Characterization of Breast Masses in Digital Breast Tomosynthesis and Digital Mammograms

Chan, Heang Ping; Helvie, Mark A.; Hadjiiski, Lubomir M.; Jeffries, Deborah O.; Klein, Katherine A.; Neal, Colleen H.; Noroozian, Mitra; Paramagul, Chintana; Roubidoux, Marilyn A.

doi:10.1016/j.acra.2017.04.016

Cited by 20 publications

(14 citation statements)

References 31 publications

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“…[1][2][3]10,11 Our study is one of the first to evaluate the impact of screening DBT on the subsequent diagnostic work-up of recalled findings. Since DBT improves differentiation of true findings from superimposition of fibroglandular tissue, mass margin visibility, and location assessment [7][8][9] and is equivalent to routine mammography in the diagnostic setting, [1][2][3]10,11 it is not surprising that most DBT screen-detected masses in the US first group in our study did not require a diagnostic mammogram. Additionally, the US visibility of masses in the MG first and the US first groups did not vary significantly (p = 0.42).…”

Section: Discussionmentioning

confidence: 99%

Masses in the era of screening tomosynthesis: Is diagnostic ultrasound sufficient?

Choudhery

Axmacher

Conners

et al. 2018

The British Journal of Radiology

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In the era of digital breast tomosynthesis (DBT), the need for diagnostic mammography (MG) before a diagnostic ultrasound for masses recalled from screening tomosynthesis has been questioned. 1-3 Historically, most masses recalled from two-dimensional (2D) screening mammography underwent diagnostic mammography prior to ultrasound. 4,5 In this setting, diagnostic mammography views have been shown to increase the specificity of mammography by improving margin assessment, determining lesion location, and confirming persistence of the screen-detected mass. 5,6 In comparison to 2D imaging, DBT allows better differentiation of true findings from superimposition of fibroglandular tissue, increases mass margin visibility, and improves location assessment. 7-9 In addition, studies have shown that DBT has similar accuracy as routine diagnostic mammography for non-calcified findings, 10 is comparable to spot compression mammography for characterizing masses as benign or malignant, 1 and is equivalent or better than spot compression mammography for evaluating findings recalled from 2D screening mammography. 2,3,11 Currently, institutions and practitioners vary in how the work-up of masses recalled from screening tomosynthesis is performed, with some opting for ultrasound first and others performing diagnostic mammography before ultrasound. There are no clear American College of Radiology practice guidelines for work-up of DBT-detected masses. The purpose of this study is to compare outcomes of masses recalled from screening DBT worked-up initially with diagnostic mammography with those first evaluated with diagnostic ultrasound. MethodS and MaterIalS Study subjects, imaging technique, and interpretation Our Institutional Review Board approved this retrospective Health Insurance Portability and Accountability Act-compliant study. Informed consent was waived. We performed a retrospective review of our mammography reporting system for all screen-detected masses from July 1, 2017, from the time of our conversion to

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Section: Discussionmentioning

confidence: 99%

Masses in the era of screening tomosynthesis: Is diagnostic ultrasound sufficient?

Choudhery

Axmacher

Conners

et al. 2018

The British Journal of Radiology

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“…A number of studies found that the combination of DBT with DM (“combo mode”) could increase the cancer detection rate and reduce recall rate compared to DM alone (Rose et al 2013, Skaane et al 2013a, Skaane et al 2013b, Friedewald et al 2014, Greenberg et al 2014, Durand et al 2015, Bernardi et al 2016, Conant et al 2016, Sharpe et al 2016). Studies also showed that wide-angle DBT alone increased cancer detection and diagnosis compared to DM alone (Lang et al 2016, Chan et al 2017)…”

