Two-View Digital Breast Tomosynthesis Screening with Synthetically Reconstructed Projection Images: Comparison with Digital Breast Tomosynthesis with Full-Field Digital Mammographic Images

Skaane, Per; Bandos, Andriy I.; Eben, Ellen B.; Jebsen, Ingvild N.; Krager, Mona; Haakenaasen, Unni; Ekseth, Ulrika; Izadi, Mina; Hofvind, Solveig; Gullien, Randi

doi:10.1148/radiol.13131391

Cited by 289 publications

(182 citation statements)

References 19 publications

(28 reference statements)

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“…l For combined imaging with 2D + DBT to be implemented in screening, the use of synthetic 2D to minimise radiation exposure would be advantageous. The overall non-inferiority of synthetic 2D + DBT to 2D alone, shown in our study and in the publications of Skaane et al 78 and Zuley et al, 143 would justify use of this imaging combination in a RCT in a screening setting. However, before synthetic 2D + DBT could be recommended for screening, further comparative work with synthetic 2D and 2D alone should be undertaken; for example quantifying the effect on sensitivity and specificity for lesions with different radiological appearances, of different pathological types (e.g.…”

Section: Resultssupporting

confidence: 57%

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The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme – a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone

Gilbert

Tucker

Gillan

et al. 2015

Health Technology Assessment

154

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The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme -a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/22/182. The contractual start date was in December 2010. The draft report began editorial review in February 2014 and was accepted for publication in August 2014. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report. Background: Digital breast tomosynthesis (DBT) is a three-dimensional mammography technique with the potential to improve accuracy by improving differentiation between malignant and non-malignant lesions.

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Section: Resultssupporting

confidence: 57%

“…Only a few studies have been published to date on the performance of synthetic 2D. Although Gur et al 70 reported lower sensitivity but comparable specificity for synthetic 2D + DBT compared with standard 2D + DBT, two recent studies using the same version of the C-View software as our study, Skaane et al 78 and Zuley et al,…”

Section: Resultsmentioning

confidence: 47%

The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme – a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone

Gilbert

Tucker

Gillan

et al. 2015

Health Technology Assessment

154

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“…A study by Gur et al 21 to evaluate the use of synthetically reconstructed 2D has shown promising results with the combination of DBT and synthetic 2D demonstrating comparable specificity but slightly lower sensitivity in comparison with DBT plus FFDM. A more recent publication by Skaane et al 22 in a large screening population has demonstrated that the combination of reconstructed 2D images combined with DBT performed comparably to FFDM plus DBT.…”

mentioning

confidence: 99%

Digital breast tomosynthesis at screening assessment: are two views always necessary?

Haq¹,

Lim²,

Maxwell³

et al. 2015

BJR

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Objective: The current recommendation from the UK National Health Service Breast Screening Programme is that digital breast tomosynthesis (DBT) can be used for further assessment of possible screen-detected softtissue abnormalities in place of spot compression views and when used should be performed in two projections. The aim of the study was to assess whether twoview DBT is necessary if the abnormality is seen only in one view on initial full-field digital mammography (FFDM). Methods: 617 cases with possible masses, distortions and asymmetrical densities visualized only in one view on screening FFDM were included. All of these females underwent two-view DBT, clinical examination and ultrasound. The FFDM and DBT findings on each view were compared and correlated with the histological diagnosis.

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“…One appeal is the reduction of false-positives (approximately 15%) and increased cancer detection rates (approximately 28%; for invasive cancers, 40% or more) [121][122][123] , together with a onethird reduction in recall rates and consequent false-positive biopsies 117,124,125 , especially in younger women and women with dense breasts in whom mammography is limited, and with no negative effect on sensitivity 123,[126][127][128] , which could potentially tip the risk:benefit ratio toward tomosynthesis 129,130 . And although compared with mammography alone, tomosynthesis roughly doubles total radiation exposure, this can be obviated using the synthesized 2D images created from the three-dimensional tomosynthesis dataset, dramatically reducing the radiation (43% or more) to that of a standard mammogram (eliminating separate 2D exposures), with superior lesion visualization for microcalcification cluster detectability [131][132][133][134][135] , and having the potential to render conventional 2D mammography obsolete 117,123,[135][136][137][138][139][140] . Confirmation in robust clinical trials such as the large randomized t-mist trial (Yaffe MJ, co-investigator) is awaited, although I note that it lacks a control group of unscreened women.…”

Section: New Screening Modalities: Digital Breast Tomosynthesismentioning

confidence: 99%

Beyond the Mammography Debate: A Moderate Perspective

Kaniklidis¹

2015

Current Oncology

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After some decades of contention, one can almost despair and conclude that (paraphrasing) "the mammography debate you will have with you always." Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete.To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis-also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patientaccessible levels to facilitate informed decisions. Key Words REFLECTIONS ON SOME CENTRAL THEMESAll screening programmes do harm; some do good as well, and, of these, some do more good than harm at reasonable cost.-Sir Muir Grey, former director of the U.K. National Screening Committee 1 Some Issues Deserving More AttentionSeveral core issues require closer examination:1. The potential benefits of mammographic screening independent of whether ultimate survival is affected, including diagnosis at earlier stages, typically with smaller tumours and node negativity; reduced likelihood of aggressive treatments and morbidities; detection of high-risk lesions (most diagnosed in the screened group 2 ) allowing for chemoprevention or magnetic resonance imaging (mri) surveillance against occult malignancies, or both; and avoidance of compromised quality of life after diagnosis of advanced disease It is not clear, as often assumed, that survival is the best (or only) measure for judging mammographic screening 2,3 . And it remains open whether claimed harms truly are disproportionate to benefits when using, for instance, a more nuanced definition of overdetection than simply breast cancer (bca) diagnosed but not bca expired (distinguishing, for example, longer recurrence-free survival from simple overall survival benefit).

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Two-View Digital Breast Tomosynthesis Screening with Synthetically Reconstructed Projection Images: Comparison with Digital Breast Tomosynthesis with Full-Field Digital Mammographic Images

Abstract: The combination of current reconstructed 2D images and DBT performed comparably to FFDM plus DBT and is adequate for routine clinical use when interpreting screening mammograms.

Cited by 289 publications

References 19 publications

The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme – a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone

The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme – a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone

Digital breast tomosynthesis at screening assessment: are two views always necessary?

Beyond the Mammography Debate: A Moderate Perspective

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