The effect of the amount of peritumoral adipose tissue in the detection of additional tumors with digital breast tomosynthesis and ultrasound

García-Barquin, Paula; Páramo, María; Elizalde, Arlette; Pina, Luis; Etxano, J.; Fernández-Montero, Alejandro; Caballeros, Meylin

doi:10.1177/0284185116668211

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…This has been seen in a comparison of anatomical noise of structures of size greater than 2 mm in DM, DBT and dedicated breast CT. DM and DBT were shown to have similar anatomical noise, while CT images showed a reduction due to true 3D reconstruction (253). As DBT fundamentally relies on the same image contrast as DM, DBT must have peritumoral fat in order to visualize the tumor (254,255). Therefore, DBT improved cancer detection compared to DM similarly for all breast densities, including non-dense breasts, by finding smaller spiculated tumors or distortions.…”

Section: Cancer Detectionmentioning

confidence: 99%

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

et al. 2018

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The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

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Section: Cancer Detectionmentioning

confidence: 99%

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

et al. 2018

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“…In noncalcified lesions, DBT was comparable to ultrasound in dense breasts, but showed significantly higher sensitivity in non-dense breasts. Noncalcified lesions are mostly hypoechoic; the contrast between hypoechoic tumour and echogenic dense tissue may contribute to the high sensitivity of ultrasound in dense breasts [ 43 , 44 ]. The high sensitivity of DBT in women recalled suggests that 2D DM spot views may not be needed where this assessment tool is available.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Efficacy across Dense and Non-Dense Breasts during Digital Breast Tomosynthesis and Ultrasound Assessment for Recalled Women

et al. 2022

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Background: To compare the diagnostic efficacy of digital breast tomosynthesis (DBT) and ultrasound across breast densities in women recalled for assessment. Methods: A total of 482 women recalled for assessment from January 2017 to December 2019 were selected for the study. Women met the inclusion criteria if they had undergone DBT, ultrasound and had confirmed biopsy results. We calculated sensitivity, specificity, PPV, and AUC for DBT and ultrasound. Results: In dense breasts, DBT showed significantly higher sensitivity than ultrasound (98.2% vs. 80%; p < 0.001), but lower specificity (15.4% vs. 55%; p < 0.001), PPV (61.3% vs. 71%; p = 0.04) and AUC (0.568 vs. 0.671; p = 0.001). In non-dense breasts, DBT showed significantly higher sensitivity than ultrasound (99.2% vs. 84%; p < 0.001), but no differences in specificity (22% vs. 33%; p = 0.14), PPV (69.2% vs. 68.8%; p = 0.93) or AUC (0.606 vs. 0.583; p = 0.57). Around 73% (74% dense and 71% non-dense) and 77% (81% dense and 72% non-dense) of lesions assigned a RANZCR 3 by DBT and ultrasound, respectively, were benign. Conclusion: DBT has higher sensitivity, but lower specificity and PPV than ultrasound in women with dense breasts recalled for assessment. Most lesions rated RANZCR 3 on DBT and ultrasound are benign and may benefit from short interval follow-up rather than biopsy.

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“…Anatomic noise of structures larger than 2 mm may have limited the visibility of breast cancers in DBT in a similar manner as observed in DM (29). Moreover, DBT is known to yield better performance if tumors located in dense tissue are surrounded by some amount of fatty tissue (30). Lack of statistical differences in screening metrics for DBT+SM and DM across VDG categories and specifically among women with dense breasts might also be due to the small number of breast cancers in this trial.…”

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confidence: 80%

Comparing Screening Outcomes for Digital Breast Tomosynthesis and Digital Mammography by Automated Breast Density in a Randomized Controlled Trial: Results from the To-Be Trial

Moshina¹,

Aase²,

Danielsen³

et al. 2022

Radiology

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BREAST IMAGING D igital breast tomosynthesis (DBT) increases the incidence of screen-detected breast cancer (SDC) when compared with standard digital mammography (DM) in paired and nonpaired prospective trials and retrospective studies (1-4). Results of a randomized controlled trial performed in Italy using DBT in combination with standard DM versus DM alone also support these findings (1). However, a randomized controlled trial performed by our group in Bergen, as part of BreastScreen Norway, had a different conclusion (5). In the latter trial, we found that DBT that includes synthetic two-dimensional mammography (SM) (hereafter, DBT+SM) yielded a breast cancer detection rate similar to that of DM. Purpose: To identify differences in screening outcomes, including rates of recall, false-positive (FP) findings, biopsy, cancer detection rate, positive predictive value of recalls and biopsies, and histopathologic tumor characteristics by density using DBT combined with two-dimensional synthetic mammography (SM) (hereafter, DBT+SM) versus DM. Materials and Methods: This randomized controlled trial comparing DBT+SM and DM was performed in Bergen as part of BreastScreen Norway, 2016-2017. Automated software measured density (Volpara Density Grade [VDG], 1-4). The outcomes were compared for DBT+SM versus DM by VDG in descriptive analyses. A stratified log-binomial regression model was used to estimate relative risk of outcomes in subgroups by screening technique. Results: Data included 28 749 women, 14 380 of whom were screened with DBT+SM and 14 369 of whom were screened with DM (both groups: median age, 59 years; interquartile range [IQR], 54-64 years). The recall rate was lower for women screened with DBT+SM versus those screened with DM for VDG 1 (2.1% [81 of 3929] vs 3.3% [106 of 3212]; P = .001) and VDG 2 (3.2% [200 of 6216] vs 4.3% [267 of 6280]; P = .002).

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The effect of the amount of peritumoral adipose tissue in the detection of additional tumors with digital breast tomosynthesis and ultrasound

Cited by 9 publications

References 10 publications

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

Diagnostic Efficacy across Dense and Non-Dense Breasts during Digital Breast Tomosynthesis and Ultrasound Assessment for Recalled Women

Comparing Screening Outcomes for Digital Breast Tomosynthesis and Digital Mammography by Automated Breast Density in a Randomized Controlled Trial: Results from the To-Be Trial

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