scholarly journals Value of Digital Breast Tomosynthesis versus Additional Views for the Assessment of Screen-Detected Abnormalities - a First Analysis

Breast Care ◽  
2017 ◽  
Vol 12 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Sylvia Heywang-Köbrunner ◽  
Alexander Jaensch ◽  
Astrid Hacker ◽  
Sabina Wulz-Horber ◽  
Thomas Mertelmeier ◽  
...  
Keyword(s):  
Digital Breast Tomosynthesis ◽  
Ethics Committee ◽  
Wide Angle ◽  
Breast Tomosynthesis ◽  
Single View ◽  
Extra Information ◽  
Standard Assessment ◽  
Sensitivity Specificity ◽  
Blinded Reader

Background: The purpose of this study was to countercheck the equivalence of single-view digital breast tomosynthesis (DBT) or DBT with additional views (DBT+AV) compared to traditional standard assessment by additional views (AV) in patients with a screen-detected abnormality. Patients and Methods: Patients with a screen-detected abnormality were consecutively invited to obtain 1 single-view wide-angle DBT in addition to the indicated AV. The study was approved by the local ethics committee and by the Federal Office for Radiation Protection. Results: This study is based on 311 lesions in 285 patients with a follow-up of > 2 years and/or biopsy. Counting BI-RADS 0 and 3 as positive calls, the sensitivity/specificity of DBT+AV versus DBT only versus AV only were 96.4/54.3%, 96.4/56.6%, and 90.9/42.2%, respectively. The specificities and BI-RADS classifications differed significantly (p < 0.01). AV appeared unnecessary in 88.8% of the cases. Conclusion: DBT appeared to be at least equivalent to AV for assessing indeterminate screen-detected lesions and could replace AV for most lesions. To obtain the extra information appears possible without increasing the overall radiation dose. Subsequent blinded reader studies are ongoing.

scholarly journals One view or two views for wide-angle tomosynthesis with synthetic mammography in the assessment setting?

2021 ◽  
Author(s):  
Paola Clauser ◽  
Pascal A. T. Baltzer ◽  
Panagiotis Kapetas ◽  
Ramona Woitek ◽  
Michael Weber ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Detection Rate ◽  
Diagnostic Performance ◽  
Digital Breast Tomosynthesis ◽  
Rate Sensitivity ◽  
Breast Lesions ◽  
Wide Angle ◽  
Breast Tomosynthesis ◽  
Lesion Type ◽  
Sensitivity Specificity

Abstract Objectives To evaluate the diagnostic performance in the assessment setting of three protocols: one-view wide-angle digital breast tomosynthesis (WA-DBT) with synthetic mammography (SM), two-view WA-DBT/SM, and two-view digital mammography (DM). Methods Included in this retrospective study were patients who underwent bilateral two-view DM and WA-DBT. SM were reconstructed from the WA-DBT data. The standard of reference was histology and/or 2 years follow-up. Included were 205 women with 179 lesions (89 malignant, 90 benign). Four blinded readers randomly evaluated images to assess density, lesion type, and level of suspicion according to BI-RADS. Three protocols were evaluated: two-view DM, one-view (mediolateral oblique) WA-DBT/SM, and two-view WA-DBT/SM. Detection rate, sensitivity, specificity, and accuracy were calculated and compared using multivariate analysis. Reading time was assessed. Results The detection rate was higher with two-view WA-DBT/SM (p = 0.063). Sensitivity was higher for two-view WA-DBT/SM compared to two-view DM (p = 0.001) and one-view WA-DBT/SM (p = 0.058). No significant differences in specificity were found. Accuracy was higher with both one-view WA-DBT/SM and two-view WA-DBT/SM compared to DM (p = 0.003 and > 0.001, respectively). Accuracy did not differ between one- and two-view WA-DBT/SM. Two-view WA-DBT/SM performed better for masses and asymmetries. Reading times were significantly longer when WA-DBT was evaluated. Conclusions One-view and two-view WA-DBT/SM can achieve a higher diagnostic performance compared to two-view DM. The detection rate and sensitivity were highest with two-view WA-DBT/SM. Two-view WA-DBT/SM appears to be the most appropriate tool for the assessment of breast lesions. Key Points • Detection rate with two-view wide-angle digital breast tomosynthesis (WA-DBT) is significantly higher than with two-view digital mammography in the assessment setting. • Diagnostic accuracy of one-view and two-view WA-DBT with synthetic mammography (SM) in the assessment setting is higher than that of two-view digital mammography. • Compared to one-view WA-DBT with SM, two-view WA-DBT with SM seems to be the most appropriate tool for the assessment of breast lesions.

