Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 2/2019

01-02-2019 | Breast

Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting

Authors: Manisha Bahl, Sarah Mercaldo, Charmi A. Vijapura, Anne Marie McCarthy, Constance D. Lehman

Published in: European Radiology | Issue 2/2019

Login to get access

Abstract

Objectives

To compare performance metrics between digital 2D mammography (DM) and digital breast tomosynthesis (DBT) in the diagnostic setting.

Methods

Consecutive diagnostic examinations from August 2008 to February 2011 (DM group) and from January 2013 to July 2015 (DM/DBT group) were reviewed. Core biopsy and surgical pathology results within 365 days after the mammogram were collected. Performance metrics, including cancer detection rate (CDR), abnormal interpretation rate (AIR), positive predictive value (PPV) 2, PPV3, sensitivity, and specificity were calculated. Multivariable logistic regression models were fit to compare performance metrics in the DM and DM/DBT groups while adjusting for clinical covariates.

Results

A total of 22,883 mammograms were performed before DBT integration (DM group), and 22,824 mammograms were performed after complete DBT integration (DM/DBT group). After adjusting for multiple variables, the CDR was similar in both groups (38.2 per 1,000 examinations in the DM/DBT group versus 31.3 per 1,000 examinations in the DM group, p = 0.14); however, a higher proportion of cancers were invasive rather than in situ in the DM/DBT group [83.7% (731/873) versus 72.3% (518/716), p < 0.01]. The AIR was lower in the DM/DBT group (p < 0.01), and PPV2, PPV3, and specificity were higher in the DM/DBT group (all p = 0.01 or p < 0.01).

Conclusions

Complete integration of DBT into the diagnostic setting is associated with improved diagnostic performance. Increased utilization of DBT may thus result in better patient outcomes and lead to a shift in the benchmarks that have been established for DM.

