Comparison of Diagnostic Test Accuracy of Cone-Beam Breast Computed Tomography and Digital Breast Tomosynthesis for Breast Cancer: A Systematic Review and Meta-Analysis Approach

Abstract

Background: Cone-beam breast computed tomography (CBBCT) and digital breast tomosynthesis (DBT) remain the main 3D modalities for X-ray breast imaging. This study aimed to systematically evaluate and meta-analyze the comparison of diagnostic accuracy of CBBCT and DBT to characterize breast cancers. Methods: Two independent reviewers identified screening on diagnostic studies from 1 January 2015 to 30 December 2021, with at least reported sensitivity and specificity for both CBBCT and DBT. A univariate pooled meta-analysis was performed using the random-effects model to estimate the sensitivity and specificity while other diagnostic parameters like the area under the ROC curve (AUC), positive likelihood ratio (LR+), and negative likelihood ratio (LR−) were estimated using the bivariate model. Results: The pooled sensitivity specificity, LR+ and LR− and AUC at 95% confidence interval are 86.7% (80.3–91.2), 87.0% (79.9–91.8), 6.28 (4.40–8.96), 0.17 (0.12–0.25) and 0.925 for the 17 included studies in DBT arm, respectively, while, 83.7% (54.6–95.7), 71.3% (47.5–87.2), 2.71 (1.39–5.29), 0.20 (0.04–1.05), and 0.831 are the pooled sensitivity specificity, LR+ and LR− and AUC for the five studies in the CBBCT arm, respectively. Conclusions: Our study demonstrates that DBT shows improved diagnostic performance over CBBCT regarding all estimated diagnostic parameters; with the statistical improvement in the AUC of DBT over CBBCT. The CBBCT might be a useful modality for breast cancer detection, thus we recommend more prospective studies on CBBCT application.

Novel feature extraction based on DCT-DOST features for classification of Digital Breast Tomosynthesis images into benign and malignant tumors

“…After acquiring several thin, highresolution images, the DBT system produces a quasi-3D format of reconstructed breast images with the aim of reducing the effect of tissue distortion. In addition, unlike conventional imaging techniques the radiation dose required is not high, and the produced images appear to have greater resolution and contrast [7,8]. DBT represents a more accurate diagnostic index than twodimensional imaging for the evaluation of morphological features, for example, the shape and margin of various breast cancer immunophenotypes, so it can play an important role in molecular imaging and prognosis [9] in addition, DBT is accepted for breast cancer screening in women in the United States Due to reduced tissue overlap, offers better cancer detection sensitivity than mammography, especially for dense breasts, and better visualization of masses, potentially reducing Recall Rates [10,11].…”