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Published in: European Radiology 2/2022

01-02-2022 | Mammography | Breast

Virtual clinical trial to compare cancer detection using combinations of 2D mammography, digital breast tomosynthesis and synthetic 2D imaging

Authors: Alistair Mackenzie, Emma L. Thomson, Melissa Mitchell, Premkumar Elangovan, Chantal van Ongeval, Lesley Cockmartin, Lucy M. Warren, Louise S. Wilkinson, Matthew G. Wallis, Rosalind M. Given-Wilson, David R. Dance, Kenneth C. Young

Published in: European Radiology | Issue 2/2022

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Abstract

Objectives

This study was designed to compare the detection of subtle lesions (calcification clusters or masses) when using the combination of digital breast tomosynthesis (DBT) and synthetic mammography (SM) with digital mammography (DM) alone or combined with DBT.

Methods

A set of 166 cases without cancer was acquired on a DBT mammography system. Realistic subtle calcification clusters and masses in the DM images and DBT planes were digitally inserted into 104 of the acquired cases. Three study arms were created: DM alone, DM with DBT and SM with DBT. Five mammographic readers located the centre of any lesion within the images that should be recalled for further investigation and graded their suspiciousness. A JAFROC figure of merit (FoM) and lesion detection fraction (LDF) were calculated for each study arm. The visibility of the lesions in the DBT images was compared with SM and DM images.

Results

For calcification clusters, there were no significant differences (p > 0.075) in FoM or LDF. For masses, the FoM and LDF were significantly improved in the arms using DBT compared to DM alone (p < 0.001). On average, both calcification clusters and masses were more visible on DBT than on DM and SM images.

Conclusions

This study demonstrated that masses were detected better with DBT than with DM alone and there was no significant difference (p = 0.075) in LDF between DM&DBT and SM&DBT for calcifications clusters. Our results support previous studies that it may be acceptable to not acquire digital mammography alongside tomosynthesis for subtle calcification clusters and ill-defined masses.

