scholarly journals Diagnostic accuracy of digital breast tomosynthesis in combination with 2D mammography for the characterisation of mammographic abnormalities

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Vithya Visalatchi Sanmugasiva ◽  
Marlina Tanty Ramli Hamid ◽  
Farhana Fadzli ◽  
Faizatul Izza Rozalli ◽  
Chai Hong Yeong ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Asian Population ◽  
Architectural Distortion ◽  
Breast Lesions ◽  
Cross Sectional ◽  
Breast Tomosynthesis ◽  
Full Field

AbstractThis study aims to assess the diagnostic accuracy of digital breast tomosynthesis in combination with full field digital mammography (DBT + FFDM) in the charaterisation of Breast Imaging-reporting and Data System (BI-RADS) category 3, 4 and 5 lesions. Retrospective cross-sectional study of 390 patients with BI-RADS 3, 4 and 5 mammography with available histopathology examination results were recruited from in a single center of a multi-ethnic Asian population. 2 readers independently reported the FFDM and DBT images and classified lesions detected (mass, calcifications, asymmetric density and architectural distortion) based on American College of Radiology-BI-RADS lexicon. Of the 390 patients recruited, 182 malignancies were reported. Positive predictive value (PPV) of cancer was 46.7%. The PPV in BI-RADS 4a, 4b, 4c and 5 were 6.0%, 38.3%, 68.9%, and 93.1%, respectively. Among all the cancers, 76% presented as masses, 4% as calcifications and 20% as asymmetry. An additional of 4% of cancers were detected on ultrasound. The sensitivity, specificity, PPV and NPV of mass lesions detected on DBT + FFDM were 93.8%, 85.1%, 88.8% and 91.5%, respectively. The PPV for calcification is 61.6% and asymmetry is 60.7%. 81.6% of cancer detected were invasive and 13.3% were in-situ type. Our study showed that DBT is proven to be an effective tool in the diagnosis and characterization of breast lesions and supports the current body of literature that states that integrating DBT to FFDM allows good characterization of breast lesions and accurate diagnosis of cancer.

scholarly journals Comparing the diagnostic efficacy of digital breast tomosynthesis with full-field digital mammography using BI-RADS scoring

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Rana M. Naeim ◽  
Rania A. Marouf ◽  
Merhan A. Nasr ◽  
Marwa E. Abd El-Rahman
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Breast Lesions ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Dense Breasts ◽  
Full Field Digital Mammography ◽  
Diagnostic Indices

Abstract Background Mammography has been the mainstay for the detection of breast cancer over decades. It has gradually advanced from screen film to full-field digital mammography. Tomosynthesis has evolved as advanced imaging for early diagnosis of breast lesions with a promising role in both diagnostic and screening settings, particularly in dense and treated breasts. Results This study included 90 female patients according to our inclusion criteria. All patients perform full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and were classified according to breast density and age groups. Breast imaging reporting and data system (BI-RADS) scoring was assigned for each case. This was correlated with the final diagnosis; the diagnostic indices of mammography were a sensitivity of 64.44%, a specificity of 77.78%, a positive predictive value (PPV) 74.63%, a negative predictive value (NPV) of 68.63%, and a diagnostic accuracy of 71.11%. Diagnostic indices of DBT were a sensitivity of 100%, a specificity of 97.77%, PPV 97.78%, NPV 100%, and diagnostic accuracy of 97.7%. In patients with dense breasts American College of Radiology (ACR) (c and d), 61% of cases had changed their BIRADS scoring with the addition of tomosynthesis. Yet, in non-dense breast ACR (a and b), 45% of cases had changed BIRADS scoring with the addition of DBT to FFDM. Conclusion DBT is a promising imaging modality offering better detection and characterization of different breast abnormalities, especially in young females, and those with dense breasts with an increase of sensitivity and specificity than FFDM. This leads to a reduction in the recalled cases, negative biopsies, and assessing the efficacy of therapy as it enables improving detection of breast cancer and different breast lesions not visualized by conventional mammography

scholarly journals Does automated breast ultrasound (ABUS) add to breast tomosynthesis (DBT) in assessment of lesions in dense breasts?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Rania Mohamed Hegazy ◽  
Omnia Mokhtar Nada ◽  
Engy A. Ali
Keyword(s):  
Digital Mammography ◽  
Breast Ultrasound ◽  
Architectural Distortion ◽  
Breast Lesions ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Dense Breasts ◽  
The Masses ◽  
Automated Breast Ultrasound

