Dose comparison of mammography with two photographic modes / 中华放射医学与防护杂志

Objective:To compare radiation dose between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM), and explore the correlation of average glandular dose(AGD) with breast density and compression thickness.Methods:The mammographic data of patients with breast diseases who underwent digital breast tomosynthesis (DBT) and the population who underwent full-field digital mammography (FFDM) screening in the First Affiliated Hospital of Kunming Medical University from October 2020 to May 2022 were retrospectively collected. The compression thickness, compression force and AGD were recorded. According to the 2013 ACR BI-RADS MAMMOGRAPHY, the breast gland density was classified into 4 types: a(glandular tissue<25%), b(glandular tissue 25%~50%), c(glandular tissue 50%~75%) and d(glandular tissue >75%), by two senior doctors engaged in breast imaging diagnosis. The relationships between different gland densities, different compression thicknesses and AGD under FFDM and DBT mode were analyzed.Results:In both FFDM and DBT modes, the AGD increased significantly with the increase of breast density( F=861.63, 617.83, 330.33, 451.45, 290.47, P<0.001), and AGD a<AGD b<AGD c<AGD d. For type c and d breasts undergoing FFDM, AGD was lowest when the compression thickness was 31~40 mm. Under the same compression thickness, The AGD DBT was significantly higher than the AGD FFDMin all types (Type a: t=-17.88, -42.19, -29.90, -28.14, -24.95, P<0.001; Type b: t=-49.18, -35.94, -27.25, -28.37, -24.10, P<0.001; Type c: t=-11.78, -32.90, -23.13, -20.51, -18.24, P<0.001; Type d: t=-7.94, -26.24, -17.24, -15.44, -13.81, P<0.001). The difference between two AGDs of Type d with compression thickness of 61~70 mm was the largest, which was 1.07 mGy (95% CI: 0.92~1.22). The AGD was positively correlated with breast density and compression thickness, and the relationship of FFDM was stronger than that of DBT. Conclusions:The AGD is positively correlated with breast density and compression thickness in mammography. Compared with FFDM, DBT can increase AGD, The AGD would increase in DBT than FFDM but be safe. DBT would be beneficial to patients with breast diseases in clinical practice.

Study on the correlation between radiation dose and breast compression thickness and density in full-field digital mammography combined with digital breast tomosynthesis / 中华放射医学与防护杂志

Objective:To compare and analyze the relationship between average glandular dose (AGD) and breast density and compression thickness in digital breast tomosynthesis(DBT)/full-field digital mammography(FFDM), and to explore the optimal selection and application of imaging parameters for different types of breast (thickness and density) in specific situations.Methods:The clinical data of 229 cases of breast Combo (DBT+ FFDM) were retrospectively analyzed. The compression thickness, AGD, kVp and type of quantified breast density (Q_abd) of CC and MLO view were collected respectively. The relationship between the AGD and the breast compression thickness and Q_abd density classification was analyzed.Results:There was a positive correlation between AGD and compression thickness (CC: r =0.55, 0.53, P< 0.001; MLO: r =0.62, 0.48, P< 0.001) and breast density(CC: r =0.36, 0.39, P< 0.001; MLO: r =0.16, 0.30, P < 0.001) in DBT/FFDM. The difference between groups for AGD was little in CC of DBT, but significant in CC of FFDM(groups by thickness, CC: F =35.29, 31.32, P<0.005; MLO: F =44.83, 27.02, P<0.005; groups by Q_abd, CC: F =18.68, 19.76, P<0.005, MLO: F=4.58, 10.52, P<0.005); the breast Q_abd was inversely proportion to the mean compression thickness (CC: F =16.28, P<0.005; MLO: F =17.81, P<0.005). At the same time, the interaction effect on AGD between the breast density and thickness was considered, and only for the MLO in FFDM mode they had an interaction on AGD ( F =3.16, P =0.005). Conclusions:The cumulative dose of DBT and FFDM may increase the radiation risk. Single-view CC/MLO-DBT or CC/MLO-(DBT+ FFDM)+ single-view MLO/CC-FFDM mode is preferred for mammography, which plays a positive role in radiation risk reduction.

