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Comparison of the diagnostic performance of synthesized two-dimensional mammography and full-field digital mammography alone or in combination with digital breast tomosynthesis

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Abstract

Purpose

To investigate whether digital breast tomosynthesis (DBT) and subsequently generated synthesized mammography (SM) images show a better performance than full-field digital mammography (FFDM) images for diagnosing malignant breast lesions. In addition, the radiation doses for SM using different procedures were compared.

Materials and methods

This prospective study enrolled 212 women (age ≥ 25 years) with clinically suspicious breast lesions. All participants underwent FFDM and DBT with the same breast compression. Finally, 222 lesions were confirmed by pathological analysis. The mammogram results were evaluated according to the BI-RADS criteria and compared with the pathological results. The diagnostic performances, morphological features and average glandular doses (AGDs) were compared.

Results

In total, 141 malignant lesions and 81 benign lesions were confirmed by pathological analysis. The overall AGD showed no significant difference between FFDM and DBT. Compared with 2D imaging, the AUC values of FFDM plus DBT and SM plus DBT were both significantly different overall (P = 0.0002) and remained significantly different in dense breasts (P < 0.0001). In terms of morphologic characteristics, lesions showed similar morphology between FFDM and SM, while the lesion characteristics were discordant from 2D imaging to DBT in 33 lesions in dense breasts.

Conclusions

Compared to FFDM, 2D SM images generated from DBT had significantly improved diagnostic efficacy for detecting malignant breast lesions without increasing radiation doses. This new procedure is useful for characterizing breast lesions, particularly in dense breasts.

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Acknowledgements

We thank all the patients of this study for their participation. We greatly appreciate Li Liu, Xiaojing Zheng, Jian Wu, Danting Hu and Yujiao Jin at Department of Radiology for their excellent assistance.

Funding

Weijun Peng received funding from the National Natural Science Foundation of China (Grant number: 61731008). Yajia Gu received funding from National Key Research and Development Program of China (Grant number: 2016YFC1303003) and Cancer Research Program of National Cancer Center (Grant number: NCC2017A03). Chao You received funding from Shanghai Municipal Health Planning Commission Youth Project (Grant number: 20184Y0010).

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Author notes

  1. Chao You and Yunyan Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Fudan University Cancer Center, Shanghai, People’s Republic of China

    Chao You, Yajia Gu, Qin Xiao, Xigang Shen & Weijun Peng

  2. Department of Oncology, Shanghai Medical College, Fudan University, No 270, Dongan Road, Shanghai, 200032, People’s Republic of China

    Chao You, Yajia Gu, Qin Xiao, Guangyu Liu, Xigang Shen, Wentao Yang & Weijun Peng

  3. Department of Radiology, Shanghai Proton and Heavy Ion Center, Shanghai, 201321, People’s Republic of China

    Yunyan Zhang

  4. Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Guangyu Liu

  5. Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Wentao Yang

Authors
  1. Chao You
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  2. Yunyan Zhang
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  3. Yajia Gu
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  4. Qin Xiao
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  5. Guangyu Liu
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  6. Xigang Shen
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  7. Wentao Yang
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  8. Weijun Peng
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Correspondence to Weijun Peng.

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You, C., Zhang, Y., Gu, Y. et al. Comparison of the diagnostic performance of synthesized two-dimensional mammography and full-field digital mammography alone or in combination with digital breast tomosynthesis. Breast Cancer 27, 47–53 (2020). https://doi.org/10.1007/s12282-019-00992-1

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  • DOI: https://doi.org/10.1007/s12282-019-00992-1

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