Choi Woo Jung, Kim Hak Hee, Lee Sun Young, Chae Eun Young, Shin Hee Jung, Cha Joo Hee, Son Byung Ho, Ahn Sei Hyun, Choi Young-Wook
Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Pungnap-2dong, Songpa-Gu, Seoul, 138-736, Korea.
Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Breast Cancer. 2016 Nov;23(6):886-892. doi: 10.1007/s12282-015-0656-1. Epub 2015 Nov 3.
To evaluate interobserver agreement in full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in terms of both lesion detection and characterization, and to evaluate the cancer detection rate of standard two-view FFDM compared to various combinations of DBT.
Thirty-five women (mean age 59.7; range 50-80 years) with 37 breast cancers who underwent both two-view DBT and two-view FFDM were included. DBT images were obtained using an investigational prototype. We performed interobserver agreement analyses using kappa (k) statistics. The cancer detection rate of various combinations of DBT compared to standard two-view FFDM was estimated using a generalized estimation equation.
There was fair to moderate agreement on detectability (k = 0.59-0.62) in both views of FFDM and DBT, while fair to substantial agreement was found for lesion location (k = 0.52-0.84) and fair to moderate agreement for lesion type (k = 0.46-0.70) and BI-RADS final assessment (k = 0.48-0.69). In generalized estimation equations, standard two-view FFDM was inferior to any combination of DBT. The detection rate ratio was significantly higher in the combined four views of DBT and FFDM compared to standard FFDM (p < 0.046).
Our study showed good agreement in lesion detection and characterization between FFDM and DBT images. Our findings also demonstrated that combining DBT and FFDM is superior in detecting cancer compared to standard FFDM.
从病变检测和特征描述两方面评估全视野数字乳腺摄影（FFDM）和数字乳腺断层合成（DBT）中观察者间的一致性，并评估标准双视角FFDM与DBT的各种组合相比的癌症检测率。
纳入35名女性（平均年龄59.7岁；范围50 - 80岁），她们均患有37例乳腺癌，且都接受了双视角DBT和双视角FFDM检查。DBT图像使用研究性原型设备获取。我们使用kappa（k）统计进行观察者间一致性分析。使用广义估计方程估计DBT的各种组合与标准双视角FFDM相比的癌症检测率。
FFDM和DBT的两个视角在可检测性方面（k = 0.59 - 0.62）有中等程度的一致性，而在病变位置方面（k = 0.52 - 0.84）有中等至高度一致性，在病变类型方面（k = 0.46 - 0.70）和乳腺影像报告和数据系统（BI - RADS）最终评估方面（k = 0.48 - 0.69）有中等程度的一致性。在广义估计方程中，标准双视角FFDM不如DBT的任何组合。与标准FFDM相比，DBT和FFDM的四视图联合检测率显著更高（p < 0.046）。
我们的研究表明FFDM和DBT图像在病变检测和特征描述方面有良好的一致性。我们的研究结果还表明，与标准FFDM相比，DBT和FFDM联合在癌症检测方面更具优势。
