Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
Br J Radiol. 2012 Nov;85(1019):e1074-82. doi: 10.1259/bjr/53282892. Epub 2012 Jun 6.
Our aim was to compare the ability of radiologists to detect breast cancers using one-view breast tomosynthesis (BT) and two-view digital mammography (DM) in an enriched population of diseased patients and benign and/or healthy patients.
All participants gave informed consent. The BT and DM examinations were performed with about the same average glandular dose to the breast. The study population comprised patients with subtle signs of malignancy seen on DM and/or ultrasonography. Ground truth was established by pathology, needle biopsy and/or by 1-year follow-up by mammography, which retrospectively resulted in 89 diseased breasts (1 breast per patient) with 95 malignant lesions and 96 healthy or benign breasts. Two experienced radiologists, who were not participants in the study, determined the locations of the malignant lesions. Five radiologists, experienced in mammography, interpreted the cases independently in a free-response study. The data were analysed by the receiver operating characteristic (ROC) and jackknife alternative free-response ROC (JAFROC) methods, regarding both readers and cases as random effects.
The diagnostic accuracy of BT was significantly better than that of DM (JAFROC: p=0.0031, ROC: p=0.0415). The average sensitivity of BT was higher than that of DM (∼90% vs ∼79%; 95% confidence interval of difference: 0.036, 0.108) while the average false-positive fraction was not significantly different (95% confidence interval of difference: -0.117, 0.010).
The diagnostic accuracy of BT was superior to DM in an enriched population.
我们旨在比较在患有疾病的患者以及良性和/或健康患者的丰富人群中，使用单视图乳腺断层合成术（BT）和双视图数字乳腺成像（DM）检测乳腺癌的放射科医生的能力。
所有参与者均给予知情同意。BT 和 DM 检查的乳房腺体平均剂量大致相同。研究人群包括在 DM 和/或超声检查中出现恶性肿瘤可疑迹象的患者。通过病理、针吸活检和/或 1 年的乳腺钼靶随访建立了金标准，回顾性地确定了 89 例患病乳房（每位患者 1 例），其中 95 例为恶性病变，96 例为健康或良性乳房。2 名经验丰富的放射科医生（未参与本研究）确定了恶性病变的位置。5 名经验丰富的乳腺钼靶放射科医生独立进行了自由响应研究。通过受试者工作特征（ROC）和刀切替代自由响应 ROC（JAFROC）方法对数据进行分析，将读者和病例视为随机效应。
BT 的诊断准确性明显优于 DM（JAFROC：p=0.0031，ROC：p=0.0415）。BT 的平均敏感度高于 DM（约 90%比约 79%；差异 95%置信区间：0.036，0.108），而平均假阳性率差异无统计学意义（差异 95%置信区间：-0.117，0.010）。
在丰富的人群中，BT 的诊断准确性优于 DM。
