Skip to main content
Top
Published in: European Radiology 7/2010

01-07-2010 | Breast

Digital breast tomosynthesis versus digital mammography: a clinical performance study

Authors: Gisella Gennaro, Alicia Toledano, Cosimo di Maggio, Enrica Baldan, Elisabetta Bezzon, Manuela La Grassa, Luigi Pescarini, Ilaria Polico, Alessandro Proietti, Aida Toffoli, Pier Carlo Muzzio

Published in: European Radiology | Issue 7/2010

Login to get access

Abstract

Objective

To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population.

Methods

The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores.

Results

Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was −4.9%.

Conclusion

Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views.
Literature
1.
go back to reference Niklason LT, Christian BT, Niklason LE, Kopans DB, Castleberry DE, Ophsal-Ong BH, Landberg CE, Slanetz PJ, Giardino AA, Moore R, Albagli D, DeJoule MC, Fitzgerald PF, Fobare DF, Giambattista BW, Kwasnick RF, Liu J, Lubowski SJ, Possin GE, Richotte JF, Wei C-Y, Wirth RF (1997) Digital tomosynthesis in breast imaging. Radiology 205:399–406PubMed Niklason LT, Christian BT, Niklason LE, Kopans DB, Castleberry DE, Ophsal-Ong BH, Landberg CE, Slanetz PJ, Giardino AA, Moore R, Albagli D, DeJoule MC, Fitzgerald PF, Fobare DF, Giambattista BW, Kwasnick RF, Liu J, Lubowski SJ, Possin GE, Richotte JF, Wei C-Y, Wirth RF (1997) Digital tomosynthesis in breast imaging. Radiology 205:399–406PubMed
2.
go back to reference Dobbins JT III, Godfrey DJ (2003) Digital x-ray tomosynthesis: current state of the art and clinical potential. Phys Med Biol 48:R65–R106CrossRefPubMed Dobbins JT III, Godfrey DJ (2003) Digital x-ray tomosynthesis: current state of the art and clinical potential. Phys Med Biol 48:R65–R106CrossRefPubMed
3.
go back to reference Park JM, Franken EA Jr, Garg M, Fajardo LL, Niklason LT (2007) Breast tomosynthesis: present considerations and future applications. Radiographics (Suppl 1):S231–S240 Park JM, Franken EA Jr, Garg M, Fajardo LL, Niklason LT (2007) Breast tomosynthesis: present considerations and future applications. Radiographics (Suppl 1):S231–S240
5.
go back to reference van Tiggelen R (2002) In search for the third dimension: from radiostereoscopy to three-dimensional imaging. JBR-BTR 85:266–270PubMed van Tiggelen R (2002) In search for the third dimension: from radiostereoscopy to three-dimensional imaging. JBR-BTR 85:266–270PubMed
9.
go back to reference Wu T, Liu B, Moore R, Kopans D (2006) Optimal acquisition techniques for digital breast tomosynthesis screening. In: Flynn MJ, Hsieh J (eds) Medical imaging 2006: physics of medical imaging. Proceedings of SPIE 2006 6142:61425-E Wu T, Liu B, Moore R, Kopans D (2006) Optimal acquisition techniques for digital breast tomosynthesis screening. In: Flynn MJ, Hsieh J (eds) Medical imaging 2006: physics of medical imaging. Proceedings of SPIE 2006 6142:61425-E
10.
go back to reference Sechopoulos I, Suryanarayanan S, Vedhantam S, D’Orsi C, Karellas A (2007) Computation of the glandular radiation dose in digital tomosynthesis of the breast. Med Phys 34:331–232 Sechopoulos I, Suryanarayanan S, Vedhantam S, D’Orsi C, Karellas A (2007) Computation of the glandular radiation dose in digital tomosynthesis of the breast. Med Phys 34:331–232
11.
go back to reference Ma AKW, Darambera DG, Stewart A, Gunn S, Bullard E (2008) Mean glandular dose estimation using MNCPX for a digital breast tomosynthesis system with tungsten/aluminum and tungsten/aluminum + silver x-ray anode/filter combination. Med Phys 35:5278–5289CrossRefPubMed Ma AKW, Darambera DG, Stewart A, Gunn S, Bullard E (2008) Mean glandular dose estimation using MNCPX for a digital breast tomosynthesis system with tungsten/aluminum and tungsten/aluminum + silver x-ray anode/filter combination. Med Phys 35:5278–5289CrossRefPubMed
12.
