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: 7998774
• 负责人: WALTER F GOOD
• 金额: $ 25.15万
• 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 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7998774
• 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; arm; calcification; digital; imaging modality; improved; public health relevance; radiologist; reconstruction

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（DBT）能够根据以不同角度采集的一系列 2D 投影对多个层面的乳腺组织进行 3D 重建。它的主要优点是它生成一个体积数据集，可以解决投影乳房X光照片中经常出现的组织叠加模糊性。目前正在研究 DBT 作为主要筛查方式，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 线摄影 (FFDM) 结合使用可在保持灵敏度的同时将召回率降低 30%，但组合检查使辐射暴露量增加一倍。单独使用 DBT 与 FFDM 相比，仅降低了 10%。召回率降低 30% 足以证明将 DBT 纳入筛查方案是合理的，但如果它需要将辐射暴露量加倍于 FFDM，则不然。该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）作为直接采集的 FFDM 的替代品，在不获取单独的 FFDM 和 DBT 研究的情况下实现 30% 的减少。为了测试这一点，我们将开发从 DBT 数据导出合成 FFDM 的算法，然后进行观察者性能研究，测量 1) 单独使用 FFDM，然后是 FFDM 与传统 DBT 相结合，以及 2) 单独使用传统 DBT，然后是 DBT 与合成 FFDM 相结合的性能。先前已证明模式 1 可以提供上述性能增益，但需要模式 2 两倍的辐射剂量。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 名放射科医生在两种模式下读取 100 个病例，并报告 BIRADS 评分和 ROC 类型评分。每个病例都将包括在我们的 Hologic DBT 系统上通过单一程序获得的 FFDM 和 DBT。这项工作意义重大，因为如果我们用 DBT 数据预测取代 FFDM 采集的目标成功，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%。 公共健康相关性：乳房断层合成是最近推出的一种成像方式，如果在筛查环境中与乳房 X 线摄影结合使用，可以显着降低召回率，同时保持筛查敏感性。然而，这种联合检查使辐射暴露量比单独进行乳房X光检查所需的辐射暴露量增加了一倍。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女性人数。