Veneto Institute of Oncology (IOV)-IRCCS, via Gattamelata 64, 35128 Padua, Italy.
Eur Radiol. 2013 Mar;23(3):664-72. doi: 10.1007/s00330-012-2649-1. Epub 2012 Sep 14.
To determine the performance of combined single-view mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus single-view cranio-caudal (CC) mammography (MX) compared with that of standard two-view digital mammography.
A multi-reader multi-case (MRMC) receiver-operating characteristic (ROC) study was conducted, involving six breast radiologists. Two hundred fifty patients underwent bilateral MX and DBT imaging. MX and DBT images with the adjunct of the CC-MX view from 469 breasts were evaluated and rated independently by six readers. Differences in mean areas under the ROC curves (AUCs), mean sensitivity and mean specificity were analysed by analysis of variance (ANOVA) to assess clinical performance.
The combined technique was found to be non-inferior to standard two-view mammography (MX((CC+MLO))) in mean AUC (difference: +0.021;95 % LCL = -0.011), but was not statistically significant for superiority (P = 0.197). The combined technique had equivalent sensitivity to standard mammography (76.2 % vs. 72.8 %, P = 0.269) and equivalent specificity (84.9 % vs. 83.0 %, P = 0.130). Specificity for benign lesions was significantly higher with the combination of techniques versus mammography (45.6 % vs. 36.8 %, P = 0.002).
In this enriched study population, the combination of single-view MLO tomosynthesis plus single-view CC mammography was non-inferior to that of standard two-view digital mammography in terms of ROC curve area, sensitivity and specificity.
评估单视角斜侧位（MLO）数字乳腺断层合成摄影（DBT）加单视角头尾位（CC）乳腺摄影（MX）联合应用的性能，与标准双视角数字乳腺摄影比较。
采用多读者多病例（MRMC）受试者工作特征（ROC）研究，涉及 6 名乳腺放射科医生。250 例患者行双侧 MX 和 DBT 成像。对 469 个乳房的 MX 和 DBT 图像，以及附加的 CC-MX 视图进行评估，由 6 名读者独立评估和评分。采用方差分析（ANOVA）分析平均 ROC 曲线下面积（AUC）、平均敏感度和平均特异度的差异，以评估临床性能。
联合技术在平均 AUC 方面不劣于标准双视角乳腺摄影（MX((CC+MLO)))（差异：+0.021；95%可信区间下限= -0.011），但无统计学意义（P = 0.197）。联合技术的敏感度与标准乳腺摄影相当（76.2% vs. 72.8%，P = 0.269），特异度相当（84.9% vs. 83.0%，P = 0.130）。联合技术对良性病变的特异度显著高于乳腺摄影（45.6% vs. 36.8%，P = 0.002）。
在这个丰富的研究人群中，单视角 MLO 断层合成摄影加单视角 CC 乳腺摄影的组合在 ROC 曲线面积、敏感度和特异度方面不劣于标准双视角数字乳腺摄影。
