Clinical Performance Metrics of 3D Digital Breast Tomosynthesis Compared With 2D Digital Mammography for Breast Cancer Screening in Community Practice
Clinical Performance Metrics of 3D Digital Breast Tomosynthesis Compared With 2D Digital Mammography for Breast Cancer Screening in Community Practice
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DOI：
10.2214/ajr.14.12642
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发表时间：
2014-09-01
影响因子：
5
通讯作者：
Holland, Agnes E.
中科院分区：
文献类型：
--
作者：
Greenberg, Julianne S.;Javitt, Marcia C.;Holland, Agnes E.
OBJECTIVE.本研究的目的是评估在社区放射学实践中，与单独使用2D数字乳腺X射线摄影（DM）进行筛查性乳腺X射线摄影相比，2D-3D数字乳腺断层合成摄影（DBT）（简称“3DDBT”）的临床性能。对14名放射科医生的性能结局指标进行了评估，这些放射科医生在开始断层合成后解释了500多项筛查性乳腺X射线摄影3D DBT研究。比较了2011年8月9日至2012年11月30日研究期间使用3D DBT（n = 23，149例患者）与2D DM（n = 54，684例患者）进行筛查性乳腺X线摄影的结局。对于接受3D DBT筛查的患者，回忆率的相对变化比接受2D DM筛查的患者低16.1%（p > 0.0001）。3D DBT（6.3/1000）的总体癌症检出率（CDR）（表示为每1000例筛查患者的癌症数量）比2D DM（4.9/1000）高28.6%（p = 0.035）。3D DBT（4.6/1000）浸润性癌症的CDR比2D DM（3.2/1000）高43.8%（p = 0.0056）。与2D DM（3.0%）相比，3D DBT（4.6%）的筛选回忆（PPV 1）阳性预测值高53.3%（p = 0.0003）。3D DBT与2D DM的活检阳性预测值（PPV 3）无显著差异（分别为22.8%和23.8%）（p = 0.696）。在基于社区的放射学实践中，与2D DM相比，使用3D DBT进行乳房X线摄影筛查的召回率较低，总体癌症的CDR增加，浸润性癌症的CDR增加。在使用3D DBT筛选的组中，PPV 1显著更大。
OBJECTIVE. The objective of our study was to assess the clinical performance of combined 2D-3D digital breast tomosynthesis (DBT), referred to as ''3DDBT,'' compared with 2D digital mammography (DM) alone for screening mammography in a community-based radiology practice.MATERIALS AND METHODS. Performance outcomes measures were assessed for 14 radiologists who interpreted more than 500 screening mammography 3D DBT studies after the initiation of tomosynthesis. Outcomes from screening mammography during the study period between August 9, 2011, and November 30, 2012, using 3D DBT (n = 23,149 patients) versus 2D DM (n = 54,684 patients) were compared.RESULTS. For patients screened with 3D DBT, the relative change in recall rate was 16.1% lower than for patients screened with 2D DM (p > 0.0001). The overall cancer detection rate (CDR), expressed as number of cancers per 1000 patients screened, was 28.6% greater (p = 0.035) for 3D DBT (6.3/1000) compared with 2D DM (4.9/1000). The CDR for invasive cancers with 3D DBT (4.6/1000) was 43.8% higher (p = 0.0056) than with 2D DM (3.2/1000). The positive predictive value for recalls from screening (PPV1) was 53.3% greater (p = 0.0003) for 3D DBT (4.6%) compared with 2D DM (3.0%). No significant difference in the positive predictive value for biopsy (PPV3) was found for 3D DBT versus 2D DM (22.8% and 23.8%, respectively) (p = 0.696).CONCLUSION. In community-based radiology practice, mammography screening with 3D DBT yielded lower recall rates, an increased CDR for cancer overall, and an increased CDR for invasive cancer compared with 2D DM. The PPV1 was significantly greater in the group screened using 3D DBT.