Abstract Background As mammography has its known limitations in dense breast, additional imaging is usually needed. We aimed to evaluate the role of automated breast ultrasound in addition to tomosynthesis in detection and diagnosis of breast lesions in dense breasts. Seventy patients with dense breasts subjected to full-field digital mammography (FFDM) including digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS). Both studies were evaluated by two experienced radiologists to assess breast composition, mass characterization, asymmetry, calcification, axillary lymphadenopathy, extent of disease (EOD), skin thickening, retraction, architectural distortion, and BIRADS classification. All breast masses were interpreted as above described and then correlated with final pathological diagnosis. Results Study included 70 females presenting with different types of breast lesions. Eighty-two masses were detected: 53 benign (n = 53/82), 29 malignant (n = 29/82). Histopathology of the masses was reached by core biopsy (n = 30), FNAC (n = 14), and excisional biopsy (n = 11). The rest of the masses (n = 27/82) were confirmed by their characteristic sonographic appearances; 20 cases of multiple bilateral anechoic simple cysts, 7 typical fibroadenomas showed stationary course on follow-up. As regards the final BIRADS score given for both modalities, tomosynthesis showed accuracy of 93.1% in characterization of malignant masses with accuracy of 94.3% in benign masses, on the other hand automated ultrasound showed 100% accuracy in characterization of malignant masses with 98.1% accuracy in benign masses. Conclusion Adding ABUS to tomosynthesis has proven a valuable imaging tool for characterization of breast lesions in dense breasts both as screening and diagnostic tool. They proved to be more sensitive and specific than digital mammography alone in showing tissue overlap, tumor characterization, lesion margins, extent, and multiplicity of malignant lesions.

Comparison of Microcalcifications Detection and Characterization in Digital Breast Tomosynthesis (DBT) With Synthesized 2D Mammography (SM) versus DBT with Full-Field Digital Mammography (FFDM)

2021 ◽  
Vol 104 (9) ◽  
pp. 1503-1510
Keyword(s):  
Radiation Dose ◽  
Sensitivity And Specificity ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography

Background: Synthesized 2D mammography (SM) has been invented to help lower the radiation dose by circumventing the need for acquiring full-field digital mammography (FFDM) when digital breast tomosynthesis (DBT) is performed. Prior studies have compared microcalcifications detection and characterization in FFDM with SM or with DBT alone. Only few studies have compared DBT plus SM and DBT plus FFDM. Objective: To determine the performance of DBT with SM versus DBT with FFDM in detection and characterization of microcalcifications. Materials and Methods: Three hundred three paired examinations of 2D plus DBT images in the same session were performed. Fifty-five biopsyproven malignancy, 198 biopsy-proven benign microcalcifications, and 50 randomly selected negative screening studies were retrospectively reviewed by two radiologists. Comparison of sensitivity and specificity between the two modalities were performed. Results: From the 55 malignant microcalcifications, three cases were missed by DBT with FFDM but detected and correctly categorized as malignant by DBT with SM. Only one case of malignant microcalcifications was not detected by DBT with SM, and the present case was also miscategorized as benign by DBT with FFDM. There were no statistically significant differences in both detections (p=0.42), and characterization (p=0.65) of microcalcification between both modalities. In DBT with SM, the sensitivity was higher, and the specificity was lower for both detection and characterization of microcalcification when compared to DBT with FFDM. Conclusion: DBT in combination with SM is comparable to DBT in combination with FFDM for detection and characterization of microcalcifications. Keywords: Synthesized 2D mammography; Full-field digital mammography; Digital breast tomosynthesis; Microcalcifications detection and characterization

scholarly journals Comparison of Digital Breast Tomosynthesis and Digital Mammography for Detection of Breast Cancer in Kuwaiti Women