go back to reference Gong X, Glick SJ, Liu B, Vedula AA, Thacker S (2006) A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis and cone-beam CT breast-imaging. Med Phys 33:1041–1052CrossRefPubMed Gong X, Glick SJ, Liu B, Vedula AA, Thacker S (2006) A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis and cone-beam CT breast-imaging. Med Phys 33:1041–1052CrossRefPubMed
13.
go back to reference Zhao B, Zhao W (2008) Three-dimensional linear system analysis for breast tomosynthesis. Med Phys 35:5219–5232CrossRefPubMed Zhao B, Zhao W (2008) Three-dimensional linear system analysis for breast tomosynthesis. Med Phys 35:5219–5232CrossRefPubMed
14.
go back to reference Zhou J, Zhao B, Zhao W (2007) A computer simulation platform for the optimization of a breast tomosynthesis system. Med Phys 34:1098–1109CrossRefPubMed Zhou J, Zhao B, Zhao W (2007) A computer simulation platform for the optimization of a breast tomosynthesis system. Med Phys 34:1098–1109CrossRefPubMed
15.
go back to reference Chawla AS, Samei E, Saunders RS, Lo JY, Baker JA (2008) A mathematical model platform for optimizing a multiprojection breast imaging system. Med Phys 35:1337–1345CrossRefPubMed Chawla AS, Samei E, Saunders RS, Lo JY, Baker JA (2008) A mathematical model platform for optimizing a multiprojection breast imaging system. Med Phys 35:1337–1345CrossRefPubMed
16.
go back to reference Wang X, Mainprize JG, Kempston MP, Mawdsley GE, Yaffe MJ (2007) Digital breast tomosynthesis geometry calibration. In: Flynn MJ, Hsieh J (ed) Medical imaging 2007: physics of medical imaging. Proceedings of SPIE 2007 6510:65103B Wang X, Mainprize JG, Kempston MP, Mawdsley GE, Yaffe MJ (2007) Digital breast tomosynthesis geometry calibration. In: Flynn MJ, Hsieh J (ed) Medical imaging 2007: physics of medical imaging. Proceedings of SPIE 2007 6510:65103B
17.
go back to reference Sechopoulos I, Suryanarayanan S, Vedhantam S, D’Orsi C, Karellas A (2007) Scatter radiation in digital tomosynthesis of the breast. Med Phys 34:564–576CrossRefPubMed Sechopoulos I, Suryanarayanan S, Vedhantam S, D’Orsi C, Karellas A (2007) Scatter radiation in digital tomosynthesis of the breast. Med Phys 34:564–576CrossRefPubMed
18.
go back to reference Wu T, Moore RH, Rafferty EA, Kopans DB (2004) A comparison of reconstruction algorithms for breast tomosynthesis. Med Phys 31:2636–2647CrossRefPubMed Wu T, Moore RH, Rafferty EA, Kopans DB (2004) A comparison of reconstruction algorithms for breast tomosynthesis. Med Phys 31:2636–2647CrossRefPubMed
19.
go back to reference Wu T, Moore RH, Kopans DB (2006) Voting strategy for artifact reduction in digital breast tomosynthesis. Med Phys 33:1461–1471 Wu T, Moore RH, Kopans DB (2006) Voting strategy for artifact reduction in digital breast tomosynthesis. Med Phys 33:1461–1471
20.
go back to reference Zhang Y, Chan H-P, Sahiner B, Wei J, Goodsitt MM, Hadjiiski LM, Ge J, Zhou C (2006) A comparative study of limited angle cone-beam reconstruction methods for breast tomosynthesis. Med Phys 33:3781–3795CrossRefPubMed Zhang Y, Chan H-P, Sahiner B, Wei J, Goodsitt MM, Hadjiiski LM, Ge J, Zhou C (2006) A comparative study of limited angle cone-beam reconstruction methods for breast tomosynthesis. Med Phys 33:3781–3795CrossRefPubMed
21.
go back to reference Chan H-P, Sahiner B, Rafferty EA, Wu T, Roubidoux MA, Moore RH, Kopans DB, Hadjiiski LM, Helvie MA (2005) Computer-aided detection system for breast masses on digital tomosynthesis mammograms: preliminary experience. Radiology 237:1075–1080CrossRefPubMed Chan H-P, Sahiner B, Rafferty EA, Wu T, Roubidoux MA, Moore RH, Kopans DB, Hadjiiski LM, Helvie MA (2005) Computer-aided detection system for breast masses on digital tomosynthesis mammograms: preliminary experience. Radiology 237:1075–1080CrossRefPubMed
22.
go back to reference Reiser I, Nishikawa RM, Giger ML, Wu T, Rafferty EA, Moore R, Kopans DB (2006) Computerized mass detection for digital breast tomosynthesis directly from projection images. Med Phys 33:482–491CrossRefPubMed Reiser I, Nishikawa RM, Giger ML, Wu T, Rafferty EA, Moore R, Kopans DB (2006) Computerized mass detection for digital breast tomosynthesis directly from projection images. Med Phys 33:482–491CrossRefPubMed
