Massachusetts General Hospital - Radiology, Avon comprehensive Breast Center, Boston, Massachusetts 02114, USA.
Breast J. 2011 Nov-Dec;17(6):638-44. doi: 10.1111/j.1524-4741.2011.01152.x. Epub 2011 Sep 12.
Our study was to compare the clarity with which calcifications are seen on conventional mammography (CM) with the same calcifications on digital breast tomosynthesis (DBT). We define clarity as the sharpness, contrast, and diagnostic quality by which the calcifications were depicted. In a HIPPA compliant Institutional Review Board approved study, 3,000 women volunteered to have both a screening mammogram and a DBT study. A total of 119 sequential cases with relevant calcifications (not clearly benign) were reviewed. Two board certified, dedicated, breast imaging radiologists reviewed the CM and DBT images in an unblinded paired comparison. Only the mediolateral oblique (MLO) projection was available for the DBT studies. The MLO and craniocaudal projections were reviewed using the 2D images. Window and leveling, and electronic zoom were permitted. Unlimited time was allowed to provide a subjective assessment as too how well the calcifications were seen, from a diagnostic perspective, when the two studies were evaluated side-by-side. In 41.6% of the cases, the readers felt that calcifications were seen with superior clarity on DBT. In 50.4% of the cases, the visibility of calcifications was the same for DBT and CM, and in 8% of the cases, calcifications were seen with greater clarity on CM than DBT. In 92% of the cases, the clarity with which calcifications were seen on DBT was equal to or better than for CM and in almost half, the clarity on DBT was judged to be better than for CM. Our analysis shows that calcifications can be demonstrated with equal or greater clarity on DBT as on CM, thus allowing for comparable, and, perhaps, improved interpretive analysis of detected calcifications.
我们的研究旨在比较传统乳腺 X 线摄影（CM）和数字乳腺断层合成术（DBT）对钙化的显示清晰度。我们将清晰度定义为钙化的清晰度、对比度和诊断质量。在符合 HIPAA 规定的机构审查委员会批准的研究中，3000 名女性自愿接受筛查性乳房 X 线摄影和 DBT 研究。共有 119 例连续存在相关钙化（不能明确为良性）的病例进行了回顾性研究。两名经过认证的、专门从事乳腺成像的放射科医生在未设盲的配对比较中对 CM 和 DBT 图像进行了回顾性分析。DBT 研究仅提供了内外斜位（MLO）投影。MLO 和头尾位（CC）投影使用二维图像进行了回顾性分析。允许调整窗宽和窗位、水平位和电子缩放。在对两侧图像进行并排评估时，允许使用不限时的时间来从诊断角度主观评估钙化的显示清晰度。在 41.6%的病例中，读者认为 DBT 上的钙化显示清晰度更高。在 50.4%的病例中，DBT 和 CM 上钙化的可见度相同，而在 8%的病例中，CM 上钙化的显示清晰度更高。在 92%的病例中，DBT 上钙化的显示清晰度与 CM 相当或更好，几乎有一半的病例认为 DBT 上的清晰度优于 CM。我们的分析表明，DBT 上的钙化可以与 CM 上一样清晰或更清晰地显示，从而可以对检测到的钙化进行可比的、甚至可能更好的解释性分析。
