Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Acad Radiol. 2018 Aug;25(8):973-976. doi: 10.1016/j.acra.2017.12.015. Epub 2018 Feb 1.
This study aims to evaluate the screening performance of digital breast tomosynthesis (DBT) combined with synthesized mammography (SM) vs combined with full-field digital mammography (FFDM).
We retrospectively reviewed all screening studies utilizing FFDM + DBT (n = 7845) and SM + DBT (n = 14,776) between April 1, 2013, and February 15, 2016. Recall rate, biopsy rate, positive predictive value 1 (PPV1), positive predictive value 3 (PPV3), and cancer detection rate (CDR) were compared between the two groups. A generalized linear mixed model specifying the reading radiologist as the random effect and controlling for age was used to compare clinical outcomes between the two groups.
The overall recall rate was significantly lower in the SM + DBT cohort compared to the FFDM + DBT cohort (7.06% vs 7.63%, P = .04). There was no difference in biopsy rate, PPV1, PPV3, or CDR between the two groups.
When DBT is performed for screening, the use of SM rather than acquiring an additional FFDM has no significant effect on biopsy rate, PPV1, PPV3, or CDR. We found a decrease in recall rate in the SM + DBT group, which may be related to the learning curve of interpreting DBT. These findings support the use of SM for patients undergoing screening with DBT.
本研究旨在评估数字乳腺断层合成摄影术（DBT）联合合成乳腺摄影术（SM）与全数字化乳腺摄影术（FFDM）联合的筛查性能。
我们回顾性分析了 2013 年 4 月 1 日至 2016 年 2 月 15 日期间所有使用 FFDM+DBT（n=7845）和 SM+DBT（n=14776）进行筛查的研究。比较两组之间的召回率、活检率、阳性预测值 1（PPV1）、阳性预测值 3（PPV3）和癌症检出率（CDR）。使用指定阅读放射科医师为随机效应并控制年龄的广义线性混合模型来比较两组之间的临床结果。
SM+DBT 组的总体召回率明显低于 FFDM+DBT 组（7.06% vs. 7.63%，P=0.04）。两组间活检率、PPV1、PPV3 或 CDR 无差异。
当 DBT 用于筛查时，使用 SM 而不是获取额外的 FFDM 对活检率、PPV1、PPV3 或 CDR 没有显著影响。我们发现 SM+DBT 组的召回率降低，这可能与解读 DBT 的学习曲线有关。这些发现支持在接受 DBT 筛查的患者中使用 SM。
