Schulz-Wendtland R, Dilbat G, Bani M R, Lux M P, Meier-Meitinger M, Wenkel E, Schwab S, Beckmann M W, Uder M, Adamietz B
Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen.
Radiological Practice Roth and Weissenburg, Roth.
Geburtshilfe Frauenheilkd. 2011 Dec;71(12):1080-1084. doi: 10.1055/s-0031-1280427.
A prospective clinical study was done to see whether it is possible to reduce the rate of re-excisions using digital breast tomosynthesis (DBT) compared commercial FFDM. Between 1/2011 and 5/2011 we diagnosed an invasive breast cancer (BI-RADS 5) in 100 patients. After histological verification we performed breast-conserving therapy with intraoperative imaging using one of 2 different systems: 1. Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, Tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm, range: 50°, 25 projections, time for scanning > 20 s, geometry: same scanning scope, reconstruction: filtered back projection; or 2. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm as the standard. The 100 radiograms obtained with both systems were prospectively shown on a monitor to 3 radiologists. Out of a total of 100 patients with histologically proven breast cancer (BI-RADS 6) no re-excision was necessary in 78 patients. A retrospective analysis (n = 22) demonstrated an increase in sensitivity of tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e., in 8 patients re-excision would not have been necessary with tomosynthesis. Tomosynthesis has a significant higher sensitivity (p < 0.05) compared with a commercial FFDM system. Studies with higher numbers of patients will be necessary to evaluate this method.
开展了一项前瞻性临床研究，以观察与传统平板数字乳腺摄影（FFDM）相比，使用数字乳腺断层合成（DBT）是否有可能降低再次切除率。在2011年1月至2011年5月期间，我们诊断出100例浸润性乳腺癌（BI-RADS 5级）患者。经组织学验证后，我们使用以下两种不同系统之一进行了术中成像的保乳治疗：1. 断层合成系统（西门子，德国埃尔朗根），非晶硒，钨靶，焦点0.1毫米，分辨率85微米，像素间距8线对/毫米，范围：50°，25个投影，扫描时间>20秒，几何结构：相同扫描范围，重建方式：滤波反投影；或2. Inspiration™（西门子，德国埃尔朗根），非晶硒，钨靶，焦点0.1毫米，分辨率85微米，像素间距8线对/毫米作为标准。用这两种系统获得的100幅乳腺X线照片被前瞻性地展示给3位放射科医生看。在总共100例经组织学证实为乳腺癌（BI-RADS 6级）的患者中，78例患者无需再次切除。一项回顾性分析（n = 22）表明，在1.0:1.0的放大倍数下，断层合成系统的敏感性比Inspiration™提高了8%（p < 0.05），即使用断层合成系统时，8例患者本无需再次切除。与传统FFDM系统相比，断层合成系统具有显著更高的敏感性（p < 0.05）。需要开展更多患者的研究来评估这种方法。