2018 ◽  
Vol 28 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Akram M. Asbeutah ◽  
Nouralhuda Karmani ◽  
AbdulAziz A. Asbeutah ◽  
Yasmin A. Echreshzadeh ◽  
Abdullah A. AlMajran ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sensitivity And Specificity ◽  
Digital Mammography ◽  
Breast Imaging ◽  
Characteristic Curve ◽  
Digital Breast Tomosynthesis ◽  
Breast Lesions ◽  
Breast Tomosynthesis ◽  
Kappa Test ◽  
Significant Difference

Objective: To investigate the sensitivity and specificity of digital mammography (DM) and digital breast tomosynthesis (DBT) for the detection of breast cancer in comparison to histopathology findings. Subjects and Methods: We included 65 breast lesions in 58 women, each detected by two diagnostic mammography techniques – DM and DBT using Senographe Essential (GE Healthcare, Buc, France) – and subsequently confirmed by histopathology. The Breast Imaging Reporting and Data System was used for characterizing the lesions. Results: The average age of women was 48.3 years (range 26–81 years). There were 34 malignant and 31 benign breast lesions. The sensitivity of DM and DBT was 73.5 and 100%, respectively, while the specificity was 67.7 and 94%, respectively. Receiver operating characteristic curve analysis showed an overall diagnostic advantage of DBT over DM, with a significant difference between DBT and DM (p < 0.001). By performing Cohen’s kappa test, we found that there was a strong level of agreement according to Altman guidelines between DBT and histopathology findings (0.97), but a weak agreement between DM and histopathology findings (0.47). Conclusion: DBT improves the clinical accuracy of mammography by increasing both sensitivity and specificity. We believe that this improvement is due to improved image visibility and quality. These results could be of interest to health care institutions as they may impact their decision on whether to upgrade to DBT not only for diagnosis, but also for screening.

scholarly journals Visual search in breast imaging

2019 ◽  
Vol 92 (1102) ◽  
pp. 20190057 ◽  
Author(s):  
Ziba Gandomkar ◽  
Claudia Mello-Thoms
Keyword(s):  
Visual Search ◽  
Eye Tracking ◽  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Diagnostic Errors ◽  
Digital Breast Tomosynthesis ◽  
Imaging Modalities ◽  
Radiology Workflow ◽  
Breast Tomosynthesis ◽  
The Past

Breast cancer is the most common cancer among females worldwide and large volumes of breast images are produced and interpreted annually. As long as radiologists interpret these images, the diagnostic accuracy will be limited by human factors and both false-positive and false-negative errors might occur. By understanding visual search in breast images, we may be able to identify causes of diagnostic errors, find ways to reduce them, and also provide a better education to radiology residents. Many visual search studies in breast radiology have been devoted to mammography. These studies showed that 70% of missed lesions on mammograms attract radiologists’ visual attention and that a plethora of different reasons, such as satisfaction of search, incorrect background sampling, and incorrect first impression can cause diagnostic errors in the interpretation of mammograms. Recently, highly accurate tools, which rely on both eye-tracking data and the content of the mammogram, have been proposed to provide feedback to the radiologists. Improving these tools and determining the optimal pathway to integrate them in the radiology workflow could be a possible line of future research. Moreover, in the past few years deep learning has led to improving diagnostic accuracy of computerized diagnostic tools and visual search studies will be required to understand how radiologists interact with the prompts from these tools, and to identify the best way to utilize them. Visual search in other breast imaging modalities, such as breast ultrasound and digital breast tomosynthesis, have so far received less attention, probably due to associated complexities of eye-tracking monitoring and analysing the data. For example, in digital breast tomosynthesis, scrolling through the image results in longer trials, adds a new factor to the study’s complexity and makes calculation of gaze parameters more difficult. However, considering the wide utilization of three-dimensional imaging modalities, more visual search studies involving reading stack-view examinations are required in the future. To conclude, in the past few decades visual search studies provided extensive understanding about underlying reasons for diagnostic errors in breast radiology and characterized differences between experts’ and novices’ visual search patterns. Further visual search studies are required to investigate radiologists’ interaction with relatively newer imaging modalities and artificial intelligence tools.

