Yi Li, Presenter: Nothing to Disclose

Zhaoxiang Ye MD, Abstract Co-Author: Nothing to Disclose

Tao Wu PhD, Abstract Co-Author: Employee, Hologic, Inc

Compare the performance of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) on assessment of breast lesions, and evaluate the improvement in diagnostic accuracy by combining FFDM and DBT.

A total of 300 Chinese women with symptoms were imaged by FFDM and DBT under the same compression. Pathology results were available for all patients (118 benign and 182 malignant). For each case, the diagnosis was first made based on FFDM only, then DBT was provided. The diagnosis using FFDM only and FFDM plus DBT were compared with pathology. For lesion assessment, the morphology of both benign and malignant lesions (masses and calcifications) was evaluated and compared by four radiologists.

For benign cases, 85% (100/118) were accurately diagnosed (compared to pathology) by FFDM alone, and the accuracy increased to 91% (107/118) when combining FFDM and DBT. For malignant cases, the accuracy was 94% (170/182) using FFDM alone, and 97% (175/182) using FFDM plus DBT. By combining FFDM and DBT, the total number of benign cases in BIRADS 1-3 was increased by from 88 to 99; and decreased from 19 to 15 in BIRADS 4-5. For malignant cases, the total number in BIRADS 1-3 was decreased from 11 to 7; and increased from 169 to 175 in BIRADS 4-5. The number in BIRADS 0 was decreased using FFDM plus DBT (11 down to 4 in benign cases, 2 down to 0 in malignant cases). Of the 118 benign lesions, 50 benign masses showed circumscribed boundary on FFDM, while the number increased to 71 on DBT. Of the 182 malignant lesions, the number of malignant masses showing spiculation was 66 on FFDM, and 101 on DBT. The difference between FFDM and DBT was statistically significant (p<0.05) in both cases. For micro-calcifications (µCa), DBT (with 1mm slice) was superior to FFDM in 7/83 cases, equivalent in 58/83 cases, and inferior in 18/83 cases. When using 10 mm “slab view”, DBT was superior or equivalent to FFDM in all µCa cases.  

DBT is superior to FFDM in lesion characterization. Combining FFDM and DBT improves the accuracy of diagnosis. The BIRADS classification based on FFDM plus DBT is more consistent with the pathology compared to FFDM alone.

Evaluation of Digital Breast Tomosynthesis on Lesions Assessment and Diagnostic Accuracy on Chinese Patients

Li, Y, Ye, Z, Wu, T, Evaluation of Digital Breast Tomosynthesis on Lesions Assessment and Diagnostic Accuracy: A Preliminary Study on Chinese Patients.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008167.html