Influencia de la incorporación de la tomosíntesis en un centro de diagnóstico mamario / The impact of integrating breast tomosynthesis in a Breast Diagnostic Center / Influência da incorporação da tomossíntese em um centro diagnóstico de mama

Resumen: Introducción: se han producido múltiples avances tecnológicos en la historia de la mamografía. En los años más recientes surge la mamografía digital directa con tomosíntesis con mayores capacidades para detectar el cáncer. Objetivo: evaluar el efecto de la nueva tecnología en el desempeño de la mamografía, en la Unidad de Diagnóstico Mamario del Hospital Británico. Material y métodos: se compara el desempeño de la mamografía durante los años 2019-2020 en relación con los años 2010-2018. En el año 2019 se sustituyó la tecnología anterior por un mamógrafo digital directo con tomosíntesis, Hologic modelo Selenia Dimensions. Resultados: en los años 2019 a 2020 se realizaron 10.725 mamografías. Se detectaron 84 cánceres y la tasa de detección de cáncer fue de 8/1.000. El VPP fue de 35%. En los años 2010 a 2018 se realizaron 45.438 mamografías. Se detectaron 229 cánceres y la tasa de detección de cáncer fue de 5/1.000. EL VPP fue de 40%. En relación a las manifestaciones imagenológicas, se destaca el aumento de las microcalcificaciones en el período 2019-2020, que pasaron de ser 7% de los casos, a ser 19% de los casos. Las distorsiones aumentaron de 11% a 13%. En relación a los tipos histológicos de cáncer, se destaca el porcentaje del carcinoma ductal in situ (CDIS) que fue 4 veces superior en el período 2019-2020 en relación al anterior (17% de todos los casos detectados). Conclusiones: con la incorporación de la tomosíntesis aumentó 60% la tasa de detección de cáncer y el porcentaje de CDIS aumentó 4 veces.

Abstract: Introduction: significant technological progress has been made in the history of mammography. Recently, direct digital mammography plus tomosynthesis arrived and improved breast cancer screening. Objective: to evaluate the effects of new technology in the performance of mammography, at the Breast Diagnostic Service of the British Hospital. Method: mammography performance during 2019- 2020 was compared to that between 2010 and 2018. In 2019 the previous tehcnology was substituted by a direct digital mammogram with tomosynthesis, Hologic, Selenia Dimensions model. Results: 10.725 mammographies were done in 2019-2020. Cancer was detected in 84 cases and the cancer detection rate was 8 per 1000 persons. PPV was 35%. 45.438 mammographies were done in 2010-2018. Cancer was detected in 229 cases and the cancer detection rate was 5 per 1.000 persons. PPV was 40%. As to images, it is worth pointing out an increase in microcalcifications between 2019 and 2020, when they grew from 7% of cases to 19% of cases and distortions increased from 11% to 13%. DCIS was 4 times greater in 2019-2020 when compare to the previous period of time (17% of all detected cases). Conclusions: the integration of tomosynthesis increased 60% the cancer detection rate and the DCIS was 4 times greater.

Resumo: Introdução: a história da mamografia registra vários avanços tecnológicos. Nos anos mais recentes, a mamografia digital direta com tomossíntese surgiu com uma maior capacidade de detectar a presença de câncer. Em 2019 a Unidade de Diagnóstico de Mama (UDM) do Hospital Britânico no Uruguai, incorporou um mamógrafo digital direto com tomossíntese, Hologic modelo Selenia Dimensions. Objetivo: avaliar desempenho do mamógrafo digital direto com tomossíntese na UDM. Material e métodos: faz-se uma comparação dos resultados das mamografias durante dois períodos 2019-2020 e 2010-2018. Resultados: no período 2019 a 2020 foram realizadas 10.725 mamografias; 84 cânceres foram detectados com una taxa de detecção de 8/1000. O valor preditivo positivo (VPP) foi de 35%. No período 2010-2018, foram realizadas 45.438 mamografias, 229 cânceres foram detectados com una taxa de detecção de 5/1000. O VPP foi de 40%. Em relação às manifestações de imagem, destaca-se o aumento das microcalcificações no período 2019-2020, que passou de 7% para 19% dos casos. As distorções aumentaram de 11% para 13%. Em relação aos tipos histológicos de câncer, destaca-se a porcentagem de carcinoma ductal in situ (CDIS), que foi quatro vezes maior no período 2019-2020 do que no anterior (17% do total de casos detectados). Conclusões: com a incorporação da tomossíntese, a taxa de detecção de câncer aumentou 60% e a porcentagem de CDIS aumentou quatro vezes.

