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      Visualization of Breast Microcalcifications on Digital Breast Tomosynthesis and 2-Dimensional Digital Mammography Using Specimens

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          Abstract

          PURPOSE

          The purpose of this study is to compare the visibility of microcalcifications of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) using breast specimens.

          MATERIALS AND METHODS

          Thirty-one specimens’ DBT and FFDM were retrospectively reviewed by four readers.

          RESULTS

          The image quality of microcalcifications of DBT was rated as superior or equivalent in 71.0% by reader 1, 67.8% by reader 2, 64.5% by reader 3, and 80.6% by reader 4. The Fleiss kappa statistic for agreement among readers was 0.31.

          CONCLUSIONS

          We suggest that image quality of DBT appears to be comparable with or better than FFDM in terms of revealing microcalcifications.

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          Most cited references36

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          Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program.

          Per Skaane, Andriy Bandos, Randi Gullien … (2013)
          To assess cancer detection rates, false-positive rates before arbitration, positive predictive values for women recalled after arbitration, and the type of cancers detected with use of digital mammography alone and combined with tomosynthesis in a large prospective screening trial.
          Article 0 comments Cited 174 times – based on 0 reviews     Review now
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            Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography.

            H Nagy, Christine Kogel, Tor Tosteson … (2007)
            The purpose of our study was to compare the image quality of tomosynthesis with that of conventional mammography and to estimate the recall rate of screening when tomosynthesis is used in addition to mammography. Women with an abnormal screening mammography were recruited sequentially. Consenting women underwent tomosynthesis of the affected breast corresponding to the views obtained with diagnostic mammography. The study radiologist compared the image quality, including lesion conspicuity and feature analysis, of tomosynthesis with diagnostic film-screen mammography and assessed the need for recall when tomosynthesis was added to digital screening mammography. Screening recalls were considered unnecessary when tomosynthesis did not show a corresponding abnormality or allowed definitely benign lesion characterization. Fisher's exact test was used to determine the association of equivalence and recall status with mammographic finding type. There were 99 digital screening recalls in 98 women. The image quality of tomosynthesis was equivalent (n = 51) or superior (n = 37) to diagnostic mammography in 89% (88/99). Finding type was significantly (p < 0.001) associated with equivalence. Approximately half--52/99 (52%)--of the findings would not have been recalled when digital screening mammography was supplemented with tomosynthesis. When adjusting for confounding conditions, the recall reduction was 40% (37/92). The likelihood of recall was also dependent on finding type (p = 0.004). Subjectively, tomosynthesis has comparable or superior image quality to that of film-screen mammography in the diagnostic setting, and it has the potential to decrease the recall rate when used adjunctively with digital screening mammography.
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              Digital breast tomosynthesis: observer performance study.

              L Perrin, Margarita L. Zuley, Christiane Hakim … (2009)
              The purpose of this study was to compare in a retrospective observer study the diagnostic performance of full-field digital mammography (FFDM) with that of digital breast tomosynthesis. Eight experienced radiologists interpreted images from 125 selected examinations, 35 with verified findings of cancer and 90 with no finding of cancer. The four display conditions included FFDM alone, 11 low-dose projections, reconstructed digital breast tomosynthesis images, and a combined display mode of FFDM and digital breast tomosynthesis images. Observers rated examinations using the screening BI-RADS rating scale and the free-response receiver operating characteristic paradigm. Observer performance levels were measured as the proportion of examinations prompting recall of patients for further diagnostic evaluation. The results were presented in terms of true-positive fraction and false-positive fraction. Performance levels were compared among the acquisitions and reading modes. Time to view and interpret an examination also was evaluated. Use of the combination of digital breast tomosynthesis and FFDM was associated with 30% reduction in recall rate for cancer-free examinations that would have led to recall if FFDM had been used alone (p < 0.0001 for the participating radiologists, p = 0.047 in the context of a generalized population of radiologists). Use of digital breast tomosynthesis alone also tended to reduce recall rates, an average of 10%, although the observed decrease was not statistically significant (p = 0.09 for the participating radiologists). There was no convincing evidence that use of digital breast tomosynthesis alone or in combination with FFDM results in a substantial improvement in sensitivity. Use of digital breast tomosynthesis for breast imaging may result in a substantial decrease in recall rate.
              Article 0 comments Cited 45 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Breast Cancer (Auckl)
                Journal ID (iso-abbrev): Breast Cancer (Auckl)
                Journal ID (publisher-id): Breast Cancer: Basic and Clinical Research
                Title: Breast Cancer : Basic and Clinical Research
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Electronic): 1178-2234
                Publication date Collection: 2017
                Publication date (Electronic): 12 April 2017
                Volume: 11
                Electronic Location Identifier: 1178223417703388
                Affiliations
                Department of Radiology, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
                Author notes
                CORRESPONDING AUTHOR: Jee Eun Lee, Department of Radiology, School of Medicine, Ewha Womans University, 1071, Anyancheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea. Email: jelee77@ 123456ewha.ac.kr
                Article
                Publisher ID: 10.1177_1178223417703388
                DOI: 10.1177/1178223417703388
                PMC ID: 5391988
                SO-VID: bb910596-5641-4bee-a4c8-60db1ab66244
                Copyright © © The Author(s) 2017
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 14 October 2016
                Date accepted : 09 March 2017
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: breast microcalcification,digital breast tomosynthesis,full-field digital mammography
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: breast microcalcification, digital breast tomosynthesis, full-field digital mammography

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