Balta Christiana, Reiser Ingrid, Broeders Mireille J M, Veldkamp Wouter J H, van Engen Ruben E, Sechopoulos Ioannis
Dutch Expert Centre for Screening (LRCB), Nijmegen, The Netherlands.
Radboud University Medical Center, Department of Medical Imaging, Nijmegen, The Netherlands.
J Med Imaging (Bellingham). 2023 Feb;10(Suppl 1):S11915. doi: 10.1117/1.JMI.10.S1.S11915. Epub 2023 Jun 26.
In digital breast tomosynthesis (DBT), radiologists need to review a stack of 20 to 80 tomosynthesis images, depending upon breast size. This causes a significant increase in reading time. However, it is currently unknown whether there is a perceptual benefit to viewing a mass in the 3D tomosynthesis volume. To answer this question, this study investigated whether adjacent lesion-containing planes provide additional information that aids lesion detection for DBT-like and breast CT-like (bCT) images.
Human reader detection performance was determined for low-contrast targets shown in a single tomosynthesis image at the center of the target (2D) or shown in the entire tomosynthesis image stack (3D). Using simulations, targets embedded in simulated breast backgrounds, and images were generated using a DBT-like (50 deg angular range) and a bCT-like (180 deg angular range) imaging geometry. Experiments were conducted with spherical and capsule-shaped targets. Eleven readers reviewed 1600 images in two-alternative forced-choice experiments. The area under the receiver operating characteristic curve (AUC) and reading time were computed for the 2D and 3D reading modes for the DBT and bCT imaging geometries and for both target shapes.
Spherical lesion detection was higher in 2D mode than in 3D, for both DBT- and bCT-like images (DBT: , , ; bCT: , , ), but equivalent for capsule-shaped signals (DBT: , , ; bCT: , , ). Average reading time was up to 134% higher for 3D viewing ().
For the detection of low-contrast lesions, there is no inherent visual perception benefit to reviewing the entire DBT or bCT stack. The findings of this study could have implications for the development of 2D synthetic mammograms: a single synthesized 2D image designed to include all lesions present in the volume might allow readers to maintain detection performance at a significantly reduced reading time.
在数字乳腺断层合成（DBT）中，放射科医生需要根据乳房大小查看20至80张断层合成图像的堆栈。这导致阅读时间显著增加。然而，目前尚不清楚在三维断层合成容积中查看肿块是否有感知上的益处。为了回答这个问题，本研究调查了相邻的含病变平面是否能提供有助于检测DBT类和乳腺CT类（bCT）图像中病变的额外信息。
确定人类读者对在目标中心的单张断层合成图像中显示的低对比度目标（二维）或在整个断层合成图像堆栈中显示的低对比度目标（三维）的检测性能。使用模拟方法，将目标嵌入模拟乳房背景中，并使用DBT类（50度角范围）和bCT类（180度角范围）成像几何结构生成图像。对球形和胶囊形目标进行了实验。11名读者在二选一的强制选择实验中查看了1600张图像。计算了DBT和bCT成像几何结构以及两种目标形状在二维和三维阅读模式下的接收器操作特征曲线（AUC）下的面积和阅读时间。
对于DBT类和bCT类图像，二维模式下球形病变的检测率均高于三维模式（DBT：[具体数值1]，[具体数值2]，[具体数值3]；bCT：[具体数值4]，[具体数值5]，[具体数值6]），但对于胶囊形信号，二者相当（DBT：[具体数值7]，[具体数值8]，[具体数值9]；bCT：[具体数值10]，[具体数值11]，[具体数值12]）。三维查看的平均阅读时间高出多达134%（[具体数值13]）。
对于低对比度病变的检测，查看整个DBT或bCT堆栈并没有内在的视觉感知益处。本研究结果可能对二维合成乳腺X线摄影的发展有影响：一张设计为包含容积中所有病变的单一合成二维图像可能使读者在显著减少阅读时间的情况下保持检测性能。
