Dose reduction in digital breast tomosynthesis (DBT) screening using synthetically reconstructed projection images: an observer performance study.
Dose reduction in digital breast tomosynthesis (DBT) screening using synthetically reconstructed projection images: an observer performance study.
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DOI：
10.1016/j.acra.2011.10.003
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发表时间：
2012-02
影响因子：
4.8
通讯作者：
Bandos, Andriy I.
中科院分区：
文献类型：
--
作者：
Gur, David;Zuley, Margarita L.;Anello, Maria I.;Rathfon, Grace Y.;Chough, Denise M.;Ganott, Marie A.;Hakim, Christiane M.;Wallace, Luisa;Lu, Amy;Bandos, Andriy I.
回顾性比较结合 DBT 与 FFDM 加 DBT 的综合重建二维图像的解释性能。十名放射科医生接受过阅读断层合成检查的培训，在两种模式下回顾性解释 114 张乳房 X 光照片。一种模式包括直接采集的FFDM结合DBT，另一种模式包括结合DBT的综合重建投影图像。重建图像不需要额外的辐射暴露。我们比较了两种模式的“敏感性”，即建议召回患有病理证实的癌症（n=48）或高风险病变（n=6）的乳房；和“特异性”，即不建议召回未描述异常的乳房（n = 144）或仅描述良性异常（n = 30）。带有 DBT 的 FFDM 的平均灵敏度为 0.826，而带有 DBT 的合成 FFDM 的平均灵敏度为 0.772（固定和随机读取器效应的差异分别为 0.054、p=0.017 和 p=0.053）。建议回忆的无异常或良性异常的乳房比例几乎相同：两种方式分别为 0.298 和 0.297（固定和随机读者效应的差异的 95% 置信区间 CI= -0.028、0.036，CI = -0.070、0.066）。在使用合成图像与 FFDM 解释模式时，所有读者综合起来都错过了另外 16 个微钙化簇（“阳性”乳房）。与 FFDM（两者均与 DBT 结合）相比，合成生成图像的测试版本具有较低的灵敏度和相当的特异性。需要改进合成图像并通过实验验证可接受的诊断质量，以消除基于 DBT 的筛查过程中的双重曝光。
Retrospectively compare interpretive performance of synthetically reconstructed two-dimensional images in combination with DBT versus FFDM plus DBT. Ten radiologists trained in reading tomosynthesis examinations interpreted retrospectively, under two modes, 114 mammograms. One mode included the directly acquired FFDM combined with DBT and the other, synthetically reconstructed projection images combined with DBT. The reconstructed images do not require additional radiation exposure. We compared the two modes with respect to “sensitivity”, namely recommendation to recall a breast with either a pathology proven cancer (n=48) or a high risk lesion (n=6); and “specificity”, namely no recommendation to recall a breast not depicting an abnormality (n=144) or depicting only benign abnormalities (n=30). The average sensitivity for FFDM with DBT was 0.826 versus 0.772 for synthetic FFDM with DBT (difference=0.054, p=0.017 and p=0.053 for fixed and random reader effect, respectively). The fraction of breasts with no, or benign, abnormalities recommended to be recalled were virtually the same: 0.298 and 0.297 for the two modalities, respectively (95% confidence intervals for the difference CI= −0.028, 0.036 and CI = −0.070, 0.066 for fixed and random reader effects, correspondingly). Sixteen additional clusters of micro-calcifications (“positive” breasts) were missed by all readers combined when interpreting the mode with synthesized images versus FFDM. Lower sensitivity with comparable specificity was observed with the tested version of synthetically generated images versus FFDM, both combined with DBT. Improved synthesized images with experimentally verified acceptable diagnostic quality will be needed to eliminate double exposure during DBT based screening.
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影响因子：
5
作者：
Gur, David;Bandos, Andriy I.;Hakim, Christiane M.
通讯作者：
Hakim, Christiane M.
影响因子：
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作者：
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