Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts
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To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts.
Materials and methods
This is a substudy of the ‘ASTOUND’ trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D.
The median age of the patients was 53 years (range, 36–88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (p<0.001) and a mean reading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other.
Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time.
• Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images
• Double reading using S-2D plus tomosynthesis had the highest global accuracy (p<0.001).
• Double reading of S-2D plus tomosynthesis increased reading time.
KeywordsAccuracy Reading time Digital Breast Tomosynthesis Dense breasts Breast density
Compliance with ethical standards
The scientific guarantor of this publication is Alberto Tagliafico, MD.
Conflict of interest
The authors of this manuscript declare relationships with the following companies:
Alberto Stefano Tagliafico: Honoraria: Esaote-Philips. Patents, Royalties, Other Intellectual
Property: Springer. Travel, Accommodations, Expenses: Hologic, Technologic.
Massimo Calabrese: Travel, Accommodations, Expenses: Hologic, Technologic
The other Authors have nothing to disclose.
The authors state that this work was partially funded through the following sources: A.S.T. receives research support from Associazione Italiana per la Ricerca sul Cancro (IG n.15697) and University of Genoa (PRA 2013). N.H. receives research support from a National Breast Cancer Foundation Australia Breast Cancer Research Leadership Fellowship. F.V. receives research support from Associazione Italiana per la Ricerca sul Cancro (IG n.15697)
Statistics and biometry
The statistical analysis was done entirely by four authors with specific expertise in medical statistics: Prof. Alberto Stefano Tagliafico, Dr. Bianca Bignotti, Prof. Nehmat Houssami and by a professional biostatistician, Dr. Alessio Signori.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board: the study received institutional review board approval (514REG2014).
-Performed at one institution
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