Comparison of the Detection Rate of Simulated Microcalcifications in Full-Field Digital Mammography, Digital Breast Tomosynthesis, and Synthetically Reconstructed 2-Dimensional Images Performed With 2 Different Digital X-ray Mammography Systems

Peters, Susan; Hellmich, Martin; Stork, Alexander; Kemper, J.; Grinstein, Olga; Püsken, Michael; Stahlhut, Leandra; Kinner, Sonja; Maintz, David; Krug, Kathrin Barbara

doi:10.1097/rli.0000000000000334

Cited by 21 publications

(18 citation statements)

References 23 publications

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“…We found that this also holds true for INSIGHT3D without significant differences with respect to SM or the standard stack reconstruction. Previous studies about SM described a worse depiction of the morphology of microcalcifications compared to FFDM [7,12]. This comparison, however, was not part of this study and describing the morphology with either of these reconstruction techniques might not be comparable with FFDM.…”

Section: Discussioncontrasting

confidence: 43%

“…While the advantages of SM, such as better and faster comparability to previous examinations and contralateral imaging [6], are preserved with INSIGHT3D, its superior depiction of microcalcifications shows added value to SM. In this context, however, it should be remembered that it is not yet clear whether SM can generally substitute FFDM for the depiction of microcalcifications [7,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Tomosynthesis is superior to FFDM in the diagnosis of mass lesions. However, tomosynthesis still does not achieve the image quality of FFDM in the depiction of microcalcifications, where FFDM is still considered the gold standard [7,12].…”

Section: Discussionmentioning

confidence: 99%

“…SM may replace FFDM while still enabling intuitive comparison to previous FFDM and evaluation of symmetry [6]. Although some studies show equal performance between SM and FFDM, other data suggest that SM might not be able to fully replace FFDM, especially regarding the evaluation of microcalcifications [7,8]. Further development in the field of SM, therefore, seems to be mandatory.…”

Section: Introductionmentioning

confidence: 99%

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Multiple Angulated Mammography Reconstructions in Digital Breast Tomosynthesis for the Diagnosis of Microcalcifications – Added Value to Standard Stack Reconstructions and Synthesized Mammography

Neubauer

Wicklein

et al. 2018

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZweck Vergleich der Bildqualitätsbewertungen, diagnostischen Genauigkeit und Läsionscharakterisierung von synthetischer Mammografie (SM), mehrfach angulierten Mammografierekonstruktionen (INSIGHT3D) und StandardSchicht-Rekonstruktionen für Mikroverkalkungen in der digitalen Brust-Tomosynthese. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Materialen und Methoden ABSTR AC TPurpose To compare ratings regarding the depiction, diagnostic accuracy and lesion characterization of conventional synthesized mammography (SM), multiple angulated mammography reconstructions (INSIGHT3D), and standard stack reconstructions in digital breast tomosynthesis for microcalcifications.Materials and Methods This is a retrospective, multicase, multireader study. We included patients with digital breast tomosynthesis (DBT), microcalcifications and histology over a period of four months in our institution and the same number of normal cases. Three radiologists, who were blinded to patient data, independently rated the depiction, distribution, morphology and BI-RADS score of microcalcifications in SM, INSIGHT3D and standard stack reconstructions. Deidentified images were presented in random order. Reading time was measured. Friedman and post hoc Nemenyi tests, Cochrane's Q and post hoc Wilcoxon signed rank tests, Fleiss' kappa and receiver operating characteristics were used for statistical analysis.Results We included 41 histopathologically proven and 41 normal cases. Depiction of microcalcifications was rated better in INSIGHT3D than in SM and better in stack reconstructions than in INSIGHT3D and SM (P < 0.001). The reading time was lower in SM and INSIGHT3D compared to stack reconstructions (P < 0.001). The diagnostic accuracy and inter-rater correlation were comparable between all tested modes of reconstruction.Conclusions INSIGHT3D has higher ratings regarding the depiction of microcalcifications compared to SM while maintaining a short reading time. Our preliminary assessment suggests that INSIGHT3D provides added value to SM. Fortschr Röntgenstr 2018; 190: 433-440

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multiple Angulated Mammography Reconstructions in Digital Breast Tomosynthesis for the Diagnosis of Microcalcifications – Added Value to Standard Stack Reconstructions and Synthesized Mammography

Neubauer

Wicklein

et al. 2018

Fortschr Röntgenstr

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“…DBT is now being evaluated as a stand-alone technique for screening in women with dense breasts. The development of synthetic 2D images of comparable quality to standard DM (except for microcalcifications) goes some way to relieve concerns about radiation dosages (190,191) and DBT with either synthetic or standard 2D DM is substantially more sensitive than 2D DM alone (192). Subgroup analysis of the UK TOMMY trial demonstrated that DBT was significantly more sensitive than 2D DM in women with more than 50% MD (93% and 86% respectively, p 0.03) (193).…”

Section: Risk Adapted Screening Protocolsmentioning

confidence: 99%

Breast density: why all the fuss?