Benefits of digital breast tomosynthesis: A lesion-level analysis

2020 ◽  
pp. 096914132097826
Author(s):  
Tali Amir ◽  
Emily B Ambinder ◽  
Susan C Harvey ◽  
Eniola T Oluyemi ◽  
Mary K Jones ◽  
...  
Keyword(s):  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Architectural Distortion ◽  
Screening Mammogram ◽  
Diagnostic Challenge ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Lesion Type ◽  
Lesion Level ◽  
Screening Mammograms

Objective To compare outcome metrics of digital breast tomosynthesis (DBT) breast cancer screening with full-field digital mammogram (FFDM); specifically, to compare recall rates by the type of recalled finding, and to assess if screening with DBT versus FFDM changes biopsy recommendations and if the likelihood of malignancy varied by lesion type, if detected on DBT or FFDM screening mammogram. Methods The outcomes of 22,055 FFDM and DBT screening mammograms were retrospectively reviewed. The exams were performed at an academic institution between August 2015 and September 2016. Performance of screening with FFDM versus DBT was compared in terms of recall rate and percentage of recalled lesions resulting in a cancer diagnosis, with subset analyses performed for specific mammographic findings. Results The recall rate was 10.6% for FFDM and 8.0% for DBT ( p < 0.001). Architectural distortion was more likely to be recalled on DBT screening than FFDM ( p = 0.002), and was associated with an increased likelihood of malignancy ( p = 0.008). Asymmetries were less likely to be recalled on DBT than FFDM ( p < 0.001) screening mammogram, but more likely to be recommended for biopsy when detected on DBT. Calcifications more frequently required short-term follow-up or biopsy on both DBT and FFDM. Conclusions DBT screening confers an advantage in detection of architectural distortion representing malignancy. Recall rate of asymmetries are reduced with screening DBT, probably due to reduction of tissue superimposition. Calcifications pose a particularly difficult diagnostic challenge for breast imagers, regardless of screening mammogram type.

scholarly journals RADIOLOGICAL TESTS VERSUS PATHOLOGICAL DIAGNOSTICS: COMPLIMENTARY OR ANTAGONISTIC RELATIONSHIP- AN INSTITUTIONAL EXPERIENCE

2021 ◽  
Vol 9 (11) ◽  
pp. 1077-1083
Author(s):  
Indira Sahu ◽  
Suman Ruhela ◽  
Laghuta Verma
Keyword(s):  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Analytical Study ◽  
Data System ◽  
Breast Lesions ◽  
Radiological Findings ◽  
Cross Sectional ◽  
Standard Material ◽  
The Core ◽  
Institutional Experience

Aims & Objective: To determine the yield, reliability and diagnostic accuracy of Breast Imaging Reporting and Data System in evaluation of breast lesions taking histopathology as gold standard. Material and Methods: This cross-sectional, analytical study was conducted at Pathology dept. Of SMSMC Jaipur from June 2019 to June 2020. The data of the core needle biopsies of breast lesions received at the Pathology department which had been also categorized on mammogram, according to the Breast Imaging Reporting and Data System (BI-RADS), were selected for the study. All clinical parameters, the site of the biopsy, the radiological findings, the pathological diagnoses were studied. The concordance between the radiological and pathological results was studied . According to BI-RADS, categories II and III were classified as benign and BI-RADs IV and V as malignant. The breast core biopsies were classified as benign and malignant, according to the diagnosis. Results: A total of 115 patients were included in the study. BI-RADS system for reporting whencompared with histopathology had sensitivity of 93.55%, specificity 68.18%, positive predictive value92.55%, negative predictive value 71.43% and diagnostic accuracy 88.70%. Conclusion: The findings of this study report a high diagnostic accuracy of BI-RADS in the diagnosis ofbreast carcinoma.

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