Diagnostic performance of contrast-enhanced spectral mammography in suspected breast lesions based on histological results / 中华放射学杂志

Objective@#To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) in suspected breast lesions.@*Methods@#A total of 97 patients with suspected breast cancer identified by clinical examination or screening underwent two-views CESM examination on the basis of digital breast tomosynthesis (DBT) combined with full-field digital mammography (FFDM), and they were finally confirmed by biopsy or pathology. Three senior radiologists analyzed images, including lesion visibility, lesion characteristics, enhancement type, degree of enhancement, BIRDS classification, etc. Finally, based on the pathology, we compared the CESM+DBT+FFDM and DBT+FFDM two models according to sensitivity, specificity and ROC for diagnostic performance.@*Results@#There were a total of 120 lesions. Eighty-nine lesions were malignant, 31 benign; CESM was not enhanced in 2 cases, mild enhancement was performed in 22 cases, moderately intensive in 15 cases, highly intensive in 81 cases, and 2 cases were not enhanced; mass-enhanced in 96 cases, including ring-enhanced in 12 cases, 22 cases of non-mass type. The sensitivities of the combination of CESM and not combination of CESM were 91.0% and 80.9%, respectively, and the specificities were 93.5% and 87.1%, respectively. The area under the ROC curve of combination of CESM was higher than the without combination of CESM (0.923 and 0.900, P<0.05), The difference was statistically significant.@*Conclusion@#For suspicious lesions, CESM examination can improve the diagnosis accuracy of breast cancer.

Evaluation of common inspection techniques for acute atlantoaxial trauma / 中华创伤骨科杂志

Objective To evaluate and compare the 3 common inspection techniques for acute atlantoaxial trauma:tomosynthesis(DTS),digital radiology(DR) and computed tomography(CT).Methods The imaging data from March 2013 through December 2017 were retrieved from the Picture Archiving and Communication Systems(PACS) of The First Affiliated Hospital of Chongqing Medical University concerning the patients with acute atlantoaxial trauma.Selected for this study were 50 DTS images(DTS group),50 CT images(CT group) and 50 DR images(DR group).The image diagnoses for the 3 groups were conducted by 2 senior radiologists and their judgments were compared with the definite clinical diagnoses.The 3 groups were compared in terms of diagnostic accuracy,diagnostic rate of acute atlantoaxial trauma,image quality and effective radiation dosage.Results DR was insignificantly different from DTS or CT in diagnostic accuracy for the acute atlantoaxial Irauma which had been caused by mild violence like spraining and falling(P>0.05),but significantly inferior to both DTS and CT in diagnostic accuracy and diagnostic rate of the acute atlantoaxial trauma which had been caused by severe violence like traffic accident(P<0.05).In detection of atlas/axial fracture and atlantoaxial dislocation,DTS was slightly weaker than CT but significantly better than DR(P<0.05).The image quality scores for CT group(4.60±0.11) and DTS group(4.16±0.15) were significantly higher than that for DR group(2.80±0.18)(P<0.05).In average effective radiation dosage,CT group(2.33±0.020 mSv/time) was the highest,followed by DTS group(0.61±0.076 mSv/time) and DR group(0.025±0.003 mSv/time),showing significant differences between any two(P<0.05).Conclusions DR technique may be used for inspection of the atlantoaxial acute trauma caused by mild violence like spraining and falling,but has little value for inspection of most cases of atlantoaxial acute trauma.DTS technique may be the first choice for inspection of most atlantoaxial acute trauma.CT should be applied as a further inspection for complex cases because of its highest diagnostic accuracy and highest effective radiation dosage.

Digital Breast Tomosynthesis Mammography System Registration Application Data Technical Review Concerns / 中国医疗器械杂志

In this paper, the focus of technical review of the registration application data of digital Breast Tomosynthesis Mammography System was sorted out, so as to provide reference for researchers and manufacturers in China when applying for registration and preparation of such products.