Use of single-view digital breast tomosynthesis (DBT) and ultrasound vs. additional views and ultrasound for the assessment of screen-detected abnormalities: German multi-reader study

2017 ◽  
Vol 59 (7) ◽  
pp. 782-788 ◽  
Author(s):  
Sylvia H Heywang-Köbrunner ◽  
Astrid Hacker ◽  
Alexander Jänsch ◽  
Ronald Kates ◽  
Sabina Wulz-Horber ◽  
...  
Keyword(s):  
Random Sequence ◽  
Digital Breast Tomosynthesis ◽  
Region Of Interest ◽  
Screening Mammography ◽  
Breast Tomosynthesis ◽  
Single View ◽  
Lower Specificity ◽  
Malignant Lesions ◽  
Tissue Abnormalities

Background Data on the value of digital breast tomosynthesis (DBT) for further assessment of screen-detected lesions are still limited. Purpose To compare screening mammography, single-view DBT and ultrasound-information (TS) vs. screening mammography, additional views and ultrasound-information (AV) for assessment of screen-detected abnormalities. Material and Methods The use of wide-angle DBT for screen-detected, soft-tissue abnormalities requiring additional views was investigated: 241 cases (206 benign and 35 malignant lesions), verified by histology or two-year follow-up, were read by ten readers as TS and as AV sets, yielding 2410 diagnoses for each set. Readings were randomly sequenced. Results The mean interval between readings was nine weeks (random sequence). Evaluation was breast-based. Overall, in terms of area under receiver operating characteristic (AUC; varying degree of suspicion cutoff), TS and AV readings showed similar performance: for TS, AUC was 0.889 (95% confidence interval [CI] = 0.871–0.907) and for AV, AUC was 0.903 (95% CI = 0.886–0.921). TS readings had slightly higher sensitivity than AV readings (96.9% vs. 95.4%) but lower specificity (50% vs. 58.1%) and more variations between reader performance; absolute false negatives (FN) were reduced in 8/16 readers, equal in 5/16, and increased in only 3/16. Conclusion This study broadly confirms previous data showing equivalence of DBT to AV. However, bias against TS may have occurred since the region of interest was not indicated in the TS set as compared to its obvious identification on the AV set by the selected spot views. A key finding is that reader experience with DBT may be more important than so far reported.

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.

Architectural Distortion on Digital Breast Tomosynthesis: Management Algorithm and Pathological Outcome

2020 ◽  
Vol 2 (5) ◽  
pp. 424-435
Author(s):  
Naziya Samreen ◽  
Linda Moy ◽  
Cindy S Lee
Keyword(s):  
Digital Mammography ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Digital Breast Tomosynthesis ◽  
Percutaneous Biopsy ◽  
Architectural Distortion ◽  
Imaging Findings ◽  
Breast Tomosynthesis ◽  
Management Algorithm

Abstract Architectural distortion on digital breast tomosynthesis (DBT) can occur due to benign and malignant causes. With DBT, there is an increase in the detection of architectural distortion compared with 2D digital mammography, and the positive predictive value is high enough to justify tissue sampling when imaging findings are confirmed. Workup involves supplemental DBT views and ultrasound, with subsequent image-guided percutaneous biopsy using the modality on which it is best visualized. If architectural distortion is subtle and/or questionable on diagnostic imaging, MRI may be performed for problem solving, with subsequent biopsy of suspicious findings using MRI or DBT guidance, respectively. If no suspicious findings are noted on MRI, a six-month follow-up DBT may be performed. On pathology, malignant cases are noted in 6.8%–50.7% of the cases, most commonly due to invasive ductal carcinoma, followed by invasive lobular carcinoma. Radial scars are the most common benign cause, with stromal fibrosis and sclerosing adenosis being much less common. As there is an increase in the number of benign pathological outcomes for architectural distortion on DBT compared with 2D digital mammography, concordance should be based on the level of suspicion of imaging findings. As discordant cases have upgrade rates of up to 25%, surgical consultation is recommended for discordant radiologic-pathologic findings.

Synthetic 2-Dimensional Mammography Can Replace Digital Mammography as an Adjunct to Wide-Angle Digital Breast Tomosynthesis

2019 ◽  
Vol 54 (2) ◽  
pp. 83-88 ◽  
Author(s):  
Paola Clauser ◽  
Pascal A.T. Baltzer ◽  
Panagiotis Kapetas ◽  
Ramona Woitek ◽  
Michael Weber ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Wide Angle ◽  
Breast Tomosynthesis

scholarly journals Detection of microcalcification clusters by 2D-mammography and narrow and wide angle digital breast tomosynthesis

2016 ◽  
Author(s):  
Andria Hadjipanteli ◽  
Premkumar Elangovan ◽  
Padraig T. Looney ◽  
Alistair Mackenzie ◽  
Kevin Wells ◽  
...  
Keyword(s):  
Digital Breast Tomosynthesis ◽  
Wide Angle ◽  
Breast Tomosynthesis ◽  
Microcalcification Clusters

Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography

2012 ◽  
Vol 23 (3) ◽  
pp. 664-672 ◽  
Author(s):  
Gisella Gennaro ◽  
R. Edward Hendrick ◽  
Patricia Ruppel ◽  
Roberta Chersevani ◽  
Cosimo di Maggio ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Performance Comparison ◽  
Breast Tomosynthesis ◽  
Single View

Digital breast tomosynthesis M3 category: Reason for recall, management and follow-up

2018 ◽  
Vol 44 (6) ◽  
pp. 904
Author(s):  
Rucha Shukla ◽  
Anita Maria Huws ◽  
Asma Munir ◽  
Helen Williams ◽  
Vummiti Muralikrishnan ◽  
...  
Keyword(s):  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis
Sign in / Sign up

Export Citation Format

Share Document