lee, Nariya Cho, Mirinae Seo, Won Hwa Kim & Woo Kyung Moon

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  1. Sung Ui Shin
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  2. Jung Min Chang
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Correspondence to Jung Min Chang.

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Shin, S.U., Chang, J.M., Bae, M.S. et al. Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density. Eur Radiol 25, 1–8 (2015). https://doi.org/10.1007/s00330-014-3399-z

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  • DOI: https://doi.org/10.1007/s00330-014-3399-z

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