Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy
Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy
复制标题
DOI：
10.1259/bjr/53282892
复制
发表时间：
2012-11-01
影响因子：
2.6
通讯作者：
Andersson, I.
中科院分区：
文献类型：
--
作者：
Svahn, T. M.;Chakraborty, D. P.;Andersson, I.
目的：我们的目的是比较放射科医生检测乳腺癌的能力，使用一个视图乳腺断层合成摄影（BT）和两个视图数字乳腺X射线摄影（DM）在丰富的人群中的患病患者和良性和/或健康patients.Methods：所有参与者都给予知情同意。BT和DM检查是在乳房平均腺体剂量大致相同的情况下进行的。研究人群包括在DM和/或超声检查中观察到微小恶性肿瘤体征的患者。通过病理学、针吸活检和/或通过乳房X线摄影的1年随访确定了基础事实，回顾性地发现89个患病乳房（每例患者1个乳房），其中95个恶性病变和96个健康或良性乳房。两名经验丰富的放射科医生，谁没有参与这项研究，确定恶性病变的位置。五名在乳房X线摄影方面经验丰富的放射科医生在一项自由反应研究中独立解释了这些病例。结果：BT的诊断准确率明显高于DM（JAFROC：p = 0.0031，ROC：p = 0.0415），而DM的诊断准确率明显低于BT（JAFROC：p=0.0031，ROC：p=0.0415）。BT的平均敏感性高于DM（相似于90% vs相似于79%;差异的95%置信区间：0.036，0.108），而平均假阳性分数无显著差异（95%可信区间：-0.117，0.010）。结论：在丰富的人群中，BT的诊断准确性上级DM。
Objective: Our aim was to compare the ability of radiologists to detect breast cancers using one-view breast tomosynthesis (BT) and two-view digital mammography (DM) in an enriched population of diseased patients and benign and/or healthy patients.Methods: All participants gave informed consent. The BT and DM examinations were performed with about the same average glandular dose to the breast. The study population comprised patients with subtle signs of malignancy seen on DM and/or ultrasonography. Ground truth was established by pathology, needle biopsy and/or by 1-year follow-up by mammography, which retrospectively resulted in 89 diseased breasts (1 breast per patient) with 95 malignant lesions and 96 healthy or benign breasts. Two experienced radiologists, who were not participants in the study, determined the locations of the malignant lesions. Five radiologists, experienced in mammography, interpreted the cases independently in a free-response study. The data were analysed by the receiver operating characteristic (ROC) and jackknife alternative free-response ROC (JAFROC) methods, regarding both readers and cases as random effects.Results: The diagnostic accuracy of BT was significantly better than that of DM (JAFROC: p=0.0031, ROC: p=0.0415). The average sensitivity of BT was higher than that of DM (similar to 90% vs similar to 79%; 95% confidence interval of difference: 0.036, 0.108) while the average false-positive fraction was not significantly different (95% confidence interval of difference: -0.117, 0.010).Conclusion: The diagnostic accuracy of BT was superior to DM in an enriched population.