Abstract
Mammography is the most basic modality in breast cancer imaging. However, the overlap of breast tissue depicted on conventional two-dimensional mammography (2DMMG) may create significant obstacles to detecting abnormalities, especially in dense or heterogeneously dense breasts. In three-dimensional digital breast tomosynthesis (3DBT), tomographic images of the breast are reconstructed from multiple projections acquired at different angles. It has reported that this technology allows the generation of 3D data, therefore overcoming the limitations of conventional 2DMMG for Western women. We assessed the detectability of lesions by conventional 2DMMG and 3DBT in diagnosis of breast cancer for Japanese women. The subjects were 195 breasts of 99 patients (median age of 48 years, range 34~82 years) that had been pathologically diagnosed with breast cancer from December 20, 2010 through March 31, 2011. Both conventional 2DMMG and 3DBT imaging were performed for all patients. Detectability of lesions was assessed based on differences in category class. Of the affected breasts, 77 (75.5%) had lesions assigned to the same categories by 2DMMG and 3DBT. For 24 (23.5%) lesions, the category increased in 3DBT indicating improvement in diagnostic performance compared to 2DMMG. 3DBT improved diagnostic sensitivity for patients with mass, focal asymmetric density (FAD), and architectural distortion. However, 3DBT was not statistically superior in diagnosis of the presence or absence of calcification. In this study, 3DBT was superior in diagnosing lesions in form of mass, FAD, and/or architectural distortion. 3DBT is a novel technique that may provide a breakthrough in solving the difficulties of diagnosis caused by parenchyma overlap for Japanese women.
Highlights
Mammography is the most basic modality in breast cancer imaging
The overlap of breast tissue depicted on conventional two-dimensional mammography (2DMMG) may create significant obstacles to detecting abnormalities, especially in dense or heterogeneously dense breasts
In three-dimensional digital breast tomosynthesis (3DBT), tomographic images of the breast are reconstructed from multiple projections acquired at different angles
Summary
Mammography is the most basic technique in diagnostic imaging of the breast, despite the various modalities are used (Humpherey et al, 2003). In 3D digital mammography tomosynthesis (3DBT), tomographic images are reconstructed from multiple projections acquired from different angles. This technique allows the generation of 3D data and resolves the problem of tissue overlap. It was reported that the advantage of this technique is to improve the diagnostic accuracy by better visibility of the low contrast features that are hard to depict in conventional 2DMMG due to breast tissue overlap for Western women (Gur, 2007; Park et al, 2007; Michell et al, 2012; Alakhras et al, 2013; Houssami et al, 2013; Skaane et al, 2013; Zuley et al, 2013). We performed a 3DBT study assessing its diagnostic performance for a series of breast cancer patients, making comparison with conventional 2DMMG
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