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European Radiology
Published in: European Radiology 9/2013

01-09-2013 | Breast

Digital breast tomosynthesis versus mammography and breast ultrasound: a multireader performance study

Authors: Fabienne Thibault, Clarisse Dromain, Catherine Breucq, Corinne S. Balleyguier, Caroline Malhaire, Luc Steyaert, Anne Tardivon, Enrica Baldan, Harir Drevon

Published in: European Radiology | Issue 9/2013

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Abstract

Objectives

To compare the diagnostic performance of single-view breast tomosynthesis (BT) with that of dual-view mammography (MX); to assess the benefit of adding the craniocaudal (CC) mammographic view to BT, and of adding BT to MX plus breast ultrasound, considered to be the reference work-up.

Methods

One hundred and fifty-five consenting patients with unresolved mammographic and/or ultrasound findings or breast symptoms underwent conventional work-up plus mediolateral oblique-view BT of the affected breast. The final study set in 130 patients resulted in 55 malignant and 76 benign and normal cases. Seven breast radiologists rated the cases through five sequential techniques using a BIRADS-based scale: MX, MX + ultrasound, MX + ultrasound + BT, BT, BT + MX(CC). Multireader, multicase receiver operating characteristic (ROC) analysis was performed and performance of the techniques was assessed from the areas under ROC curves. The performance of BT and of BT + MX(CC) was tested versus MX; the performance of MX + ultrasound + BT tested versus MX + ultrasound.

Results

Tomosynthesis was found to be non-inferior to mammography. BT + MX(CC) did not appear to be superior to MX, and MX + ultrasound + BT not superior to MX + ultrasound.

Conclusions

Overall, none of the five techniques tested outperformed the others. Further clinical studies are needed to clarify the role of BT as a substitute for traditional work-up in the diagnostic environment.

Key Points

• Digital breast tomosynthesis is a new adjunct to mammography and breast ultrasound.
• We compared the diagnostic performance of these investigations in an experimental observer study.
• Single-view breast tomosynthesis was confirmed as non-inferior to dual-view mammography.
• None of the investigations (or combinations) tested outperformed the others.
• Further prospective studies are needed to clarify precise role of tomosynthesis for diagnostic application.
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Metadata
Title
Digital breast tomosynthesis versus mammography and breast ultrasound: a multireader performance study
Authors
Fabienne Thibault
Clarisse Dromain
Catherine Breucq
Corinne S. Balleyguier
Caroline Malhaire
Luc Steyaert
Anne Tardivon
Enrica Baldan
Harir Drevon
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2863-5

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