Key technologies in digital breast tomosynthesis system:theory, design, and optimization / 南方医科大学学报

OBJECTIVE@#To develop a digital breast tomosynthesis (DBT) imaging system with optimizes imaging chain.@*METHODS@#Based on 3D tomography and DBT imaging scanning, we analyzed the methods for projection data correction, geometric correction, projection enhancement, filter modulation, and image reconstruction, and established a hardware testing platform. In the experiment, the standard ACR phantom and high-resolution phantom were used to evaluate the system stability and noise level. The patient projection data of commercial equipment was used to test the effect of the imaging algorithm.@*RESULTS@#In the high-resolution phantom study, the line pairs were clear without confusing artifacts in the images reconstructed with the geometric correction parameters. In ACR phantom study, the calcified foci, cysts, and fibrous structures were more clearly defined in the reconstructed images after filtering and modulation. The patient data study showed a high contrast between tissues, and the lesions were more clearly displayed in the reconstructed image.@*CONCLUSIONS@#This DBT imaging system can be used for mammary tomography with an image quality comparable to that of commercial DBT systems to facilitate imaging diagnosis of breast diseases.

Comparison of the Diagnostic Values of Dynamic Enhanced Magnetic Resonance Imaging,Digital Breast Tomosynthesis,and Digital Mammography for Early Breast Cancer / 中国医学科学院学报

Objective To compare the values of dynamic enhanced magnetic resonance imaging(DCE-MRI),digital breast tomosynthesis(DBT),and digital mammography(DM)in the early detection and diagnosis of breast cancer.Methods We retrospectively analyzed the clinical and imaging data of 65 cases with early breast cancer confirmed by surgical pathology from June 2017 to December 2018.All patients underwent breast DCE-MRI,DM and DBT before surgery.The receiver operating characteristic(ROC)curves were drawn,with the pathological results as the gold standard,to evaluate the diagnostic performance of different examination methods.The areas under ROC curves(AUCs)were compared using test.The differences among DCE-MRI,DBT and DM in detecting early breast cancer were compared using chi-square test in terms of positive rates,accuracy,sensitivity,and specificity.Pearson correlation analysis was performed to assess the accuracy of these imaging methods in detecting the size of early breast cancer.Results The AUCs of DCE-MRI,DBT,and DM based on the BI-RADS classification for early diagnosis of breast cancer were 0.910,0.832,and 0.700,respectively(=2.132,=0.001);the sensitivity of DCE-MRI,DBT,and DM for early breast cancer was 92.3%,70.8%,and 52.5%,the specificity was 65.0%,85.0%,and 79.3%,and the accuracy was 83.1%,70.8%,and 50.8%,indicating that DCE-MRI(=15.330,=0.0001) and DBT(=5.450,=0.020) had significantly higher diagnostic accuracy than DM.The measurement results of DM,DBT,and DCE-MRI were positively correlated with the pathological measurements(=0.781,=0.847,=0.946;all <0.01). Conclusions DCE-MRI and DBT have higher positive rates and accuracies than DM in detecting early breast cancer.Medical institutions where DCE-MRI is still not available can use DBT to improve the early detection of breast cancer.

Diagnostic performance of contrast?enhanced spectral mammography in suspected breast lesions based on histological results / 中华放射学杂志

Objective To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) in suspected breast lesions. Methods A total of 97 patients with suspected breast cancer identified by clinical examination or screening underwent two-views CESM examination on the basis of digital breast tomosynthesis (DBT) combined with full-field digital mammography (FFDM), and they were finally confirmed by biopsy or pathology. Three senior radiologists analyzed images, including lesion visibility, lesion characteristics, enhancement type, degree of enhancement, BIRDS classification, etc. Finally, based on the pathology, we compared the CESM+DBT+FFDM and DBT+FFDM two models according to sensitivity, specificity and ROC for diagnostic performance. Results There were a total of 120 lesions. Eighty-nine lesions were malignant, 31 benign; CESM was not enhanced in 2 cases, mild enhancement was performed in 22 cases, moderately intensive in 15 cases, highly intensive in 81 cases, and 2 cases were not enhanced; mass-enhanced in 96 cases, including ring-enhanced in 12 cases, 22 cases of non-mass type. The sensitivities of the combination of CESM and not combination of CESM were 91.0% and 80.9%, respectively, and the specificities were 93.5% and 87.1%, respectively. The area under the ROC curve of combination of CESM was higher than the without combination of CESM (0.923 and 0.900, P<0.05), The difference was statistically significant. Conclusion For suspicious lesions, CESM examination can improve the diagnosis accuracy of breast cancer.

