Clinical implementation of synthesized mammography with digital breast tomosynthesis in a routine clinical practice
- 05.08.2017
- Clinical trial
Erschienen in:
- Verfasst von
- Phoebe E. Freer
- Joanna Riegert
- Laura Eisenmenger
- Dominik Ose
- Nicole Winkler
- Matthew A. Stein
- Gregory J. Stoddard
- Rachel Hess
- Erschienen in
- Breast Cancer Research and Treatment | Ausgabe 2/2017
Abstract
Background
Most published studies evaluating digital breast tomosynthesis (DBT) included a separate 2-dimensional full-field digital mammogram (FFDM) for DBT screening protocols, increasing radiation from screening mammography. Synthesized mammography (SM) creates a 2-dimensional image from the DBT source data, and if used in place of FFDM, it reduces radiation of DBT screening. This study evaluated the implementation of SM + DBT in routine screening practice in terms of recall rates, cancer detection rates (CDR), % of minimal cancers, % of node-positive cancers, and positive predictive values (PPV).
Materials and methods
A multivariate retrospective institutional analysis was performed on 31,979 women who obtained screening mammography (10/2013–12/2015) with cohorts divided by modality (SM + DBT, FFDM + DBT, and FFDM). We adjusted for comparison mammograms, age, breast density, and the interpreting radiologist. Recall type was analyzed for differences (focal asymmetry, asymmetry, masses, calcifications, architectural distortion).
Results
SM + DBT significantly decreased the recall rate compared to FFDM (5.52 vs. 7.83%, p < 0.001) with no differences in overall CDR (p = 0.66), invasive and/or in situ CDR, or percentages of minimal and node-negative cancers. PPV1 significantly increased with SM + DBT relative to FFDM (9.1 vs. 6.2%, p = 0.02). SM + DBT did not differ significantly in recall rate or overall CDR compared to FFDM + DBT. There were statistically significant differences in certain findings recalled by screening modality (e.g., focal asymmetries).
Conclusions
SM + DBT reduces false positives compared to FFDM, while maintaining the CDR and other desirable audit outcome data. SM + DBT is more accurate than FFDM alone, and is a desirable alternative to FFDM + DBT, given the added benefit of radiation reduction.
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- Titel
- Clinical implementation of synthesized mammography with digital breast tomosynthesis in a routine clinical practice
- Verfasst von
-
Phoebe E. Freer
Joanna Riegert
Laura Eisenmenger
Dominik Ose
Nicole Winkler
Matthew A. Stein
Gregory J. Stoddard
Rachel Hess
- Publikationsdatum
- 05.08.2017
- Verlag
- Springer US
- Erschienen in
-
Breast Cancer Research and Treatment / Ausgabe 2/2017
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217 - DOI
- https://doi.org/10.1007/s10549-017-4431-1
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