Section: Introductionmentioning

confidence: 99%

Synthesizing mammogram from digital breast tomosynthesis

et al. 2019

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Our purpose is to develop a new method for generating synthesized mammogram (SM) from digital breast tomosynthesis (DBT) and to assess its potential as an adjunct to DBT. We first applied multiscale bilateral filtering to the reconstructed DBT slices to enhance the high-frequency features and reduce noise. A maximum intensity projection (MIP) image was then obtained from the high-frequency components of the DBT slices. A multiscale image fusion method was designed to combine the MIP image and the central DBT projection view into an SM and further enhance the high-frequency features. We conducted a pilot reader study to visually assess the image quality of SM in comparison to full field digital mammograms (FFDM). For each DBT craniocaudal or mediolateral view, a clinical FFDM of the corresponding view was retrospectively collected. Three MQSA radiologists, blinded to the pathological and other clinical information, independently interpreted the SM and the corresponding FFDM side by side marked with the lesion locations. The differences in the BI-RADS assessments of both MCs and masses between SM and FFDM did not achieve statistical significance for all 3 readers. The conspicuity of MCs on SM was superior to that on FFDM and the BI-RADS assessments of MCs were comparable while the conspicuity of masses on SM was degraded and interpretation on SM was less accurate than that on FFDM. The SM may be useful for efficient prescreening of MCs in DBT but the DBT should be used for detection and characterization of masses.

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“…Two previous studies found that sensitivity improved with DBT compared with DM, whereas the specificity in differentiating malignant and benign lesions either was reduced slightly or remained the same. 6,12 In addition, Lang et al 13 showed a higher cancer detection rate but also observed significantly higher recall rates when DBT was compared with DM. Consequently, screening with DBT may reveal cancers that will never become clinically relevant, leading to increased costs and undue patient discomfort associated with further diagnostic studies.…”

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confidence: 99%

“…5 By combining images from different projections, DBT decreases the impact of overlapping tissue and improves lesion detection and characterization. 6 Normal structures are often clearly recognized, and suspicious findings become more apparent with DBT. Accordingly, numerous studies have demonstrated improved diagnostic performance of DM plus DBT compared with DM alone, with decreased recall rates and increased cancer detection rates.…”

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confidence: 99%

Comparison of Call-Back Rates between Digital Mammography and Digital Breast Tomosynthesis

Scott

Lashley

Drury

et al. 2019

The American Surgeon

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The effect of mammographic screening on the natural history and evolution of breast cancer treatment cannot be overstated; however, despite intensive and resource consuming screening, advanced breast cancer is still diagnosed frequently. The development of three-dimensional mammography or digital breast tomosynthesis (DBT) has already demonstrated greater sensitivity in the diagnosis of breast pathology and effectiveness in identifying early breast cancers. In addition to being a more sensitive screening tool, other studies indicate DBT has a lower call-back rate when compared with traditional DM. This study compares call-back rates between these two screening tools. A single institution, retrospective review was conducted of almost 20,000 patient records who underwent digital mammography or DBTin the years 2016 to 2018. These charts were analyzed for documentation of imaging type, Breast Imaging Reporting and Data System 0 status, call-back status, and type of further imaging that was required. Charts for 19,863 patients were reviewed, 17,899 digital mammography examinations were conducted compared with 11,331 DBT examinations resulting in 1,066 and 689 Breast Imaging Reporting and Data System 0 studies, respectively. Of the DM call-backs, 82.08 per cent were recommended for additional radiographic imaging and 17.82 per cent for ultrasound imaging. In the DBT group, only 39.77 per cent of callbacks were recommended for additional radiographic imaging and 60.09 per cent for ultrasound imaging. Our data suggest that DBT results in less call-back for additional mammographic images as compared with digital mammography. DBT may offer benefits over DM, including less imaging before biopsy, less time before biopsy, quicker diagnosis, and improved patient satisfaction.

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Characterization of Breast Masses in Digital Breast Tomosynthesis and Digital Mammograms

Cited by 20 publications

References 31 publications

Masses in the era of screening tomosynthesis: Is diagnostic ultrasound sufficient?

Masses in the era of screening tomosynthesis: Is diagnostic ultrasound sufficient?

Synthesizing mammogram from digital breast tomosynthesis

Comparison of Call-Back Rates between Digital Mammography and Digital Breast Tomosynthesis

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