Key Points

• Integration of tomosynthesis into the diagnostic setting is associated with improved performance.
• A higher proportion of cancers are invasive rather than in situ with digital breast tomosynthesis.
• Increased utilization of tomosynthesis may lead to a shift in established benchmarks.
Literature
1.
Hooley RJ, Durand MA, Philpotts LE (2017) Advances in digital breast tomosynthesis. AJR Am J Roentgenol 208(2):256–266CrossRef
2.
Ciatto S, Houssami N, Bernardi D et al (2013) Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol 14(7):583–589CrossRef
3.
Skaane P, Bandos AI, Gullien R et al (2013) Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program. Radiology 267(1):47–56CrossRef
4.
Friedewald SM, Rafferty EA, Rose SL et al (2014) Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA 311(24):2499–2507CrossRef
5.
McCarthy AM, Kontos D, Synnestvedt M et al (2014) Screening outcomes following implementation of digital breast tomosynthesis in a general-population screening program. J Natl Cancer Inst 106(11)
6.
Sharpe RE Jr, Venkataraman S, Phillips J et al (2016) Increased cancer detection rate and variations in the recall rate resulting from implementation of 3D digital breast tomosynthesis into a population-based screening program. Radiology 278(3):698–706CrossRef
7.
Raghu M, Durand MA, Andrejeva L et al (2016) Tomosynthesis in the diagnostic setting: changing rates of BI-RADS final assessment over time. Radiology 281(1):54–61CrossRef
8.
Sickles EA, D'Orsi CJ, Bassett LW et al (2013) ACR BI-RADS mammography. In: ACR BI-RADS atlas, breast imaging reporting and data system. American College of Radiology, Reston, VA
9.
Rose SL, Tidwell AL, Bujnoch LJ, Kushwaha AC, Nordmann AS, Sexton R Jr (2013) Implementation of breast tomosynthesis in a routine screening practice: an observational study. AJR Am J Roentgenol 200(6):1401–1408CrossRef
10.
Bahl M, Gaffney S, McCarthy AM, Lowry KP, Dang PA, Lehman CD (2017) Breast cancer characteristics associated with 2D digital mammography versus digital breast tomosynthesis for screening-detected and interval cancers. Radiology 287(1):49–57CrossRef
11.
Sprague BL, Arao RF, Miglioretti DL et al (2017) National performance benchmarks for modern diagnostic digital mammography: update from the Breast Cancer Surveillance Consortium. Radiology 283(1):59–69CrossRef
12.
Bahl M, Lamb LR, Lehman CD (2017) Pathologic outcomes of architectural distortion on digital 2D versus tomosynthesis mammography. AJR Am J Roentgenol 209(5):1162–1167CrossRef
13.
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(3):616–623CrossRef
14.
Gennaro G, Toledano A, di Maggio C et al (2010) Digital breast tomosynthesis versus digital mammography: a clinical performance study. Eur Radiol 20(7):1545–1553CrossRef
15.
Hakim CM, Chough DM, Ganott MA, Sumkin JH, Zuley ML, Gur D (2010) Digital breast tomosynthesis in the diagnostic environment: a subjective side-by-side review. AJR Am J Roentgenol 195(2):W172–W176CrossRef
16.
Noroozian M, Hadjiiski L, Rahnama-Moghadam S et al (2012) Digital breast tomosynthesis is comparable to mammographic spot views for mass characterization. Radiology 262(1):61–68CrossRef
17.
Tagliafico A, Astengo D, Cavagnetto F et al (2012) One-to-one comparison between digital spot compression view and digital breast tomosynthesis. Eur Radiol 22(3):539–544CrossRef
18.
Brandt KR, Craig DA, Hoskins TL et al (2013) Can digital breast tomosynthesis replace conventional diagnostic mammography views for screening recalls without calcifications? A comparison study in a simulated clinical setting. AJR Am J Roentgenol 200(2):291–298CrossRef
19.
Waldherr C, Cerny P, Altermatt HJ et al (2013) Value of one-view breast tomosynthesis versus two-view mammography in diagnostic workup of women with clinical signs and symptoms and in women recalled from screening. AJR Am J Roentgenol 200(1):226–231CrossRef
20.
Zuley ML, Bandos AI, Ganott MA et al (2013) Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology 266(1):89–95CrossRef
21.
Lei J, Yang P, Zhang L, Wang Y, Yang K (2014) Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis. Eur Radiol 24(3):595–602CrossRef
22.
Peppard HR, Nicholson BE, Rochman CM, Merchant JK, Mayo RC 3rd, Harvey JA (2015) Digital breast tomosynthesis in the diagnostic setting: indications and clinical applications. Radiographics 35(4):975–990CrossRef
23.
Poplack S (2017) Breast tomosynthesis: clinical evidence. Radiol Clin North Am 55(3):475–492CrossRef
24.
Spangler ML, Zuley ML, Sumkin JH et al (2011) Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. AJR Am J Roentgenol 196(2):320–324CrossRef
25.
Svahn TM, Houssami N, Sechopoulos I, Mattsson S (2015) Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full-field digital mammography. Breast 24(2):93–99CrossRef
26.
Gennaro G, Bernardi D, Houssami N (2018) Radiation dose with digital breast tomosynthesis compared to digital mammography: per-view analysis. Eur Radiol 28(2):573–581CrossRef
Metadata
Title
Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting
Authors
Manisha Bahl
Sarah Mercaldo
Charmi A. Vijapura
Anne Marie McCarthy
Constance D. Lehman
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5596-7

Other articles of this Issue 2/2019

European Radiology 2/2019 Go to the issue

Musculoskeletal

Association of paraspinal muscle water–fat MRI-based measurements with isometric strength measurements

Magnetic Resonance

Preoperative prediction of deep myometrial invasion and tumor grade for stage I endometrioid adenocarcinoma: a simple method of measurement on DWI

Vascular-Interventional

The role of wall shear stress in the parent artery as an independent variable in the formation status of anterior communicating artery aneurysms

Physics

Radiation dose reduction with frame rate conversion in X-ray fluoroscopic imaging systems with flat panel detector: basic study and clinical retrospective analysis

Gastrointestinal

Diffusion and perfusion MRI quantification in ileal Crohn’s disease

Vascular-Interventional

Comparison of transjugular intrahepatic portosystemic shunt (TIPS) alone and combined with embolisation for the management of cardiofundal varices: a retrospective study