Medical School, Shacolas Educational Centre for Clinical Medicine, Palaios dromos Lefkosias Lemesou, University of Cyprus, Aglantzia, Nicosia, Cyprus.
Bank of Cyprus Oncology Centre, Strovolos, Nicosia, Cyprus.
PLoS One. 2021 Sep 29;16(9):e0256514. doi: 10.1371/journal.pone.0256514. eCollection 2021.
Limited work has been performed for the implementation of digital breast tomosynthesis (DBT) in breast cancer surveillance imaging. The aim of this study was to investigate the differences between two different DBT implementations in breast cancer surveillance imaging, for patients with a personal history of breast cancer.
The DBT implementations investigated were: (1) 2-view 2D digital mammography and 2-view DBT (2vDM&2vDBT) (2) 1-view (cranial-caudal) DM and 1-view (mediolateral-oblique) DBT (1vDM&1vDBT). Clinical performance of these two implementations was assessed retrospectively using observer studies with 118 sets of real patient images, from a single imaging centre, and six observers. Sensitivity, specificity and area under the curve (AUC) using the Jack-knife alternative free-response receiver operating characteristics (JAFROC) analysis were evaluated.
Results suggest that the two DBT implementations are not significantly different in terms of sensitivity, specificity and AUC. When looking at the two main different lesion types, non-calcifications and calcifications, and two different density levels, no difference in the performance of the two DBT implementations was found.
Since 1vDM&1vDBT exposes the patient to half the dose of 2vDM&2vDBT, it might be worth considering 1vDM&1vDBT in breast cancer surveillance imaging. However, larger studies are required to conclude on this matter.
在乳腺癌监测成像中实施数字乳腺断层合成（DBT）的工作有限。本研究的目的是研究两种不同的 DBT 在乳腺癌监测成像中的实施情况，这些实施情况针对的是有乳腺癌个人病史的患者。
研究的 DBT 实施情况为：（1）2 视图 2D 数字乳腺摄影和 2 视图 DBT（2vDM&2vDBT）（2）1 视图（颅尾）DM 和 1 视图（内外斜）DBT（1vDM&1vDBT）。使用来自单个成像中心的 118 组真实患者图像进行了观察者研究，评估了这两种实施的临床性能，有六位观察者参与。使用 Jack-knife 替代自由响应接收器操作特性（JAFROC）分析评估了敏感性、特异性和曲线下面积（AUC）。
结果表明，这两种 DBT 实施在敏感性、特异性和 AUC 方面没有显著差异。当观察两种主要的不同病变类型（非钙化和钙化）和两种不同的密度水平时，没有发现两种 DBT 实施性能的差异。
由于 1vDM&1vDBT 使患者暴露于 2vDM&2vDBT 剂量的一半，因此在乳腺癌监测成像中考虑 1vDM&1vDBT 可能是值得的。然而，需要进行更大规模的研究来对此事得出结论。
