Daniela Bernardi MD, Presenter: Nothing to Disclose

Marco Pellegrini MD, Abstract Co-Author: Nothing to Disclose

Marvi Valentini MD, Abstract Co-Author: Nothing to Disclose

Carmine Fanto MD, Abstract Co-Author: Nothing to Disclose

Nehmat Houssami MBBS, Abstract Co-Author: Nothing to Disclose

To compare, in population breast screening, detection using various screening modalities including integrated synthetically reconstructed 2D images (synt2D) and 3D mammography (3D) with conventional mammography screening and integrated standard 2D and 3D.

STORM II trial is a prospective study comparing 2D-only mammography with integrated 2D/3D and with integrated synthetic 2D images/3D. From June to November 2013, all the resident women aged from 49 to 70 who attended local population-based screening, after informed consent, had digital mammography in Combo® mode; synthetic 2D images were reconstructed from the data acquired during the tomo-exposures using dedicated software (c-view®, Hologic, USA). All screens had independent, double and sequential readings: two readers interpreted sequentially 2D then 2D/3D, whereas two other readers interpreted sequentially synt2D then synt2D/3D, thus each screen was read by 4 readers. Any positive screens at any reading phase was recalled. Paired data were compared using McNemar’s Chi-square test.

Based on 3312 screens, 27 breast cancers were detected in 24 women: 19 cancers were detected by standard 2D mammography, 21 cancers were detected with integrated 2D/3D screening (p=0.50) whereas 6 more cancers were detected only by integration of synthetic 2D/3D (p=0.125). None of the cancers were detected with 2D-only mammography or synt2D alone. There were 295 false positive (FP) recalls attributed to various screen-reading modalities: 30 from synt2D alone, 33 from standard 2D mammography alone, 91 from synt2D/3D alone and 100 from 2D/3D alone. FP recalls for the integrated readings was 155 using integrated 2D/3D versus 151 using integrated synt2D/3D (p=0.79).  

Although not statistically different from 2D/3D, cancer detection was highest for integrated synthetic 2D with 3D mammography amongst various screen-reading methods evaluated in this interim analysis. 

Integrated synt2D/3D mammography may have the potential to enhance cancer detection in population breast screening providing a solution to concerns about the required double x-ray exposure in 2D/3D modality.  

Bernardi, D, Pellegrini, M, Valentini, M, Fanto, C, Houssami, N, The STORM II (Screening with Tomosynthesis or Mammography II) Trial: Interim Comparison of Screen-reading Strategies in Population Breast Screening.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014699.html