scholarly journals Multiple Angulated Mammography Reconstructions in Digital Breast Tomosynthesis for the Diagnosis of Microcalcifications – Added Value to Standard Stack Reconstructions and Synthesized Mammography

2018 ◽  
Vol 190 (05) ◽  
pp. 433-440
Author(s):  
Jakob Neubauer ◽  
Claudia Neubauer ◽  
Julia Wicklein ◽  
Thomas Mertelmeier ◽  
Marisa Windfuhr-Blum ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Reading Time ◽  
Digital Breast Tomosynthesis ◽  
Random Order ◽  
Added Value ◽  
Operating Characteristics ◽  
Breast Tomosynthesis ◽  
Signed Rank ◽  
Key Points ◽  
Post Hoc

Purpose To compare ratings regarding the depiction, diagnostic accuracy and lesion characterization of conventional synthesized mammography (SM), multiple angulated mammography reconstructions (INSIGHT3D), and standard stack reconstructions in digital breast tomosynthesis for microcalcifications. Materials and Methods This is a retrospective, multicase, multireader study. We included patients with digital breast tomosynthesis (DBT), microcalcifications and histology over a period of four months in our institution and the same number of normal cases. Three radiologists, who were blinded to patient data, independently rated the depiction, distribution, morphology and BI-RADS score of microcalcifications in SM, INSIGHT3D and standard stack reconstructions. Deidentified images were presented in random order. Reading time was measured. Friedman and post hoc Nemenyi tests, Cochrane’s Q and post hoc Wilcoxon signed rank tests, Fleiss’ kappa and receiver operating characteristics were used for statistical analysis. Results We included 41 histopathologically proven and 41 normal cases. Depiction of microcalcifications was rated better in INSIGHT3D than in SM and better in stack reconstructions than in INSIGHT3D and SM (P < 0.001). The reading time was lower in SM and INSIGHT3D compared to stack reconstructions (P < 0.001). The diagnostic accuracy and inter-rater correlation were comparable between all tested modes of reconstruction. Conclusions INSIGHT3D has higher ratings regarding the depiction of microcalcifications compared to SM while maintaining a short reading time. Our preliminary assessment suggests that INSIGHT3D provides added value to SM. Key points  Citation Format

scholarly journals Impact of artificial intelligence support on accuracy and reading time in breast tomosynthesis image interpretation: a multi-reader multi-case study

2021 ◽  
Author(s):  
Suzanne L. van Winkel ◽  
Alejandro Rodríguez-Ruiz ◽  
Linda Appelman ◽  
Albert Gubern-Mérida ◽  
Nico Karssemeijer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Artificial Intelligence ◽  
Cancer Detection ◽  
Support System ◽  
Reading Time ◽  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Screening Programs ◽  
The Impact

Abstract Objectives Digital breast tomosynthesis (DBT) increases sensitivity of mammography and is increasingly implemented in breast cancer screening. However, the large volume of images increases the risk of reading errors and reading time. This study aims to investigate whether the accuracy of breast radiologists reading wide-angle DBT increases with the aid of an artificial intelligence (AI) support system. Also, the impact on reading time was assessed and the stand-alone performance of the AI system in the detection of malignancies was compared to the average radiologist. Methods A multi-reader multi-case study was performed with 240 bilateral DBT exams (71 breasts with cancer lesions, 70 breasts with benign findings, 339 normal breasts). Exams were interpreted by 18 radiologists, with and without AI support, providing cancer suspicion scores per breast. Using AI support, radiologists were shown examination-based and region-based cancer likelihood scores. Area under the receiver operating characteristic curve (AUC) and reading time per exam were compared between reading conditions using mixed-models analysis of variance. Results On average, the AUC was higher using AI support (0.863 vs 0.833; p = 0.0025). Using AI support, reading time per DBT exam was reduced (p < 0.001) from 41 (95% CI = 39–42 s) to 36 s (95% CI = 35– 37 s). The AUC of the stand-alone AI system was non-inferior to the AUC of the average radiologist (+0.007, p = 0.8115). Conclusions Radiologists improved their cancer detection and reduced reading time when evaluating DBT examinations using an AI reading support system. Key Points • Radiologists improved their cancer detection accuracy in digital breast tomosynthesis (DBT) when using an AI system for support, while simultaneously reducing reading time. • The stand-alone breast cancer detection performance of an AI system is non-inferior to the average performance of radiologists for reading digital breast tomosynthesis exams. • The use of an AI support system could make advanced and more reliable imaging techniques more accessible and could allow for more cost-effective breast screening programs with DBT.

scholarly journals The value of mammography in women with focal breast complaints in addition to initial targeted ultrasound

2020 ◽  
Author(s):  
L. Appelman ◽  
P. T. M. Appelman ◽  
C. C. N. Siebers ◽  
P. Bult ◽  
H. L. S. Go ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Breast Disease ◽  
Added Value ◽  
Breast Tomosynthesis ◽  
Targeted Ultrasound ◽  
Symptomatic Breast Cancer ◽  
Symptomatic Breast

Abstract Purpose To determine the added value of mammography in women with focal breast complaints and the utility of initial targeted ultrasound in this setting. Methods Women with symptomatic breast disease who were evaluated by breast imaging (mammography/digital breast tomosynthesis and ultrasound) between January 2016 and December 2016 in the Radboud University Medical Centre were included. We retrospectively collected the following data: date of birth, indication of imaging, visibility on mammography/ultrasound, whether biopsy was taken, additional findings, BI-RADS-classification, pathology and follow-up results. Results A total of 494 women were included (mean age 46.5, range 30 to 93). In 49 women (9.9%), symptomatic breast cancer was diagnosed, all visible during targeted ultrasound. The negative predictive value of targeted ultrasound was very high (99.8%). Additional findings on mammography were significantly more often malignant when the symptomatic lesion was also malignant (3.8% vs 70%, P < 0.05). In only one patient with symptoms caused by a benign finding, an incidental malignancy was detected on mammography outside the area of complaint (detection rate 2.2/1000 examinations). Conclusions The contribution of mammography for cancer detection in women with focal breast complaints is very low when targeted ultrasound is performed. Additional findings are most common in patients with symptomatic breast cancer. Our results suggest that initial targeted ultrasound is a more appropriate initial tool for the evaluation of focal breast complaints. Mammography could be performed on indication only.

scholarly journals Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 164 ◽  
Author(s):  
Valentina Brancato ◽  
Giuseppe Di Costanzo ◽  
Luca Basso ◽  
Liberatore Tramontano ◽  
Marta Puglia ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Multiparametric Mri ◽  
Added Value ◽  
Operating Characteristics ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Controversial Topic ◽  
Clinically Significant ◽  
Method Agreement

The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen’s kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy.

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

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