The Diagnostic Reproducibility of Tomosynthesis for the Correlation between Acromiohumeral Distance and Rotator Cuff Size or Type

OBJECTIVE: To correlate the acromiohumeral distance (AHD) using tomosynthesis and rotator cuff (RC) pathology and various anatomical indices and to assess the diagnostic reproducibility of tomosynthesis for the evaluation of subacromial impingement. MATERIALS AND METHODS: A retrospective review of 63 patients with clinically suspected subacromial impingement was conducted. Two musculoskeletal radiologists independently measured the following quantitative data: the AHD on plain radiographs and the AHD at three compartments (anterior, middle, and posterior) using tomosynthesis, computed tomography (CT) arthrography, or magnetic resonance (MR) arthrography. To investigate the association between the AHD and RC pathology and various anatomical indices, we reviewed the arthroscopic operation record as the referenced standard. RESULTS: The size of rotator cuff tear (RCT) in full-thickness tears displayed a significant inverse correlation with the middle and the posterior tomosynthetic AHDs (p < 0.05). The results of an ANOVA revealed that the middle tomosynthetic AHD retained a significant association with the type of RCT (p = 0.042), and the posterior tomosynthetic AHD retained significance for the size of RCT in a full-thickness tear (p = 0.024). The inter-modality correlation exhibited significant agreement especially among the plain radiography, tomosynthesis, and CT or MR arthrography (p < 0.05). The intraobserver and interobserver correlation coefficients (ICCs) displayed excellent agreement (ICC = 0.896–0.983). The humeral head diameter and glenoid height were significantly correlated with patient height and weight. CONCLUSION: Acromiohumeral distance measurement using tomosynthesis is reproducible compared with other modalities.

Comparison of diagnostic accuracy of digital breast tomosynthesis, digital mammography, and ultrasonography for the non-calcified ductal carcinoma in situ of the breast / 中华放射学杂志

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT), digital mammography(DM),and ultrasonography(US)for the non-calcified ductal carcinoma in situ(DCIS) of the breast.Methods To retrospectively analyze the imaging and clinical data of ductal carcinoma in situ which was confirmed by surgical pathology and displayed as non-calcified lesions in mammography in 110 patients.DBT,DM and US were performed in all the 110 cases.The breast imaging report and data system (BI-RADS)classification and breast density classification were evaluated using the 5th edition of BI-RADS. In our study, BI-RADS 4B, 4C, and 5 were regarded to be in agreement with the pathologic findings, BI-RADS 1,2,3,and 4A were considered to be negative.BI-RADS c and d were classified as dense breasts, BI-RADS a and b were classified as fatty breasts.The imaging findings of the non-calcified ductal carcinoma in situ were evaluated.The differences in the detection rate and the diagnostic accuracy among the DBT,DM and US in all cases and in different breast density were compared using χ2 test. Results The detection rates of DBT,DM,and US for non-calcified DCIS in all cases were 84.5%(93/110),70.9%(78/110),95.5% (105/110).Pairwise comparisons among the three techniques showed statistically significant difference(P<0.05). The diagnostic accuracy of DBT, DM, and US were 70.0% (77/110), 44.5% (49/110), and 69.1% (76/110),respectively.The diagnostic accuracy of DBT and US were significantly higher than that of DM(P<0.01). Of the 110 patients, 89 patients were classified as dense breasts and non-dense breasts in the remaining 21 patients.The detection rates of DBT,DM,and US for non-calcified DCIS in dense breasts were 82.0%(73/89),65.2%(58/89),and 96.6%(86/89).Pairwise comparisons among the three techniques showed statistically significant difference(P<0.01).The diagnostic accuracy of DBT,DM,and US for non-calcified DCIS in dense breast were 65.2% (58/89), 38.2% (34/89) and 66.3% (59/89), respectively.The diagnostic accuracy of DBT and US were significantly higher than that of DM in dense breast(P<0.01).The detection rate and diagnostic accuracy for DBT,DM,and US in non-dense breasts were not statistically different(P>0.05).By DBT and DM,most cases of non-calcified DCIS presented as a mass lesion with an irregular shape, indistinct margin,and isodense composition.Conclusion US is more advantageous to the detection of the non-calcified DCIS and the non-calcified DCIS in the dense breast.