23.
go back to reference Chan H-P, Wei J, Zhang Y, Helvie MA, Moore RH, Sahiner B, Hadjiiski LM, Kopans DB (2008) Computer-aided detection of masses in digital tomosynthesis mammography: comparison of three approaches. Med Phys 35:4087–4095CrossRefPubMed Chan H-P, Wei J, Zhang Y, Helvie MA, Moore RH, Sahiner B, Hadjiiski LM, Kopans DB (2008) Computer-aided detection of masses in digital tomosynthesis mammography: comparison of three approaches. Med Phys 35:4087–4095CrossRefPubMed
24.
go back to reference Reiser I, Nishikawa RM, Edwards AV, Kopans DB, Schmidt RA, Papaioannou J, Moore RH (2008) Automated detection of microcalcification clusters for digital breast tomosynthesis using projection data only: a preliminary study. Med Phys 35:1486–1493CrossRefPubMed Reiser I, Nishikawa RM, Edwards AV, Kopans DB, Schmidt RA, Papaioannou J, Moore RH (2008) Automated detection of microcalcification clusters for digital breast tomosynthesis using projection data only: a preliminary study. Med Phys 35:1486–1493CrossRefPubMed
25.
go back to reference Poplack SP, Tosteson TD, Kogel CA, Nagy HM (2007) Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography. AJR Am J Roentgenol 189:616–623CrossRefPubMed Poplack SP, Tosteson TD, Kogel CA, Nagy HM (2007) Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography. AJR Am J Roentgenol 189:616–623CrossRefPubMed
26.
go back to reference Good WF, Abrams GS, Catullo VJ, Chough DM, Ganott MA, Hakim CM, Gur D (2008) Digital breast tomosynthesis: a pilot observer study. AJR Am J Roentgenol 190:865–869CrossRefPubMed Good WF, Abrams GS, Catullo VJ, Chough DM, Ganott MA, Hakim CM, Gur D (2008) Digital breast tomosynthesis: a pilot observer study. AJR Am J Roentgenol 190:865–869CrossRefPubMed
27.
go back to reference Andersson I, Ikeda DM, Zackrisson S, Ruschin M, Svahn T, Timberg P, Timberg A (2008) Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings. Eur Radiol 18:2817–2825CrossRefPubMed Andersson I, Ikeda DM, Zackrisson S, Ruschin M, Svahn T, Timberg P, Timberg A (2008) Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings. Eur Radiol 18:2817–2825CrossRefPubMed
28.
go back to reference Smith AP, Rafferty EA, Niklason L (2008) Clinical performance of breast tomosynthesis as a function of radiologist experience level. LNCS 5116:61–66 Smith AP, Rafferty EA, Niklason L (2008) Clinical performance of breast tomosynthesis as a function of radiologist experience level. LNCS 5116:61–66
29.
go back to reference van Engen R, van Wouldenberg S, Bosmans H, Young K, Thjissen M (2006) European protocol for the quality control of the physical aspects of mammography screening—Screen-film mammography. In: European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis, 4th edn. European Commission, Luxembourg, pp 61–104 van Engen R, van Wouldenberg S, Bosmans H, Young K, Thjissen M (2006) European protocol for the quality control of the physical aspects of mammography screening—Screen-film mammography. In: European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis, 4th edn. European Commission, Luxembourg, pp 61–104
30.
go back to reference Dance DR, Skinner CL, Young KC, Beckett JR, Kotre CJ (2000) Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol. Phys Med Biol 45:3225–3240CrossRefPubMed Dance DR, Skinner CL, Young KC, Beckett JR, Kotre CJ (2000) Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol. Phys Med Biol 45:3225–3240CrossRefPubMed
31.
go back to reference American College of Radiology (ACR) (2003) Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas). American College of Radiology, Reston American College of Radiology (ACR) (2003) Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas). American College of Radiology, Reston
32.
go back to reference Metz CE, Pan X (1999) “Proper” binormal ROC curves: theory and maximum-likelihood estimation. J Math Psychol 43:1–33CrossRefPubMed Metz CE, Pan X (1999) “Proper” binormal ROC curves: theory and maximum-likelihood estimation. J Math Psychol 43:1–33CrossRefPubMed
