scholarly journals Preoperative Staging in Women with Known Breast Cancer: Comparison between Digital Breast Tomosynthesis (DBT) and Magnetic Resonance Imaging (MRI)

2018 ◽  
Vol 7 (2) ◽  
pp. 33
Author(s):  
Francesca Galati ◽  
Flaminia Marzocca ◽  
Andrea Tancredi ◽  
Emmanuel Collalunga ◽  
Carlo Catalano ◽  
...  

Objectives To prospectively evaluate the accuracy in tumor extent and size assessment of Digital Breast Tomosynthesis (DBT) and Magnetic Resonance Imaging (MRI) in women with known breast cancer, with pathological size as the gold standard. Methods From May 2014 to April 2016, 50 patients with known breast cancer were enrolled in our prospective study. All patients underwent MRI on a 3T magnet and DBT projections. Two radiologists, with 15 and 7 years of experience in breast imaging respectively, evaluated in consensus each imaging set unaware of the final histological examination. MR and DBT sensitivity, PPV and accuracy were calculated, using histology as the gold standard. McNemar test was used to compare MR and DBT sensitivity. Correlation and regression analyses were used to evaluate MRI vs Histology, DBT vs Histology and MRI vs DBT lesions tumor size agreement to histological results. Results On histological examination 70 lesions were detected. MRI showed 100% sensitivity, 96% PPV and 96% accuracy; DBT sensitivity was 81%, PPV 92% and accuracy 77%. McNemar test p-value was 0.0003. Lesions size Pearson correlation coefficient was 0.97 for MRI vs Histology, 0.92 for DBT vs Histology, (p-value<0.0001). MRI vs DBT regression coefficient was 0.83. Conclusions MRI confirmed to be the most accurate imaging technique in preoperative staging of breast cancer. However, DBT showed very good accuracy, sensitivity and tumor size assessment and could be a valid tool for preoperative staging when MRI is contraindicated.

Author(s):  
Janice Hui Ling Goh ◽  
Toh Leong Tan ◽  
Suraya Aziz ◽  
Iqbal Hussain Rizuana

Digital breast tomosynthesis (DBT) is a fairly recent breast imaging technique invented to overcome the challenges of overlapping breast tissue. Ultrasonography (USG) was used as a complementary tool to DBT for the purpose of this study. Nonetheless, breast magnetic resonance imaging (MRI) remains the most sensitive tool to detect breast lesion. The purpose of this study was to evaluate diagnostic performance of DBT, with and without USG, versus breast MRI in correlation to histopathological examination (HPE). This was a retrospective study in a university hospital over a duration of 24 months. Findings were acquired from a formal report and were correlated with HPE. The sensitivity of DBT with or without USG was lower than MRI. However, the accuracy, specificity and PPV were raised with the aid of USG to equivalent or better than MRI. These three modalities showed statistically significant in correlation with HPE (p < 0.005, chi-squared). Generally, DBT alone has lower sensitivity as compared to MRI. However, it is reassuring that DBT + USG could significantly improve diagnostic performance to that comparable to MRI. In conclusion, results of this study are vital to centers which do not have MRI, as complementary ultrasound can accentuate diagnostic performance of DBT.


2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Hongfang Xu ◽  
Wei Zeng ◽  
Zehong Fu ◽  
Qing Cui

Background: Early diagnosis and timely treatment are crucial for breast cancer patients. Objectives: This study aimed to investigate the diagnostic value of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and magnetic resonance imaging (MRI) for breast cancer. Patients and Methods: This study was performed on 210 patients diagnosed with breast cancer and benign breast lesions (n = 105) by FFDM, DBT, MRI, and pathological examination from January 2019 to December 2020. The patients’ imaging and clinical data were retrospectively analyzed. The lesions were evaluated according to the breast imaging-reporting and data system, with pathological diagnosis as the gold standard. The diagnostic efficiency of the examination methods was analyzed by plotting the receiver operating characteristic (ROC) curves. The DBT and MRI results were finally compared. Results: In 210 patients, 105 benign and 105 malignant lesions were detected. The area under the ROC curve (AUC) of FFDM, DBT, MRI, FFDM + DBT, and FFDM + MRI was 0.734, 0.857, 0.883, 0.865, and 0.924, respectively. Based on the results, the AUC values were significantly higher for DBT, MRI, FFDM + DBT, and FFDM + MRI compared to FFDM (P < 0.05), while similar values were reported for the former methods (P > 0.05). The diagnostic sensitivity of MRI was higher than that of DBT and FFDM; the sensitivity of DBT was higher than that of FFDM; and the specificity and positive predictive value were higher for DBT compared to MRI and FFDM. Conclusion: Compared to FFDM, DBT and FFDM + DBT could significantly improve the diagnostic efficiency of breast cancer; the diagnostic efficiency of these modalities was comparable to that of MRI and FFDM + MRI. The sensitivity of DBT was lower than that of MRI and higher than that of FFDM, while its specificity and positive predictive value were higher than those of MRI. Overall, FFDM + DBT and FFDM + MRI are conducive to early diagnosis.


