Skip to main content

Advertisement

SpringerLink
Log in

Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for benign and malignant lesions in breasts.

Methods

Document retrieval was conducted on PubMed, EMBASE, the Cochrane Library, Web of Science and Chinese Biomedical Literature Database, etc., from 1950 to June 2013. Metadisc1.4 software was used to analyse the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratio. The heterogeneity was assessed using forest plots and the inconsistency index (I2). Before statistical comparison, the area under (AUC) the summary receiver-operating characteristic curve (SROC) of two different diagnostic methods was calculated respectively.

Results

A total of seven studies involving 2,014 patients and 2,666 breast lesions were included. Compared with the gold standard (histological results), the pooled sensitivity and specificity of DBT were 90.0 % and 79.0 %, and for DM they were 89.0 % and 72.0 %, respectively. The pooled positive likelihood ratio of DBT and DM was 3.50 and 2.83; the pooled negative likelihood ratio of DBT and DM was 15 % and 18 %; the pooled DOR for DBT and DM was 26.04 and 16.24, respectively.

Conclusions

Digital breast tomosynthesis has a higher sensitivity and specificity in breast diagnosis than digital mammography.

Key Points

• Digital breast tomosynthesis has high sensitivity and specificity in breast diagnosis.

• DBT appears to have superior diagnostic accuracy relative to digital mammography.

• DBT images were captured at a lower dose than 2D images.

• DBT displays abnormal features of lesions more clearly than DM.

• Digital breast tomosynthesis could become the first choice for assessing breast lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

DBT:

Digital breast tomosynthesis

DM:

Full field digital mammography

DOR:

Diagnostic odds ratio

SROC:

Summary receiver-operating characteristic curve

AUC:

Area under the curve

SEN:

Sensitivity

SPE:

Specificity

LR:

Likelihood ratio

CI:

Confidence interval

CC:

Cranio-caudal

MLO:

Medio-lateral oblique

References

  1. Breast Cancer (2009) Breast Cancer in Young Women WebMD. Retrieved 9 September 2009. Available from www.webmd.com/breast-cancer/guide/breast-cancer-young-women

  2. Chow LW, Yip AY, Ng EL (2012) Prevention of oncological diseases: primary and secondary prevention. Int J Biol Markers 27:e337–e343

    Article  PubMed  Google Scholar 

  3. Andersson I, Ikeda DM, Zackrisson S et al (2008) Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings. Eur Radiol 18:2817–2825

    Article  PubMed  Google Scholar 

  4. Skaane P, Gullien R, Bjorndal H et al (2012) Digital breast tomosynthesis (DBT): initial experience in a clinical setting. Acta Radiol 53:524–529

    Article  PubMed  Google Scholar 

  5. Hakim CM, Chough DM, Ganott MA, Sumkin JH, Zuley ML, Gur D (2010) Digital breast tomosynthesis in the diagnostic environment: A subjective side-by-side review. Am J Roentgenol 195:5

    Article  Google Scholar 

  6. Gennaro G, Toledano A, di Maggio C et al (2010) Digital breast tomosynthesis versus digital mammography: a clinical performance study. Eur Radiol 20:1545–1553

    Article  PubMed  Google Scholar 

  7. Park JM, Franken EA Jr, Garg M, Fajardo LL, Niklason LT (2007) Breast tomosynthesis: present considerations and future applications. Radiogr Suppl 1:S231–S240

    Article  Google Scholar 

  8. Thibault F, Dromain C et al (2013) Digital breast tomosynthesis versus mammography and breast ultrasound: a multireader performance study. Eur Radiol. doi:10.1007/s00330-013-2863-5

    PubMed  Google Scholar 

  9. Teertstra HJ, Loo CE, van den Bosch MA et al (2010) Breast tomosynthesis in clinical practice: initial results. Eur Radiol 20:16–24

    Article  PubMed  Google Scholar 

  10. Tagliafico A, Astengo D, Cavagnetto F, Calabrese M et al (2012) One-to-one comparison between digital spot compression view and digital breast tomosynthesis. Eur Radiol 22:539–544

    Article  PubMed  Google Scholar 

  11. Chan HP, Wei J, Zhang Y et al (2008) Computer-aided detection of masses in digital tomosynthesis mammography: comparison of three approaches. Med Phys 35:4087–4095

    Article  PubMed  Google Scholar 

  12. Good WF, Abrams GS, Catullo VJ et al (2008) Digital breast tomosynthesis: a pilot observer study. Am J Roentgenol 190:865–869

