Detection and characterization of breast lesions in a selective diagnostic population: diagnostic accuracy study for comparison between one-view digital breast tomosynthesis and two-view full-field digital mammography

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

Scientific Reports ◽

10.1038/s41598-020-77456-6 ◽

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.

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

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.09.12882 ◽

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

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