Dose Reduction and Performance Enhancement During DBT Screening

DBT 筛查期间的剂量减少和性能增强

• 批准号: 8089217
• 负责人: Margarita L Zuley
• 金额: $ 24.39万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8089217
• 关键词: 3-Dimensional; Address; Algorithms; Breast; Breast Cancer Detection; Data; Data Set; Detection; Diagnostic; Digital Mammography; Dose; Eligibility Determination; Environment; Goals; Image; Mammary Gland Parenchyma; Mammography; Measures; Methods; Modality; Modeling; Negative Finding; Performance; Population; Procedures; Radiation; Reading; Reporting; Resolution; Screening Result; Screening procedure; Series; System; Technology; Testing; Tissues; Woman; Work; calcification; digital; imaging modality; improved; public health relevance; radiologist; reconstruction; two-arm study

DESCRIPTION (provided by applicant): Digital Breast Tomosynthesis (DBT) enables 3-D reconstruction of multiple levels of breast tissue from a series of 2-D projections acquired at different angles. Its main advantage is that it generates a volumetric dataset that allows resolution of tissue superposition ambiguities that are often present in projection mammograms. DBT is currently being investigated for use as a primary screening modality but issues related to radiation exposure and detection performance remain. In a previous retrospective observer performance we found that DBT in combination with Full Field Digital Mammography (FFDM) reduced recall rates by 30% while maintaining sensitivity, compared to FFDM alone, but the combined examination doubled radiation exposure. When DBT alone was compared to FFDM the reduction was only 10%. A 30% reduction in recall rates would be sufficient to justify incorporating DBT into screening protocols, but not if it requires doubling the radiation exposure over that of FFDM. The intent of this proposal is to determine whether the 30% reduction can be achieved without acquiring separate FFDM and DBT studies by using a synthetic FFDM, comprised of a high-resolution (70-5m) projection of appropriately reconstructed DBT data, as a substitute for the directly acquired FFDM. To test this we will develop algorithms for deriving the synthetic FFDM from the DBT data and then perform an observer performance study that measures performance of 1) FFDM alone followed by FFDM combined with traditional DBT, and 2) traditional DBT alone followed by DBT combined with the synthetic FFDM. Mode 1 has previously been shown to provide the performance gains discussed above, but requires twice the radiation dose of mode 2. The two study arms enable us to measure performance of FFDM alone, FFDM + DBT, DBT alone, and DBT + synthetic FFDM. The performance study will have 8 radiologists read 100 cases in both modes and report BIRADS scores and ROC-type scores. Each case will include an FFDM and a DBT acquired in a single procedure on our Hologic DBT system. This work will be significant because, if our goal of replacing the FFDM acquisition with a projection derived from the DBT data is successful, then it will be possible to achieve the 30% reduction in recall rates without the increased radiation exposure. PUBLIC HEALTH RELEVANCE: Breast tomosynthesis is a recently introduced imaging modality that can significantly reduce recall rates, while maintaining screening sensitivity, if used in conjunction with mammography in a screening environment. However, this combined exam doubles the radiation exposure over that required for mammography alone. This project tests various strategies for incorporating DBT into breast cancer screening environments that may be able to retain the performance improvements without the increase in radiation exposure. This could greatly reduce the number of women unnecessarily recalled because of a false positive screening result.

描述（由申请人提供）：数字乳腺断层合成摄影（DBT）能够根据在不同角度采集的一系列二维投影对多层乳腺组织进行三维重建。其主要优点是，它生成的体积数据集，允许分辨率的组织叠加模糊，往往存在于投影乳房X线照片。DBT目前正在研究用作主要筛查方式，但与辐射暴露和检测性能相关的问题仍然存在。在之前的回顾性观察者表现中，我们发现与单独使用FFDM相比，DBT与全视野数字乳腺X射线摄影（FFDM）联合使用可将召回率降低30%，同时保持灵敏度，但联合检查的辐射暴露量增加了一倍。当单独DBT与FFDM相比时，减少仅为10%。召回率降低30%足以证明将DBT纳入筛查方案是合理的，但如果它需要将FFDM的辐射暴露加倍，则不合理。本提案的目的是确定是否可以通过使用合成FFDM（由适当重建的DBT数据的高分辨率（70- 5 m）投影组成）代替直接采集的FFDM，在不采集单独的FFDM和DBT研究的情况下实现30%的减少。为了测试这一点，我们将开发用于从DBT数据推导合成FFDM的算法，然后进行观察者性能研究，测量1）单独FFDM，然后FFDM与传统DBT组合，以及2）单独传统DBT，然后DBT与合成FFDM组合的性能。模式1先前已被示出提供上述性能增益，但需要两倍于模式2的辐射剂量。这两个研究组使我们能够测量单独FFDM、FFDM + DBT、单独DBT和DBT +合成FFDM的性能。性能研究将由8名放射科医师在两种模式下读取100例病例，并报告BIRADS评分和ROC类型评分。每个病例将包括在我们的Hologic DBT系统上的单个手术中获得的FFDM和DBT。这项工作将是重要的，因为如果我们的目标是成功地用DBT数据得出的投影取代FFDM采集，那么就有可能在不增加辐射暴露的情况下实现召回率降低30%。 公共卫生相关性：乳腺断层合成摄影是最近引入的成像模式，如果在筛查环境中与乳腺X射线摄影结合使用，则可以显著降低召回率，同时保持筛查灵敏度。然而，这种联合检查的辐射暴露量是单独乳房X光检查所需的两倍。该项目测试了将DBT纳入乳腺癌筛查环境的各种策略，这些策略可能能够在不增加辐射暴露的情况下保留性能改进。这可以大大减少由于假阳性筛查结果而不必要地召回的妇女人数。