Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting
Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting
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DOI：
10.1007/s00330-018-5596-7
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发表时间：
2019-02-01
影响因子：
5.9
通讯作者：
Lehman, Constance D.
中科院分区：
文献类型：
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作者：
Bahl, Manisha;Mercaldo, Sarah;Lehman, Constance D.
ObjectivesTo comparison performance metrics between digital 2D mammography（DM）and digital breast tomosynthesis（DBT）in the diagnostic setting. MethodsConcurrently诊断检查从2008年8月至2011年2月（DM组）和从2013年1月至2015年7月（DM/DBT组）进行了审查。收集乳房X线检查后365天内的芯活检和手术病理结果。计算性能指标，包括癌症检测率（CDR）、异常解释率（AIR）、阳性预测值（PPV）2、PPV 3、灵敏度和特异性。多变量logistic回归模型进行拟合，以比较DM和DM/DBT组的性能指标，同时调整临床covarias.ResultsA共22，883乳房X线照片进行前DBT整合（DM组），和22，824乳房X线照片完成后DBT整合（DM/DBT组）。在调整多个变量后，两组的CDR相似（DM/DBT组为38.2/1000次检查，DM组为31.3/1000次检查，p = 0.14）;然而，在DM/DBT组中，浸润性癌的比例高于原位癌[83.7%（731/873）vs 72.3%（518/716），p < 0.01]。DM/DBT组的AIR较低（p < 0.01），而PPV 2、PPV 3和特异性较高（均为p = 0.01或p < 0.01）。因此，增加DBT的使用可能会导致更好的患者结局，并导致已为DM建立的基准发生变化。
ObjectivesTo compare performance metrics between digital 2D mammography (DM) and digital breast tomosynthesis (DBT) in the diagnostic setting.MethodsConsecutive diagnostic examinations from August 2008 to February 2011 (DM group) and from January 2013 to July 2015 (DM/DBT group) were reviewed. Core biopsy and surgical pathology results within 365 days after the mammogram were collected. Performance metrics, including cancer detection rate (CDR), abnormal interpretation rate (AIR), positive predictive value (PPV) 2, PPV3, sensitivity, and specificity were calculated. Multivariable logistic regression models were fit to compare performance metrics in the DM and DM/DBT groups while adjusting for clinical covariates.ResultsA total of 22,883 mammograms were performed before DBT integration (DM group), and 22,824 mammograms were performed after complete DBT integration (DM/DBT group). After adjusting for multiple variables, the CDR was similar in both groups (38.2 per 1,000 examinations in the DM/DBT group versus 31.3 per 1,000 examinations in the DM group, p = 0.14); however, a higher proportion of cancers were invasive rather than in situ in the DM/DBT group [83.7% (731/873) versus 72.3% (518/716), p < 0.01]. The AIR was lower in the DM/DBT group (p < 0.01), and PPV2, PPV3, and specificity were higher in the DM/DBT group (all p = 0.01 or p < 0.01).ConclusionsComplete integration of DBT into the diagnostic setting is associated with improved diagnostic performance. Increased utilization of DBT may thus result in better patient outcomes and lead to a shift in the benchmarks that have been established for DM.