Department of Physics, University of Trieste, Via A. Valerio 2, 34127 Trieste, Italy.
Radiology. 2011 Jun;259(3):684-94. doi: 10.1148/radiol.11100745. Epub 2011 Mar 24.
To prospectively evaluate the diagnostic contribution of mammography with synchrotron radiation in patients with questionable or suspicious breast abnormalities identified at combined digital mammography (DM) and ultrasonography (US).
The ethics committee approved this prospective study, and written informed consent was obtained from all patients. Mammography with synchrotron radiation was performed with a phase-detection technique at a synchrotron radiation laboratory. Forty-nine women who met at least one of the inclusion criteria (palpable mass, focal asymmetry, architectural distortion, or equivocal or suspicious mass at DM; none clarified at US) were enrolled. Forty-seven women (mean age, 57.8 years ± 8.8 [standard deviation]; age range, 43-78 years) completed the study protocol, which involved biopsy or follow-up for 1 year as the reference standard. Breast Imaging Reporting and Data System (BI-RADS) scores of 1-3 were considered to indicate a negative result, while scores 4-5 were considered to indicate a positive result. The visibility of breast abnormalities and the glandular parenchymal structure at DM and at mammography with synchrotron radiation was compared by using the Wilcoxon signed rank test.
In 29 of the 31 patients with a final diagnosis of benign entity, mammography with synchrotron radiation yielded BI-RADS scores of 1-3. In 13 of the remaining 16 patients with a final diagnosis of malignancy, mammography with synchrotron radiation yielded BI-RADS scores of 4-5. Therefore, a sensitivity of 81% (13 of 16 patients) and a specificity of 94% (29 of 31 patients) were achieved with use of the described BI-RADS dichotomization system.
These study results suggest that mammography with synchrotron radiation can be used to clarify cases of questionable or suspicious breast abnormalities identified at DM.
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100745/-/DC1.
前瞻性评估数字乳腺摄影术（DM）与超声检查（US）联合检查发现可疑或疑似乳腺异常患者的同步辐射乳腺摄影术的诊断价值。
本研究经伦理委员会批准，所有患者均签署了知情同意书。同步辐射乳腺摄影术在同步辐射实验室中采用相位检测技术进行。纳入至少符合以下一条纳入标准的 49 名女性患者（可触及肿块、局灶性不对称、结构扭曲或 DM 表现为可疑或疑似肿块但 US 检查不明确；无明确诊断）。47 名女性（平均年龄 57.8 岁±8.8[标准差]；年龄范围 43-78 岁）完成了研究方案，以活检或 1 年随访作为参考标准。BI-RADS 评分 1-3 为阴性结果，评分 4-5 为阳性结果。采用 Wilcoxon 符号秩检验比较 DM 与同步辐射乳腺摄影术对乳腺异常和腺实质结构的显示能力。
31 例最终诊断为良性病变的患者中，29 例同步辐射乳腺摄影术的 BI-RADS 评分为 1-3。在其余 16 例最终诊断为恶性病变的患者中，13 例同步辐射乳腺摄影术的 BI-RADS 评分为 4-5。因此，采用上述 BI-RADS 二分法系统，其诊断敏感度为 81%（16 例中的 13 例），特异度为 94%（31 例中的 29 例）。
这些研究结果表明，同步辐射乳腺摄影术可用于明确 DM 检查发现的可疑或疑似乳腺异常。
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100745/-/DC1.