Vinnicombe

2018

Clinical Radiology

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The term "breast density" or mammographic density (MD) denotes those components of breast parenchyma visualised at mammography that are denser than adipose tissue. MD is composed of a mixture of epithelial and stromal components, notably collagen, in variable proportions. MD is most commonly assessed in clinical practice with the time-honoured method of visual estimation of area-based percent density (PMD) on a mammogram, with categorisation into quartiles. The computerised semi-automated thresholding method, Cumulus, also yielding area-based percent density, is widely used for research purposes; however, the advent of fully automated volumetric methods developed as a consequence of the widespread use of digital mammography (DM) and yielding both absolute and percent dense volumes, has resulted in an explosion of interest in MD recently. Broadly, the importance of MD is twofold: firstly, the presence of marked MD significantly reduces mammographic sensitivity for breast cancer, even with state-of-the-art DM. Recognition of this led to the formation of a powerful lobby group ('Are You Dense') in the US, as a consequence of which 32 states have legislated for mandatory disclosure of MD to women undergoing mammography. Secondly, it is now widely accepted that MD is in itself a risk factor for breast cancer, with a four-to sixfold increased relative risk in women with PMD in the highest quintile compared to those with PMD in the lowest quintile. Consequently, major research efforts are underway to assess whether use of MD could provide a major step forward towards risk-adapted, personalised breast cancer prevention, imaging, and treatment.

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Audit of data from examination image headers collected for quality assurance in the ECOG‐ACRIN EA1151 tomosynthesis mammographic imaging screening trial (TMIST)

Maki,

Mawdsley,

Mainprize

et al. 2023

Medical Physics

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PurposeA comprehensive, centrally‐monitored physics quality control (QC) program was developed for the Tomosynthesis Imaging Screening Trial (TMIST), a randomized controlled trial of digital breast tomosynthesis (TM) versus digital mammography (DM) for cancer screening. As part of the program, in addition to a set of phantom‐based tests, de‐identified data on image acquisition and processing parameters were captured from the DICOM headers of all individual patient images in the trial. These data were analyzed to assess the potential usefulness of header data from digital mammograms and tomosynthesis images of patients for quality assurance in breast imaging.MethodsData were automatically extracted from the headers of all de‐identified patient mammograms and tomosynthesis images in the TMIST study. Image acquisition parameters and estimated radiation doses were tracked for individual sites, systems and across system types. These parameters included (among others) kV, target/filter use, number of acquired views per examination, AEC mode, compression thickness and force and detector temperature. Consistency of manually entered study data parameters (subject ID, screening time‐point) from TMIST was evaluated. Preliminary observations from the program are presented.ResultsWe report on data from 812 651 images from 135 525 examinations acquired between October, 2017 and December, 2022. Data came from 6 system models from 3 manufacturers. There was greater variability both in the number of views used and in the estimated (proxy) doses received in DM exams compared to TM. Mean proxy doses per examination varied among manufacturers from 2.76–4.54 mGy for DM and 3–4.84 mGy for the tomosynthesis component in the TM arm with maximum examination proxy doses of 20 and 26 mGy for DM and TM respectively. Mean proxy doses per examination for the combination examination in TM (tomosynthesis plus digital mammography) varied from 6.6 to 7.6 mGy among manufacturers with a maximum of 44.5 mGy.ConclusionsOverall, modern digital mammography and tomosynthesis systems used in TMIST have operated very reliably. Doses vary considerably due to variation in the number of views per examination, thickness and fibro‐glandularity of the breast, and choices in the use of synthesized versus actual 2D mammography in the TM examination. These data may also be useful in predicting equipment problems. Header information is valuable not only for automated QC, but also for cross‐checking accuracy and consistency of data in a clinical study.

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Comparison of the Detection Rate of Simulated Microcalcifications in Full-Field Digital Mammography, Digital Breast Tomosynthesis, and Synthetically Reconstructed 2-Dimensional Images Performed With 2 Different Digital X-ray Mammography Systems

Cited by 21 publications

References 23 publications

Multiple Angulated Mammography Reconstructions in Digital Breast Tomosynthesis for the Diagnosis of Microcalcifications – Added Value to Standard Stack Reconstructions and Synthesized Mammography

Multiple Angulated Mammography Reconstructions in Digital Breast Tomosynthesis for the Diagnosis of Microcalcifications – Added Value to Standard Stack Reconstructions and Synthesized Mammography

Breast density: why all the fuss?

Audit of data from examination image headers collected for quality assurance in the ECOG‐ACRIN EA1151 tomosynthesis mammographic imaging screening trial (TMIST)

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