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Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts

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Abstract

Objective

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.

Results

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.

Conclusion

Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time.

Key Points

• 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.

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Authors and Affiliations

  1. Department of Health Sciences (DISSAL), Radiology Section, University of Genoa and Emergency Radiology, IRCCS AOU San Martino-IST, Genoa, Italy

    Alberto Stefano Tagliafico, Bianca Bignotti, Alessio Signori, Erica Fisci & Federica Rossi

  2. Emergency Radiology, Policlinico San Martino, Genoa, Italy

    Alberto Stefano Tagliafico

  3. Breast Radiology, Policlinico San Martino, Genoa, Italy

    Massimo Calabrese

  4. Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy

    Francesca Valdora

  5. Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia

    Nehmat Houssami

Authors
  1. Alberto Stefano Tagliafico
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  2. Massimo Calabrese
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  3. Bianca Bignotti
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  4. Alessio Signori
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  5. Erica Fisci
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  6. Federica Rossi
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  7. Francesca Valdora
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  8. Nehmat Houssami
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Corresponding author

Correspondence to Alberto Stefano Tagliafico.

Ethics declarations

Guarantor

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.

Funding

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.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board: the study received institutional review board approval (514REG2014).

Methodology

-Prospective

-Observational

-Performed at one institution

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Tagliafico, A.S., Calabrese, M., Bignotti, B. et al. Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. Eur Radiol 27, 5179–5184 (2017). https://doi.org/10.1007/s00330-017-4918-5

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  • DOI: https://doi.org/10.1007/s00330-017-4918-5

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