    Article  Google Scholar 

  13. Hackshaw AK, Law MR, Wald NJ (1997) The accumulated evidence on lung cancer and environmental tobacco smoke. BMJ Brit Med J 315:980–988

    Article  CAS  Google Scholar 

  14. Tian JH (2010) Systematic review of Diagnosis text accuracy. In: Yang KH (ed) System evaluation Guideline. People's Medical Publishing House, Beijin, pp 191–195

    Google Scholar 

  15. Whiting PF, Rutjes AW, Westwood ME et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536

    Article  PubMed  Google Scholar 

  16. Zhang TS, Zhong WZ (2008) Meta-DiSc software in meta-analysis of diagnostic test. J Evid Based Med 8:97–108

    Google Scholar 

  17. Leeflang MM, Deeks JJ, Gatsonis C, Bossuyt PM (2008) Systematic reviews of diagnostic test accuracy. Ann Intern Med 149:889–897

    Article  PubMed Central  PubMed  Google Scholar 

  18. Zamora J, Abraira V, Muriel A, Khan K, Coomarasamy A (2006) Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol 6:31

    Article  PubMed Central  PubMed  Google Scholar 

  19. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ Brit Med J 327:557–560

    Article  Google Scholar 

  20. Bowden J, Tierney JF et al (2011) Quantifying, displaying and accounting for heterogeneity in the meta-analysis of RCTs using standard and generalised Q statistics. BMC Med Res Methodol 11:41

    Article  PubMed Central  PubMed  Google Scholar 

  21. Liu PL, Tang SS (2011) Contrast enhanced ultrasound and contrast enhanced CT for diagnosis of focal pancreas lesions: a meta-analysis. Chin J Med Image Technol 27:2265–2269

    Google Scholar 

  22. Sterne JA, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54:1046–1055

    Article  CAS  PubMed  Google Scholar 

  23. 23 Higgins JPT, Green S (editors) (2011) Chapter 8: assessing risk of bias in included studies. In: Higgins JPT, Green S (eds) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration. Available from www.cochrane-handbook.org

  24. Gur D, Abrams GS, Chough DM et al (2009) Digital breast tomosynthesis: observer performance study. AJR Am J Roentgenol 193:586–591

    Article  PubMed  Google Scholar 

  25. Michell MJ, Iqbal A, Wasan RK et al (2012) comparison of the accuracy of film-screen mammography, full-field digital mammography, and digital breast tomosynthesis. Clin Radiol 67:976–981

    Article  CAS  PubMed  Google Scholar 

  26. Svahn TM, Chakraborty DP, Ikeda D et al (2012) Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy. Br J Radiol 85:e1074–e1082

    Article  CAS  PubMed  Google Scholar 

  27. Svane G, Azavedo E, Lindman K et al (2011) Clinical experience of photon counting breast tomosynthesis: comparison with traditional mammography. Acta Radiol 52:134–142

    Article  PubMed  Google Scholar 

  28. Tejerina Bernal A, Rabadan Doreste F et al (2012) Breast imaging: how we manage diagnostic technology at a multidisciplinary breast center. J Oncol 2012:213421

    Article  PubMed Central  PubMed  Google Scholar 

  29. Smith A (2005) Full-field breast tomosynthesis. Radiol Manag 27:25–31

    Google Scholar 

  30. Rafferty EA (2007) Digital mammography: novel applications. Radiol Clin N Am 45:831–843, vii

    Article  PubMed  Google Scholar 

  31. Poplack SP, Tosteson TD, Kogel CA, Nagy HM (2007) Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography. AJR Am J Roentgenol 189:616–623

    Article  PubMed  Google Scholar 

  32. Fornvik D, Zackrisson S, Ljungberg O et al (2010) Breast tomosynthesis: Accuracy of tumor measurement compared with digital mammography and ultrasonography. Acta Radiol 51:240–247

    Article  PubMed  Google Scholar 

  33. Spangler ML, Zuley ML, Sumkin JH et al (2011) Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol 196:320–324

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Prof. Jinhui Tian from the Evidence-based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, for his help with the meta-analysis approach and some related statistical software for radiological diagnosis applications used in this study. The other authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China

    Junqiang Lei, Pin Yang, Li Zhang & Yinzhong Wang

  2. Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China

    Junqiang Lei, Pin Yang & Kehu Yang

Authors
  1. Junqiang Lei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pin Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Li Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yinzhong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kehu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kehu Yang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lei, J., Yang, P., Zhang, L. et al. Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis. Eur Radiol 24, 595–602 (2014). https://doi.org/10.1007/s00330-013-3012-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-013-3012-x

Keywords

Search

Navigation