33.
go back to reference Pesce LL, Metz CE (2007) Reliable and computationally efficient maximum-likelihood estimation of “proper” binormal ROC curves. Acad Radiol 14:814–829CrossRefPubMed Pesce LL, Metz CE (2007) Reliable and computationally efficient maximum-likelihood estimation of “proper” binormal ROC curves. Acad Radiol 14:814–829CrossRefPubMed
34.
go back to reference Dorfman DD, Berbaum KS (2000) A contaminated binormal model for ROC data: part II. A formal model. Acad Radiol 7:427–437CrossRefPubMed Dorfman DD, Berbaum KS (2000) A contaminated binormal model for ROC data: part II. A formal model. Acad Radiol 7:427–437CrossRefPubMed
35.
go back to reference Obuchowski NA (2007) New methodological tools for multiple-reader ROC studies. Radiology 243:10–12CrossRefPubMed Obuchowski NA (2007) New methodological tools for multiple-reader ROC studies. Radiology 243:10–12CrossRefPubMed
36.
go back to reference Obuchowski NA (1995) Multireader, multimodality receiver operating characteristic curve studies: hypothesis testing and sample size estimation using an analysis of variance approach with dependent observations. Acad Radiol 2:S22–S29CrossRefPubMed Obuchowski NA (1995) Multireader, multimodality receiver operating characteristic curve studies: hypothesis testing and sample size estimation using an analysis of variance approach with dependent observations. Acad Radiol 2:S22–S29CrossRefPubMed
37.
go back to reference Hillis SL (2007) A comparison of denominator degrees of freedom methods for multiple observer ROC analysis. Stat Med 26:596–619CrossRefPubMed Hillis SL (2007) A comparison of denominator degrees of freedom methods for multiple observer ROC analysis. Stat Med 26:596–619CrossRefPubMed
38.
go back to reference Obuchowski NA (1997) Testing for equivalence of diagnostic tests. AJR Am J Roentgenol 168:13–17PubMed Obuchowski NA (1997) Testing for equivalence of diagnostic tests. AJR Am J Roentgenol 168:13–17PubMed
39.
go back to reference Gennaro G, di Maggio C (2006) Dose comparison between screen/film and full-field digital mammography. Eur Radiol 16:2559–2566CrossRefPubMed Gennaro G, di Maggio C (2006) Dose comparison between screen/film and full-field digital mammography. Eur Radiol 16:2559–2566CrossRefPubMed
40.
go back to reference Samei E, Saunders RS, Baker JA, Delong DM (2007) Digital mammography: effects of reduced radiation dose on diangostic performance. Radiology 243:396–404CrossRefPubMed Samei E, Saunders RS, Baker JA, Delong DM (2007) Digital mammography: effects of reduced radiation dose on diangostic performance. Radiology 243:396–404CrossRefPubMed
41.
go back to reference Svahn T, Hemdal B, Ruschin M, Chakraborty DP, Andersson I, Tingberg A, Mattsson S (2007) Dose reduction and its influence on diagnostic accuracy and radiation risk in digital mammography: an observer performance study using an anthropomorphic breast phantom. Br J Radiol 80:557–562CrossRefPubMed Svahn T, Hemdal B, Ruschin M, Chakraborty DP, Andersson I, Tingberg A, Mattsson S (2007) Dose reduction and its influence on diagnostic accuracy and radiation risk in digital mammography: an observer performance study using an anthropomorphic breast phantom. Br J Radiol 80:557–562CrossRefPubMed
42.
go back to reference Dobbins JT III (2009) Tomosynthesis imaging: at a translational crossroads. Med Phys 36:1956–1967CrossRefPubMed Dobbins JT III (2009) Tomosynthesis imaging: at a translational crossroads. Med Phys 36:1956–1967CrossRefPubMed
Metadata
Title
Digital breast tomosynthesis versus digital mammography: a clinical performance study
Authors
Gisella Gennaro
Alicia Toledano
Cosimo di Maggio
Enrica Baldan
Elisabetta Bezzon
Manuela La Grassa
Luigi Pescarini
Ilaria Polico
Alessandro Proietti
Aida Toffoli
Pier Carlo Muzzio
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1699-5

Other articles of this Issue 7/2010

European Radiology 7/2010 Go to the issue