European Radiology

, Volume 23, Issue 8, pp 2087–2094

Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

  • Gisella Gennaro
  • R. Edward Hendrick
  • Alicia Toledano
  • Jean R. Paquelet
  • Elisabetta Bezzon
  • Roberta Chersevani
  • Cosimo di Maggio
  • Manuela La Grassa
  • Luigi Pescarini
  • Ilaria Polico
  • Alessandro Proietti
  • Enrica Baldan
  • Fabio Pomerri
  • Pier Carlo Muzzio
Breast

Abstract

Objective

To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization.

Methods

A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography.

Results

The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT(MLO)+MX(CC), was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT(MLO)+MX(CC) was non-inferior to two-view MX for malignant lesions.

Conclusions

This study shows that readers’ capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography.

Key Points

• Digital breast tomosynthesis is becoming adopted as an adjunct to mammography (MX)

DBT(MLO)+MX(CC)is superior to MX(CC+MLO)in lesion detection (overall and benign lesions)

DBT(MLO)+MX(CC)is non-inferior to MX(CC+MLO)in cancer detection

DBT(MLO)+MX(CC)is superior to MX(CC+MLO)in lesion characterization (overall and benign lesions)

DBT(MLO)+MX(CC)is non-inferior to MX(CC+MLO)in characterization of malignant lesions

Keywords

Breast tomosynthesis Mammography Tomography Per lesion analysis Clinical performance 

Abbreviations

ANOVA

analysis of variance

CC

cranio-caudal

DBT

digital breast tomosynthesis

DBT(MLO)+MX(CC)

combination of one-view (MLO) tomosynthesis and one-view (CC) mammography

FROC

free-response receiver operating characteristics

LCF

lesion characterization fraction

LDF

lesion detection fraction

MLO

medio-lateral oblique

MX

standard mammography

MX(CC+MLO)

standard mammography in two views

Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Gisella Gennaro
    • 1
  • R. Edward Hendrick
    • 2
  • Alicia Toledano
    • 3
  • Jean R. Paquelet
    • 4
    • 5
  • Elisabetta Bezzon
    • 1
  • Roberta Chersevani
    • 6
  • Cosimo di Maggio
    • 7
  • Manuela La Grassa
    • 8
  • Luigi Pescarini
    • 1
  • Ilaria Polico
    • 1
  • Alessandro Proietti
    • 1
  • Enrica Baldan
    • 1
  • Fabio Pomerri
    • 1
  • Pier Carlo Muzzio
    • 1
  1. 1.Veneto Institute of Oncology (IRCCS)PaduaItaly
  2. 2.Department of Radiology, School of MedicineUniversity of Colorado-DenverAuroraUSA
  3. 3.Biostatistics Consulting, LLCKensingtonUSA
  4. 4.Advanced Medical Imaging ConsultantsFort CollinsUSA
  5. 5.Breast Imaging, McKee Medical CenterLovelandUSA
  6. 6.Private Medical PracticeGoriziaItaly
  7. 7.Private Medical PracticePaduaItaly
  8. 8.Department of Radiology, Oncological Reference Center (IRCCS)AvianoItaly

Personalised recommendations