Effect of Breast Density on Screening Recall with Digital Breast Tomosynthesis

乳房密度对数字乳房断层合成筛查回忆的影响

• 批准号: 8643193
• 负责人: Despina Kontos
• 金额: $ 25.52万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-04 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8643193
• 关键词: Address; Advisory Committees; Age; Back; Biopsy; Breast; Breast Cancer Detection; Breast Cancer Risk Factor; Clinical; Clinical Trials; Complement; Complex; Coupled; Data; Descriptor; Diagnosis; Diagnostic; Diagnostic Imaging; Digital Breast Tomosynthesis; Digital Mammography; Dose; Drops; Face; Family; Goals; Image; Image Analysis; Imagery; Imaging Techniques; Imaging technology; Individual; Lesion; Logistic Regressions; Mammary Gland Parenchyma; Mammography; Measures; Menopause; Modeling; Normal tissue morphology; Odds Ratio; Pattern; Performance; Process; Protocols documentation; Radiation; Recommendation; Recording of previous events; Risk; Role; Sensitivity and Specificity; Series; Source; Specificity; Technology; Texture; Tissues; Translations; Woman; base; breast density; cancer diagnosis; clinical practice; density; design; imaging modality; improved; indexing; next generation; prospective; radiologist; screening; vector

DESCRIPTION (provided by applicant): Currently, call-back rates for screening mammography in the U.S. are high at about 10%. Due to the effect of tissue superimposition on the 2D projection images, many women, especially women with dense breasts, are recalled for additional imaging of "pseudo-lesions", essentially suspicious-looking superimpositions of normal tissues which, after diagnostic workup, prove to be normal. Digital breast tomosynthesis (DBT) is a new 3D x-ray imaging modality in which tomographic breast images are reconstructed from multiple low-dose source projections. In DBT, the effects of tissue superposition are largely removed from the image set, thereby providing superior breast tissue visualization compared to mammography. Early clinical trials suggest up to a 40% reduction in false positive recalls when DBT is incorporated in the screening setting. There is however, a higher radiation dose when DBT is incorporated into the screening paradigm. Therefore this potential benefit of DBT must be carefully weighed against a potential increase of dose. The identification of a subset of women who would benefit most from DBT imaging is critical. To address this concern, our study will compare the effect of breast density and overall breast parenchymal complexity on the recall decision in breast cancer screening with digital mammography (DM) versus DBT. Our hypothesis is that complex parenchymal patterns (i.e., dense and/or texturally complex breasts) have a higher likelihood of being recalled for false positive findings with DM than when DBT is incorporated in the screening process. Towards this end, we propose to develop an imaging index for characterizing breast parenchymal tissue complexity. Currently, there is no standard lexicon to comprehensively reflect parenchymal complexity. Breast density is the only such image-based descriptor in the standard mammography BIRADS lexicon. Therefore, we propose to combine the standard density measures with advanced image texture features into a quantitative breast complexity index (BCI) that can be used to identify a subset of women who would benefit most from DBT screening. The rapidly evolving technology and the potential for superior performance will determine the role of DBT in clinical practice. If our hypothesis proves to be true, DBT could replace or complement DM for the screening of women with dense and/or texturally complex breasts, to reduce unnecessary recalls and additional diagnostic imaging procedures.

描述（由申请人提供）：目前，在美国，筛查乳房X光检查的回拨率约为10%。由于组织叠加在2D投影图像上的影响，许多女性，特别是具有致密乳房的女性，被召回进行“假病变”的额外成像，假病变基本上是正常组织的可疑叠加，在诊断检查之后，正常组织被证明是正常的。数字乳腺断层合成（DBT）是一种新的三维X射线成像模式，其中断层乳腺图像是从多个低剂量源投影重建的。在DBT中，组织叠加的影响在很大程度上被从图像集中去除，从而提供与乳房X线摄影相比更好的上级乳房组织可视化。早期的临床试验表明，当DBT被纳入筛查设置时，假阳性召回率降低了40%。然而，有一个更高的辐射剂量时，DBT被纳入筛选范例。因此，必须仔细权衡DBT的这种潜在益处与潜在的剂量增加。确定从DBT成像中获益最多的女性子集至关重要。为了解决这一问题，我们的研究将比较乳腺密度和整体乳腺实质复杂性对数字乳腺X射线摄影（DM）与DBT乳腺癌筛查召回决策的影响。我们的假设是复杂的实质模式（即，致密和/或纹理复杂的乳房）与DBT结合在筛查过程中相比，因DM的假阳性结果而被召回的可能性更高。为此，我们建议制定一个成像指标表征乳腺实质组织的复杂性。目前，还没有一个标准的词汇来全面反映实质的复杂性。乳腺密度是标准乳腺X线摄影BIRADS词典中唯一基于图像的描述符。因此，我们建议联合收割机结合标准密度测量与先进的图像纹理特征，形成一个定量的乳腺复杂性指数（BCI），可用于确定一个子集的妇女谁将受益最大的DBT筛查。快速发展的技术和潜在的上级性能将决定DBT在临床实践中的作用。如果我们的假设被证明是正确的，DBT可以取代或补充DM用于筛查致密和/或纹理复杂的乳房，以减少不必要的召回和额外的诊断成像程序。