Department of Radiologic Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait,
Department of Clinical Radiology, Clinical Breast Imaging Unit, Al-Sabah Hospital, Ministry of Health, Kuwait City, Kuwait.
Med Princ Pract. 2019;28(1):10-15. doi: 10.1159/000495753. Epub 2018 Nov 26.
To investigate the sensitivity and specificity of digital mammography (DM) and digital breast tomosynthesis (DBT) for the detection of breast cancer in comparison to histopathology findings.
We included 65 breast lesions in 58 women, each detected by two diagnostic mammography techniques - DM and DBT using Senographe Essential (GE Healthcare, Buc, France) - and subsequently confirmed by histopathology. The Breast Imaging Reporting and Data System was used for characterizing the lesions.
The average age of women was 48.3 years (range 26-81 years). There were 34 malignant and 31 benign breast lesions. The sensitivity of DM and DBT was 73.5 and 100%, respectively, while the specificity was 67.7 and 94%, respectively. Receiver operating characteristic curve analysis showed an overall diagnostic advantage of DBT over DM, with a significant difference between DBT and DM (p < 0.001). By performing Cohen's kappa test, we found that there was a strong level of agreement according to Altman guidelines between DBT and histopathology findings (0.97), but a weak agreement between DM and histopathology findings (0.47).
DBT improves the clinical accuracy of mammography by increasing both sensitivity and specificity. We believe that this improvement is due to improved image visibility and quality. These results could be of interest to health care institutions as they may impact their decision on whether to upgrade to DBT not only for diagnosis, but also for screening.
通过与组织病理学检查结果进行比较，研究数字乳腺断层摄影术（DBT）和数字乳腺钼靶摄影术（DM）在乳腺癌检测中的敏感性和特异性。
我们纳入了 58 名女性的 65 个乳腺病变，每个病变均通过两种诊断性乳腺 X 线摄影技术（DM 和 DBT）进行检测，所用设备为 Senographe Essential（GE Healthcare，Buc，法国），随后通过组织病理学检查对病变进行了证实。采用乳腺影像报告和数据系统对病变进行了特征描述。
女性的平均年龄为 48.3 岁（26-81 岁）。共有 34 个恶性和 31 个良性乳腺病变。DM 和 DBT 的敏感性分别为 73.5%和 100%，特异性分别为 67.7%和 94%。受试者工作特征曲线分析显示，DBT 的总体诊断优势优于 DM，且差异具有统计学意义（p<0.001）。通过进行 Cohen's kappa 检验，我们发现 DBT 与组织病理学检查结果之间的一致性较强（根据 Altman 指南为 0.97），而 DM 与组织病理学检查结果之间的一致性较弱（0.47）。
DBT 通过提高敏感性和特异性，提高了乳腺 X 线摄影的临床准确性。我们认为这种改善归因于图像可见度和质量的提高。这些结果可能会引起医疗机构的兴趣，因为它们可能会影响医疗机构是否升级到 DBT 进行诊断和筛查的决策。