Key Points

The detection of masses was significantly better using DBT than with digital mammography alone.
The detection of calcification clusters was not significantly different between digital mammography and synthetic 2D images combined with tomosynthesis.
Our results support previous studies that it may be acceptable to not acquire digital mammography alongside tomosynthesis for subtle calcification clusters and ill-defined masses for the imaging technology used.
Literature
8.
go back to reference Mackenzie A, Marshall NW, Hadjipanteli A, David R Dance, Bosmans H, Young KC (2017) Characterisation of noise and sharpness of images from four digital breast tomosynthesis systems for simulation of images for virtual clinical trials. Phys Med Biol 62:2376–2397. https://doi.org/10.1088/1361-6560/aa5dd9 Mackenzie A, Marshall NW, Hadjipanteli A, David R Dance, Bosmans H, Young KC (2017) Characterisation of noise and sharpness of images from four digital breast tomosynthesis systems for simulation of images for virtual clinical trials. Phys Med Biol 62:2376–2397. https://​doi.​org/​10.​1088/​1361-6560/​aa5dd9
10.
go back to reference Romero Martín S, Raya Povedano JL, Cara García M, Romero ALS, Garriguet MP, Benito MA (2018) Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis. Eur Radiol 28:2484–2491. https://doi.org/10.1007/s00330-017-5219-8 Romero Martín S, Raya Povedano JL, Cara García M, Romero ALS, Garriguet MP, Benito MA (2018) Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis. Eur Radiol 28:2484–2491. https://​doi.​org/​10.​1007/​s00330-017-5219-8
12.
go back to reference Bakic PR, Myers KJ, Glick SJ, Maidment ADA (2016) Virtual tools for the evaluation of breast imaging: state-of-the science and future directions. In: Tingberg A, Lång K, Timberg P (eds) Breast Imaging. IWDM 2016 Lecture Notes in Computer Science 9699:518–524. https://doi.org/10.1007/978-3-319-41546-8_65 Bakic PR, Myers KJ, Glick SJ, Maidment ADA (2016) Virtual tools for the evaluation of breast imaging: state-of-the science and future directions. In: Tingberg A, Lång K, Timberg P (eds) Breast Imaging. IWDM 2016 Lecture Notes in Computer Science 9699:518–524. https://​doi.​org/​10.​1007/​978-3-319-41546-8_​65
16.
go back to reference Elangovan P, Mackenzie A, Warren LM et al (2019) Validation of modelling tools for simulating wide-angle DBT systems. In: Bosmans H, Chen G-H, Gilat Schmidt T (eds) Proc.SPIE Medical Imaging. SPIE, pp 109482E-1–109482E10 Elangovan P, Mackenzie A, Warren LM et al (2019) Validation of modelling tools for simulating wide-angle DBT systems. In: Bosmans H, Chen G-H, Gilat Schmidt T (eds) Proc.SPIE Medical Imaging. SPIE, pp 109482E-1–109482E10
24.
go back to reference Giampietro RR, Cabral MVG, Lima SAM, Weber SAT, Dos Santos Nunes-Nogueira V (2020) Accuracy and effectiveness of mammography versus mammography and tomosynthesis for population-based breast cancer screening: a systematic review and meta-analysis. Sci Rep 10:7991. https://doi.org/10.1038/s41598-020-64802-x Giampietro RR, Cabral MVG, Lima SAM, Weber SAT, Dos Santos Nunes-Nogueira V (2020) Accuracy and effectiveness of mammography versus mammography and tomosynthesis for population-based breast cancer screening: a systematic review and meta-analysis. Sci Rep 10:7991. https://​doi.​org/​10.​1038/​s41598-020-64802-x
28.
go back to reference Mackenzie A, Kaur S, Elangovan P et al (2018) Comparison of synthetic 2D images with planar and tomosynthesis imaging of the breast using a virtual clinical trial. In: Nishikawa RM, Samuelson FW (eds) Progress in Biomedical Optics and Imaging - Proceedings of SPIE. SPIE, 10577:0H-1–9. https://doi.org/10.1117/12.2293070 Mackenzie A, Kaur S, Elangovan P et al (2018) Comparison of synthetic 2D images with planar and tomosynthesis imaging of the breast using a virtual clinical trial. In: Nishikawa RM, Samuelson FW (eds) Progress in Biomedical Optics and Imaging - Proceedings of SPIE. SPIE, 10577:0H-1–9. https://​doi.​org/​10.​1117/​12.​2293070
29.
30.
go back to reference Rodriguez-Ruiz A, van Engen R, Michielsen K et al (2018) How does wide-angle breast tomosynthesis depict calcifications in comparison to digital mammography? A retrospective observer study. In: Krupinski EA (ed) 14th International Workshop on Breast Imaging (IWBI 2018). SPIE, pp 107181T1–107181T11 Rodriguez-Ruiz A, van Engen R, Michielsen K et al (2018) How does wide-angle breast tomosynthesis depict calcifications in comparison to digital mammography? A retrospective observer study. In: Krupinski EA (ed) 14th International Workshop on Breast Imaging (IWBI 2018). SPIE, pp 107181T1–107181T11
32.
go back to reference Alabousi M, Wadera A, Kashif Al-Ghita M et al (2021) Performance of digital breast tomosynthesis, synthetic mammography, and digital mammography in breast cancer screening: a systematic review and meta-analysis. J Natl Cancer Inst 113:680–690. https://doi.org/10.1093/jnci/djaa205 Alabousi M, Wadera A, Kashif Al-Ghita M et al (2021) Performance of digital breast tomosynthesis, synthetic mammography, and digital mammography in breast cancer screening: a systematic review and meta-analysis. J Natl Cancer Inst 113:680–690. https://​doi.​org/​10.​1093/​jnci/​djaa205
Metadata
Title
Virtual clinical trial to compare cancer detection using combinations of 2D mammography, digital breast tomosynthesis and synthetic 2D imaging
Authors
Alistair Mackenzie
Emma L. Thomson
Melissa Mitchell
Premkumar Elangovan
Chantal van Ongeval
Lesley Cockmartin
Lucy M. Warren
Louise S. Wilkinson
Matthew G. Wallis
Rosalind M. Given-Wilson
David R. Dance
Kenneth C. Young
Publication date
01-02-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08197-x

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