Author(s):  
Mai M. K. Barakat ◽  
Eman K. A. E. Mohamed ◽  
Lobna A. E. Habib ◽  
Mortada Elsayed Ahmed

Abstract Background Digital breast tomosynthesis with complementary ultrasound is a powerful imaging modality in detection of breast cancer. Magnetic resonance imaging has many limitations due to its low specificity multiple pitfalls especially signal-to-noise ratio, as well as the spatial resolution. Our purpose of the study is to evaluate the role of digital breast tomosynthesis with complementary ultrasound compared to magnetic resonance imaging in the assessment of postoperative changes and locoregional recurrence of breast cancer. Results Our prospective study included thirty women who underwent conservative breast surgery. Digital breast tomosynthesis with complementary ultrasound revealed greater specificity (95.2%) than Magnetic resonance imaging (90.5%) in the detection of locoregional recurrence of breast cancer. On the other hand, it revealed the same sensitivity (88.9%). Subsequently, digital breast tomosynthesis with complementary ultrasound showed higher accuracy (93.3%) and higher positive predictive value (88.9%) than magnetic resonance imaging (90%), (80%), respectively. However, both of them revealed a comparable negative predictive value (95%). Conclusion Digital breast tomosynthesis with complementary ultrasound is a powerful imaging modality that can be used to detect any recurrence in patients who are surgically treated for breast cancer with higher specificity, accuracy than magnetic resonance imaging. Additionally, the use of these modalities enhances the diagnosis of surgically treated breast cancer for early detection of recurrence.


Author(s):  
Mariam Raafat ◽  
Soha H. Talaat ◽  
Salma M. Abdelghaffar ◽  
Engy A. Ali

Abstract Background Endometriosis is a common gynecologic disorder characterized by the implantation of the endometrial tissue ectopically outside the endometrial cavity. It affects about 10% of females at the childbearing period and is estimated to be present up to 20–50% in women complaining of infertility. While laparoscopy is considered the mainstay for diagnosis, magnetic resonance imaging (MRI) is recognized as a useful tool for definitive diagnosis, pre-surgical planning, and determining whether the patient will require multi-specialty involvement. The aim of this study is to evaluate the performance of MRI with the addition of diffusion-weighted imaging (DWI) and T2 star (T2*) to conventional MRI, for the accurate assessment of ectopic endometrium. Results Endometriotic lesions that showed diffusion restriction on DWI were 80.7%, and 96.1% of the endometriotic lesions had signal voids on the T2*W sequence, whereas only 65.4% of the lesions had typical signal intensities on T1WI and T2WI. Diagnostic performance of the MRI examination was improved by the use of the diffusion sequence and better improved by the T2* sequence, compared to the conventional MR protocol sensitivity (SE) = 96.12% and specificity (SP) = 85.7% in T2*-weighted images, SE = 80.7% and SP = 71.4% in DWI, and SE = 65.4% and SP = 71.4% in conventional MRI. P value for conventional MRI was 0.1, which is of no statistical significance (p < 0.05). P value for DWI was 0.016, which is statistically significant (p < 0.05). P value for T2*WI was 0.001, which is more statistically significant (p < 0.05) and could be adequately correlated with laparoscopy. Conclusion DWI and T2* significantly increase MRI diagnostic accuracy by allowing the detection of the hemorrhagic character of the endometriotic lesions. Studies with a large sample size are needed to confirm that they can replace invasive laparoscopy for the diagnosis of endometriosis.


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