Replacing single-view mediolateral oblique (MLO) digital mammography (DM) with synthesized mammography (SM) with digital breast tomosynthesis (DBT) images: Comparison of the diagnostic performance and radiation dose with two-view DM with or without MLO-DBT

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• 作者：Hyo-Jin Kang ; M.D.^a ; Jung Min Chang ; M.D^a ; ^b ; ^{imchangjm@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Joongyub Lee ; M.D. ; Ph.D.^c ; Sung Eun Song ; M.D.^a ; Sung Ui Shin ; M.D.^a ; Won Hwa Kim ; M.D.^d ; Min Sun Bae ; M.D.^a ; Woo Kyung Moon ; M.D.^a ; ^b ; ^e
• 关键词：AGD ; average glandular dose ; BCS ; breast conserving surgery ; BI-RADS ; breast imaging reporting and data system ; CC ; cranio-caudal ; DBT ; digital breast tomosynthesis ; DCIS ; ductal carcinoma in situ ; DM ; digital mammography ; FDA ; food and drug administration ; FOM ; figure of merit ; FFDM ; full field digital mammography ; IDC ; invasive ductal carcinoma ; ILC ; invasive lobular carcinoma ; JAFROC ; jackknife alternative ; free-response receiver operator curve ; MLO ; mediolateral oblique ; PACS ; picture archiv
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：85
• 期：11
• 页码：2042-2048
• 全文大小：761 K

文摘

To evaluate the diagnostic performance and radiation dose of single view cranio-caudal (CC) digital mammography (DM) plus mediolateral oblique (MLO) digital breast tomosynthesis (DBT) combined with synthesized mammography (SM) in comparison with two-view DM with or without DBT.

Material and methods

This study was approved by our institutional review board, and informed consent was obtained from 130 women. Paired two-view DM and single MLO-DBT with SM images were acquired, and four independent retrospective reading sessions of different combinations of DM, SM and DBT were performed for the presence of malignant tumors using jackknife alternative free-response receiver operator curve (JAFROC) methods. The diagnostic performances and average glandular dose (AGD) were compared between different combinations of DM, SM and DBT.

Results

Of 159 lesions in 130 patients, 27 were malignant. When using MLO-DBT with SM instead of MLO-DM, a significantly higher sensitivity (P = 0.016) and specificity (P = 0.012) were noted than with two-view DM, and comparable figure of merit (FOM), sensitivity, and specificity to two-view DM with DBT were noted. The mean AGD of CC-DM plus MLO-DBT with SM was 5.78mGy ± 1.06 per patient, which was significantly lower than that with two-view DM with MLO-DBT (8.45mGy ± 1.32; P <0.001) and slightly higher than that with two-view DM (5.30mGy ± 0.63).

Conclusions

The combined use of CC-DM plus MLO-DBT with SM showed higher sensitivity and specificity to two-view DM with a smaller AGD increment and comparable diagnostic performance to that of two-view DM with MLO-DBT with a significantly lower mean AGD.