From the Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (X.W.).
Radiology. 2023 Feb;306(2):e213198. doi: 10.1148/radiol.213198. Epub 2022 Sep 27.
Background A new modality, phase-sensitive breast tomosynthesis (PBT), may have similar diagnostic performance to conventional breast tomosynthesis but with a reduced radiation dose. Purpose To perform a pilot study of the performance of a novel PBT system compared with conventional digital breast tomosynthesis (DBT) in patients undergoing additional diagnostic imaging workup for breast lesions. Materials and Methods In a prospective study from June 2020 to March 2021, participants with suspicious breast lesions detected at screening DBT or MRI were recruited for additional PBT imaging before additional diagnostic workup or biopsy. In this pilot study, nine radiologists independently evaluated image quality and assessed the likelihood of lesion malignancy by retrospectively evaluating DBT and PBT images in two separate reading sessions. Image quality was rated subjectively using a Likert scale from 1 to 5. Areas under the receiver operating characteristic curve (AUCs) were used to compare the lesion classification (malignant vs benign) performance of the radiologists. Results Images in 50 patients (mean age, 56 years ± 12 [SD]; 49 women) with 52 evaluable lesions (28 malignant) were assessed. For image appearance and general feature visibility, DBT images had a higher total mean image quality score (3.8) than PBT images (2.9), with < .002 for each comparison. For classification of lesions as benign or malignant, the AUCs were 0.74 for both PBT and DBT. PBT images were acquired at a 24% mean radiation dose reduction (mean, 1.78 mGy vs 2.34 mGy for DBT; < .001). Conclusion The phase-sensitive breast tomosynthesis system had a 24% lower mean radiation dose compared with digital breast tomosynthesis, although with lower image quality. Diagnostic performance of the system remains to be determined in larger studies. © RSNA, 2022 See also the editorial by Gao and Moy in this issue.
背景 一种新的模式，相敏乳腺断层合成术（PBT），可能与传统的乳腺断层合成术具有相似的诊断性能，但辐射剂量降低。目的 对一种新型 PBT 系统与常规数字乳腺断层合成术（DBT）在因乳腺病变而行额外诊断性影像学检查的患者中的性能进行初步研究。材料与方法 在 2020 年 6 月至 2021 年 3 月的前瞻性研究中，招募了在筛查性 DBT 或 MRI 检查中发现可疑乳腺病变的患者，以便在额外的诊断性检查或活检前进行额外的 PBT 成像。在这项初步研究中，9 名放射科医生通过回顾性评估两次独立阅读的 DBT 和 PBT 图像，独立评估图像质量并评估病变恶性的可能性。使用从 1 到 5 的李克特量表对图像质量进行主观评分。受试者工作特征曲线下的面积（AUC）用于比较放射科医生对病变分类（恶性与良性）的性能。结果 在 50 例患者（平均年龄，56 岁±12[标准差]；49 例女性）的 52 个可评估病变（28 个恶性）中评估了图像。对于图像外观和一般特征的可见性，DBT 图像的总体平均图像质量评分（3.8）高于 PBT 图像（2.9），每次比较均 <.002。对于将病变分类为良性或恶性，PBT 和 DBT 的 AUC 均为 0.74。PBT 图像的平均辐射剂量降低了 24%（平均，1.78 mGy 与 DBT 的 2.34 mGy；<.001）。结论 与数字乳腺断层合成术相比，相敏乳腺断层合成系统的平均辐射剂量降低了 24%，尽管图像质量较低。该系统的诊断性能仍需在更大的研究中确定。
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