Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography
- 1k Downloads
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.
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.
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).
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.
• 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.
KeywordsBreast tomosynthesis Mammography Tomography Clinical performance Receiver-operating characteristics
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.
- 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: 22674710Google 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 139:113–117CrossRefGoogle 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: 22625656Google Scholar
- 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-EGoogle Scholar
- 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 34:232–331Google Scholar
- 17.American College of Radiology (ACR) (2003) Breast imaging reporting and data system Atlas (BI-RADS® Atlas). © American College of Radiology, RestonGoogle 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