Comparison of diagnostic performances in the evaluation of breast microcalcifications: synthetic mammography versus full-field digital mammography
Comparison of diagnostic performances in the evaluation of breast microcalcifications: synthetic mammography versus full-field digital mammography
复制标题
DOI：
10.1007/s11845-021-02744-7
复制
发表时间：
2021-09-01
影响因子：
2.1
通讯作者：
Cerit, Mahinur
中科院分区：
文献类型：
--
作者：
Kilic, Pinar;Sendur, Halit Nahit;Cerit, Mahinur
虽然一些研究证明SM可以替代FFDM，但SM在微钙化评价中的有效性仍存在争议。目的探讨合成乳房x线摄影（SM）与全视野数字乳房x线摄影（FFDM）对微钙化的诊断价值。方法回顾性分析了2018年至2019年期间同时接受FFDM和数字乳腺断层合成（DBT）采集的76例患者的76张乳房x线照片，这些患者的最终乳房x线照片解释显示微钙化（28例恶性微钙化，48例良性微钙化）。所有的乳房x光片都由三名具有不同乳腺成像经验的放射科医生独立审查。根据BI-RADS词典，读者对患者结果不知情，并在两个单独的阅读阶段（第一次FFDM，第二次SM + DBT）中解释每个病例。采用ROC分析计算FFDM和SM + DBT治疗的受试者工作特征曲线下面积（AUC）。读者还对乳房x光片进行了显著性评分。使用类内相关系数（ICC）计算观察者间的一致性。结果FFDM组和SM组恶性微钙化的总体auc分别为0.80 （95% CI: 0.75 ~ 0.85）和0.85 (95% CI: 0.80 ~ 0.89)，两组间差异无统计学意义（p = 0.0603）。读者的敏感度随着经验的增加而略有提高。FFDM和SM读者之间BI-RADS分类的ICC值分别为0.93 （95% CI: 0.90-0.95）和0.94 （95% CI: 0.91-0.96）。结论：与FFDM相比，无论读者经验水平如何，SM在评估乳房微钙化方面具有相似的诊断性能。
Background Although several studies proved that SM could substitute for FFDM, the efficacy of SM in microcalcification evaluation remains controversial. Aims To investigate the diagnostic performance of synthetic mammography (SM) in the evaluation of microcalcifications in comparison with full-field digital mammography (FFDM). Methods In this retrospective study, 76 mammograms of 76 patients who underwent FFDM and digital breast tomosynthesis (DBT) acquisitions concomitantly between 2018 and 2019 and whose final mammography interpretation revealed microcalcifications (28 malignant microcalcifications and 48 benign microcalcifications) were included. All mammograms were reviewed independently by three radiologists with different levels of breast imaging experience. Readers were blinded to patient outcomes and interpreted each case in two separate reading sessions (first FFDM, second SM + DBT), according to the BI-RADS lexicon. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated using ROC analysis in all cases for FFDM and SM + DBT sessions. The readers also assigned conspicuity scores to mammograms. The interobserver agreement was calculated using intraclass correlation coefficients (ICC). Results The overall AUCs for malignant microcalcifications were 0.80 (95% CI: 0.75-0.85) in FFDM and 0.85 (95% CI: 0.80-0.89) in SM, and no significant difference was found between the groups (p = 0.0603). The sensitivity of the readers increased slightly with experience. The ICC values of BI-RADS categorization between readers were 0.93 (95% CI: 0.90-0.95) and 0.94 (95% CI: 0.91-0.96) for FFDM and SM, respectively. Conclusions SM had similar diagnostic performance in the evaluation of breast microcalcifications in comparison with FFDM, regardless of reader experience levels.