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Portrait of Sophia Zackrisson. Photo

Sophia Zackrisson

Research group manager, Principal investigator, Professor, MD

Portrait of Sophia Zackrisson. Photo

One-view digital breast tomosynthesis as a stand-alone modality for breast cancer detection : do we need more?

Author

  • Alejandro Rodriguez-Ruiz
  • Albert Gubern-Merida
  • Mechli Imhof-Tas
  • Susanne Lardenoije
  • Alexander J.T. Wanders
  • Ingvar Andersson
  • Sophia Zackrisson
  • Kristina Lång
  • Magnus Dustler
  • Nico Karssemeijer
  • Ritse M. Mann
  • Ioannis Sechopoulos

Summary, in English

Purpose: To compare the performance of one-view digital breast tomosynthesis (1v-DBT) to that of three other protocols combining DBT and mammography (DM) for breast cancer detection. Materials and methods: Six radiologists, three experienced with 1v-DBT in screening, retrospectively reviewed 181 cases (76 malignant, 50 benign, 55 normal) in two sessions. First, they scored sequentially: 1v-DBT (medio-lateral oblique, MLO), 1v-DBT (MLO) + 1v-DM (cranio-caudal, CC) and two-view DM + DBT (2v-DM+2v-DBT). The second session involved only 2v-DM. Lesions were scored using BI-RADS® and level of suspiciousness (1–10). Sensitivity, specificity, receiver operating characteristic (ROC) and jack-knife alternative free-response ROC (JAFROC) were computed. Results: On average, 1v-DBT was non-inferior to any of the other protocols in terms of JAFROC figure-of-merit, area under ROC curve, sensitivity or specificity (p>0.391). While readers inexperienced with 1v-DBT screening improved their sensitivity when adding more images (69–79 %, p=0.019), experienced readers showed similar sensitivity (76 %) and specificity (70 %) between 1v-DBT and 2v-DM+2v-DBT (p=0.482). Subanalysis by lesion type and breast density showed no difference among modalities. Conclusion: Detection performance with 1v-DBT is not statistically inferior to 2v-DM or to 2v-DM+2v-DBT; its use as a stand-alone modality might be sufficient for readers experienced with this protocol. Key points: • One-view breast tomosynthesis is not inferior to two-view digital mammography.• One-view DBT is not inferior to 2-view DM plus 2-view DBT.• Training may lead to 1v-DBT being sufficient for screening.

Department/s

  • Radiology Diagnostics, Malmö
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • Tumor microenvironment
  • Medical Radiation Physics, Malmö

Publishing year

2018-05

Language

English

Pages

1938-1948

Publication/Series

European Radiology

Volume

28

Issue

5

Document type

Journal article

Publisher

Springer

Topic

  • Cancer and Oncology
  • Medical Image Processing

Keywords

  • Breast cancer
  • Digital breast tomosynthesis
  • Digital mammography
  • Jack-knife alternative free-response receiver operating characteristic
  • Receiver operating characteristic

Status

Published

Research group

  • Radiology Diagnostics, Malmö
  • Medical Radiation Physics, Malmö

ISBN/ISSN/Other

  • ISSN: 0938-7994