Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Diagnostic Breast Center Göttingen, Göttingen, Germany.
Eur Radiol. 2017 Dec;27(12):5185-5195. doi: 10.1007/s00330-017-4911-z. Epub 2017 Jul 4.
To evaluate the impact of breast density on the diagnostic accuracy of non-contrast cone-beam breast computed tomography (CBBCT) in comparison to mammography for the detection of breast masses.
A retrospective study was conducted from August 2015 to July 2016. Fifty-nine patients (65 breasts, 112 lesions) with BI-RADS, 5th edition 4 or 5 assessment in mammography and/or ultrasound of the breast received an additional non-contrast CBBCT. Independent double blind reading by two radiologists was performed for mammography and CBBCT imaging. Sensitivity, specificity and AUC were compared between the modalities.
Breast lesions were histologically examined in 85 of 112 lesions (76%). The overall sensitivity for CBBCT (reader 1: 91%, reader 2: 88%) was higher than in mammography (both: 68%, p<0.001), and also for the high-density group (p<0.05). The specificity and AUC was higher for mammography in comparison to CBBCT (p<0.05 and p<0.001). The interobserver agreement (ICC) between the readers was 90% (95% CI: 86-93%) for mammography and 87% (95% CI: 82-91%) for CBBCT.
Compared with two-view mammography, non-contrast CBBCT has higher sensitivity, lower specificity, and lower AUC for breast mass detection in both high and low density breasts.
• Overall sensitivity for non-contrast CBBCT ranged between 88%-91%. • Sensitivity was higher for CBBCT than mammography in both density types (p<0.001). • Specificity was higher for mammography than CBBCT in both density types (p<0.05). • AUC was larger for mammography than CBBCT in both density types (p<0.001).
评估乳腺密度对非对比锥形束乳腺计算机断层扫描（CBBCT）在检测乳腺肿块方面的诊断准确性的影响，与乳腺钼靶摄影相比。
本研究为回顾性研究，于 2015 年 8 月至 2016 年 7 月进行。59 例（65 个乳房，112 个病灶）患者乳腺 X 线摄影和/或超声 BI-RADS 第五版评估为 4 或 5 类，行附加非对比 CBBCT 检查。两位放射科医生对乳腺 X 线摄影和 CBBCT 成像进行独立的双盲阅读。比较两种模式的敏感性、特异性和 AUC。
112 个病灶中有 85 个（76%）经组织学检查。CBBCT（读者 1：91%，读者 2：88%）的总体敏感性高于乳腺 X 线摄影（均为 68%，p<0.001），也高于高密度组（p<0.05）。与 CBBCT 相比，乳腺 X 线摄影的特异性和 AUC 更高（p<0.05 和 p<0.001）。两位观察者之间的观察者间一致性（ICC）为乳腺 X 线摄影 90%（95%CI：86-93%），CBBCT 为 87%（95%CI：82-91%）。
与双视图乳腺 X 线摄影相比，非对比 CBBCT 对高、低密乳腺的乳腺肿块检测具有更高的敏感性、更低的特异性和更低的 AUC。
非对比 CBBCT 的总体敏感性在 88%-91%之间。
CBBCT 在两种密度类型中的敏感性均高于乳腺 X 线摄影（均 p<0.001）。
两种密度类型中，乳腺 X 线摄影的特异性均高于 CBBCT（均 p<0.05）。
两种密度类型中，CBBCT 的 AUC 均小于乳腺 X 线摄影（均 p<0.001）。
