Addition Of Tomosynthesis Research Articles

Comparing the diagnostic efficacy of digital breast tomosynthesis with full-field digital mammography using BI-RADS scoring

BackgroundMammography has been the mainstay for the detection of breast cancer over decades. It has gradually advanced from screen film to full-field digital mammography. Tomosynthesis has evolved as advanced imaging for early diagnosis of breast lesions with a promising role in both diagnostic and screening settings, particularly in dense and treated breasts.ResultsThis study included 90 female patients according to our inclusion criteria. All patients perform full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and were classified according to breast density and age groups. Breast imaging reporting and data system (BI-RADS) scoring was assigned for each case. This was correlated with the final diagnosis; the diagnostic indices of mammography were a sensitivity of 64.44%, a specificity of 77.78%, a positive predictive value (PPV) 74.63%, a negative predictive value (NPV) of 68.63%, and a diagnostic accuracy of 71.11%. Diagnostic indices of DBT were a sensitivity of 100%, a specificity of 97.77%, PPV 97.78%, NPV 100%, and diagnostic accuracy of 97.7%.In patients with dense breasts American College of Radiology (ACR) (c and d), 61% of cases had changed their BIRADS scoring with the addition of tomosynthesis. Yet, in non-dense breast ACR (a and b), 45% of cases had changed BIRADS scoring with the addition of DBT to FFDM.ConclusionDBT is a promising imaging modality offering better detection and characterization of different breast abnormalities, especially in young females, and those with dense breasts with an increase of sensitivity and specificity than FFDM. This leads to a reduction in the recalled cases, negative biopsies, and assessing the efficacy of therapy as it enables improving detection of breast cancer and different breast lesions not visualized by conventional mammography

Utility of tomosynthesis in decreasing skin calcification workup rate

Aim: Tomosynthesis permits some skin calcifications to be identified as such without diagnostic workup. We aim to quantify the reduction in skin calcification workups at our institution after the advent of tomosynthesis. Methods: This study was approved by the Institutional Review Board with waiver of informed consent. We searched the medical record from 3/1/2011 to 3/31/2017 for all cases of screening mammography with the terms “skin” or “dermal” included in the report. We excluded all cases that did not include a recommendation for skin/dermal calcification workup and/or tangential views. Of the included cases, note was made of whether the screening examination was done without or with tomosynthesis. We calculated the percentage of cases recalled for skin calcification workup that were done without and with tomosynthesis. We then compared the percentages using chi-squared to evaluate for significance. Results: 40 cases met the inclusion criteria. 24 cases (60%) were done without tomosynthesis, and 16 (40%) were done with tomosynthesis. There were 132,789 total screening mammograms done, 65,299 (49.2%) without tomosynthesis and 67,490 (50.8%) with tomosynthesis. The percentage of all cases recalled for skin calcification workup done without tomosynthesis was 0.037%, and done with tomosynthesis was 0.024% (chi-square statistic 8587744.4875, p < .00001). Conclusions: We found that since the addition of tomosynthesis to our screening protocol, the recall rate for skin calcification workup has decreased by 35%. However, tomosynthesis did not entirely eliminate the need for skin calcification workup.

Assessing Radiologist Performance Using Combined Digital Mammography and Breast Tomosynthesis Compared with Digital Mammography Alone: Results of a Multicenter, Multireader Trial

To compare radiologists' diagnostic accuracy and recall rates for breast tomosynthesis combined with digital mammography versus digital mammography alone. Institutional review board approval was obtained at each accruing institution. Participating women gave written informed consent. Mediolateral oblique and craniocaudal digital mammographic and tomosynthesis images of both breasts were obtained from 1192 subjects. Two enriched reader studies were performed to compare digital mammography with tomosynthesis against digital mammography alone. Study 1 comprised 312 cases (48 cancer cases) with images read by 12 radiologists; study 2, 312 cases (51 cancer cases) with 15 radiologists. Study 1 readers recorded only that an abnormality requiring recall was present; study 2 readers had additional training and recorded both lesion type and location. Diagnostic accuracy was compared with receiver operating characteristic analysis. Recall rates of noncancer cases, sensitivity, specificity, and positive and negative predictive values determined by analyzing Breast Imaging Reporting and Data System scores were compared for the two methods. Diagnostic accuracy for combined tomosynthesis and digital mammography was superior to that of digital mammography alone. Average difference in area under the curve in study 1 was 7.2% (95% confidence interval [CI]: 3.7%, 10.8%; P < .001) and in study 2 was 6.8% (95% CI: 4.1%, 9.5%; P < .001). All 27 radiologists increased diagnostic accuracy with addition of tomosynthesis. Recall rates for noncancer cases for all readers significantly decreased with addition of tomosynthesis (range, 6%-67%; P < .001 for 25 readers, P < .03 for all readers). Increased sensitivity was largest for invasive cancers: 15% and 22% in studies 1 and 2 versus 3% for in situ cancers in both studies. Addition of tomosynthesis to digital mammography offers the dual benefit of significantly increased diagnostic accuracy and significantly reduced recall rates for noncancer cases. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120674/-/DC1.