Romanucci Giovanna, Fornasa Francesca, Caneva Andrea, Rossati Claudia, Mandarà Marta, Tommasini Oscar, Rella Rossella
UOSD Breast Unit ULSS9, Ospedale di Marzana, Piazzale Lambranzi, 1, 37142 Verona, Italy.
Department of Radiology, G. Fracastoro Hospital, 37047 Verona, Italy.
J Imaging. 2023 May 19;9(5):103. doi: 10.3390/jimaging9050103.
to determine the positive predictive value (PPV) of tomosynthesis (DBT)-detected architectural distortions (ADs) and evaluate correlations between AD's imaging characteristics and histopathologic outcomes.
biopsies performed between 2019 and 2021 on ADs were included. Images were interpreted by dedicated breast imaging radiologists. Pathologic results after DBT-vacuum assisted biopsy (DBT-VAB) and core needle biopsy were compared with AD detected by DBT, synthetic2D (synt2D) and ultrasound (US).
US was performed to assess a correlation for ADs in all 123 cases and a US correlation was identified in 12/123 (9.7%) cases, which underwent US-guided core needle biopsy (CNB). The remaining 111/123 (90.2%) ADs were biopsied under DBT guidance. Among the 123 ADs included, 33/123 (26.8%) yielded malignant results. The overall PPV for malignancy was 30.1% (37/123). The imaging-specific PPV for malignancy was 19.2% (5/26) for DBT-only ADs, 28.2% (24/85) for ADs visible on DBT and synth2D mammography and 66.7% (8/12) for ADs with a US correlation with a statistically significant difference among the three groups ( = 0.01).
DBT-only ADs demonstrated a lower PPV of malignancy when compared with syntD mammography, and DBT detected ADs but not low enough to avoid biopsy. As the presence of a US correlate was found to be related with malignancy, it should increase the radiologist's level of suspicion, even when CNB returned a B3 result.
确定断层合成（DBT）检测到的结构扭曲（ADs）的阳性预测值（PPV），并评估ADs的影像特征与组织病理学结果之间的相关性。
纳入2019年至2021年间对ADs进行的活检。图像由专门的乳腺影像放射科医生解读。将DBT真空辅助活检（DBT-VAB）和粗针活检后的病理结果与DBT、合成二维（synt2D）和超声（US）检测到的ADs进行比较。
对所有123例病例中的ADs进行了US检查以评估相关性，其中12/123例（9.7%）发现有US相关性，这些病例接受了US引导下的粗针活检（CNB）。其余111/123例（90.2%）ADs在DBT引导下进行活检。在纳入的123例ADs中，33/123例（26.8%）为恶性结果。恶性肿瘤的总体PPV为30.1%（37/123）。仅DBT检测到的ADs的恶性肿瘤影像特异性PPV为19.2%（5/26），DBT和合成二维乳腺摄影可见的ADs为28.2%（24/85），与US有相关性的ADs为66.7%（8/12），三组之间差异有统计学意义（ = 0.01）。
与合成二维乳腺摄影相比，仅DBT检测到的ADs显示出较低的恶性肿瘤PPV，DBT检测到了ADs，但不足以避免活检。由于发现与US有相关性与恶性肿瘤有关，即使CNB结果为B3，也应提高放射科医生的怀疑程度。
