Cornford Eleanor J, Turnbull Anne E, James Jonathan J, Tsang Rachel, Akram Tayeba, Burrell Helen C, Hamilton Lisa J, Tennant Sarah L, Bagnall Mark J, Puri Shama, Ball Graham R, Chen Yan, Jones Vivienne
1 Nottingham Breast Institute, Nottingham University Hospitals, Nottingham, UK.
2 Breast Unit, Royal Derby Hospital, Derby, UK.
Br J Radiol. 2016;89(1058):20150735. doi: 10.1259/bjr.20150735. Epub 2015 Nov 11.
To compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft-tissue mammographic abnormalities.
Women recalled for further assessment of soft-tissue abnormalities were recruited and received standard supplementary views (typically spot compression views) and two-view GE DBT. The added value of DBT in the assessment process was determined by analysing data collected prospectively by radiologists working up the cases. Following anonymization of cases, there was also a retrospective multireader review. The readers first read bilateral standard two-view digital mammography (DM) together with the supplementary mammographic views and gave a combined score for suspicion of malignancy on a five-point scale. The same readers then read bilateral standard two-view DM together with two-view DBT. Pathology data were obtained. Differences were assessed using receiver operating characteristic analysis.
The study population was 342 lesions in 322 patients. The final diagnosis was malignant in 113 cases (33%) and benign/normal in 229 cases (67%). In the prospective analysis, the performance of two-view DM plus DBT was at least equivalent to the performance of two-view DM and standard mammographic supplementary views-the area under the curve (AUC) was 0.946 and 0.922, respectively, which did not reach statistical significance. Similar results were obtained for the retrospective review-AUC was 0.900 (DBT) and 0.873 (supplementary views), which did not reach statistical significance.
The accuracy of GE DBT in the assessment of screen detected soft-tissue abnormalities is equivalent to the use of standard supplementary mammographic views.
The vast majority of evidence relating to the use of DBT has been gathered from research using Hologic equipment. This study provides evidence for the use of the commercially available GE DBT system demonstrating that it is at least equivalent to supplementary mammographic views in the assessment of soft-tissue screen-detected abnormalities.
比较标准补充视图和GE数字乳腺断层合成(DBT)在评估乳腺钼靶软组织异常方面的准确性。
招募因软组织异常需进一步评估的女性,她们接受标准补充视图(通常为点压视图)和双视图GE DBT检查。通过分析处理这些病例的放射科医生前瞻性收集的数据,确定DBT在评估过程中的附加价值。病例匿名化后,还进行了回顾性多读者评估。读者首先阅读双侧标准双视图数字乳腺摄影(DM)及补充乳腺钼靶视图,并以五点量表给出怀疑恶性的综合评分。然后,相同的读者阅读双侧标准双视图DM及双视图DBT。获取病理数据。使用受试者操作特征分析评估差异。
研究人群包括322例患者的342个病灶。最终诊断为恶性113例(33%),良性/正常229例(67%)。在前瞻性分析中,双视图DM加DBT的表现至少与双视图DM和标准乳腺钼靶补充视图相当——曲线下面积(AUC)分别为0.946和0.922,未达到统计学显著性。回顾性评估也得到类似结果——AUC分别为0.900(DBT)和0.873(补充视图),未达到统计学显著性。
GE DBT在评估筛查发现的软组织异常方面的准确性与使用标准乳腺钼靶补充视图相当。
绝大多数关于DBT使用的证据是通过使用Hologic设备的研究收集的。本研究为商用GE DBT系统的使用提供了证据,表明其在评估筛查发现的软组织异常方面至少与乳腺钼靶补充视图相当。