Estimation of effective dose to examined adult patients during digital tomosynthesis / 中华放射医学与防护杂志

Objective To estimate the absorbed dose and effective dose to the examined adult patients during digital tomosynthesis and to provide reference data for radiation dosimetry.Methods The phantom experiments were grouped according to the examined site(main beam scanned site),and the data displayed in real time during digital tomosynthesis are used as conditions for the phantom experiments.The effective doses to the examined patients were estimated on the basis of phantom scanning and tissue-absorbed dose calculation.Results During digital tomosynthesis,the effective doses to the examined patients of various groups were 0.524 mSv for head,0.736 mSv for cervical spine,2.719 mSv for thoracic vertebra,1.810 mSv for chest,1.240 mSv for lumbar spine,2.317 mSv for abdomen and 2.316 mSv for pelvis,respectively.Conclusions During digital tomography,the highest value of effective doses was estimated to be 2.719 mSv in thoracic vertebra group,followed by abdominal group 2.317 mSv and pelvic group 2.316 mS,with the lowest 0.524 mSv in head group.The main factors influencing the effective dose include tube voltage,total mAs,irradiation field size,main beam irradiation range,and the number of tissues or organs in scanned range.

Application and research progress of X-ray digital tomosynthesis in skeletal system imaging / 中国中西医结合急救杂志

Because X-ray digital tomosynthesis (DTS) imaging principle is different from that of CT, DTS has better spatial resolution than that of CT in sagittal and coronal planes, and since DTS is reconstructed to generate"layer" images, its power in the aspect of distinguishing 3D tissue structures is superior to that of general X-ray photography, so DTS can provide 3D information for clinical diagnosis; its radiation dose is markedly lower than that of CT. In recent years, DTS has made progress in the application of skeletal system imaging; the research progress and the possible direction of future application of DTS in bone fracture diagnosis, fracture healing estimation, vertebral bone quality assessment and fracture risk prediction, joint dislocation diagnosis, bone erosion evaluation and postoperative arthroplasty assessment were summarized.

Diagnostic value of digital breast tomosynthesis technique for breast suspicious calcified lesions / 中华普通外科杂志

Objective To explore the diagnostic value of digital breast tomosynthesis technique (DBT) in breast suspicious calcified lesions.Methods Clinical data of 135 patients using DBT and FFDM (Full field digital mammography) was respectively analyzed.Results Of the 135 cases,43 cases were malignant,and 92 cases were benign.The diagnostic sensitivity DBT and FFDM were 93.0％ (40/43)and 88.4％ (38/43),specificity were 88.0％ (81/92) and 75.0％ (69/92),accuracy were 89.6％ (121/135) and 79.3％ (107/135),the differences were statistically significant (P ＜0.05).The ROC curve area (AUC) of DBT and FFDM were 0.905 ± 0.026 and 0.817 ± 0.034 (P =0.000 2).In premenopausal,postmenopausal and breast density ACR3-4 cases,DBT accuracy is higher than FFDM (P ＜ 0.05).The BI-RADS classification difference of the benign calcified lesions was statistically significant (x2 =11.740,P =0.038 5).Conclusions Compared with the traditional FFDM,DBT has a higher value in the diagnosis of breast suspicious calcified lesions,especially for benign calcified lesions.

Progresses of ultrasonography and digital breast tomosynthesis in dense breast / 中国介入影像与治疗学

The dense breast notification legislation,which was passed by Connecticut in 2009,has attracted more attention to the dense breast.Now there is still no unified criterion nor global guide for reference to indicate additional supplemental screening tool suitable for women with dense breast.Ultrasonography and digital breast tomosynthesis became research focus.The progresses of these two technologies in dense breast were reviewed in this article.

The differential diagnostic value of digital breast tomosynthesis in combination with synthesized two-dimensional images in breast disease / 中华放射学杂志

Objective To investigate the diagnostic value and characteristics of breast lesion in digital breast tomosynthesis (DBT) in combination with synthesized two-dimensional (2D) images. Methods The prospective study enrolled women older than 18 years with clinically suspected breast lesion.One hundred and sixty seven patients with 177 lesions confirmed by biopsy or surgery were included. All the patients underwent full-field digital mammography(FFDM)and DBT examinations,and synthesized 2D images(V-preview)were reconstructed from DBT.The images of FFDM,V-preview images and DBT plus FFDM, V-preview images were analyzed. The breast imaging reporting and data system (BI-RADS) and characteristic for predicting benign and malignant lesion were also evaluated.The average glandular dose for a single mammographic view between FFDM and DBT was recorded.The Nonparametric Z test was used to compare the differences among four different mammographic images in BI-RADS.The differential diagnostic performance among different mammography was evaluated by ROC analysis.Independent t test was used to compare the average glandular dose between FFDM and DBT.Results One hundred three benign lesions and 74 malignant lesions were confirmed. Compared with FFDM images alone or plus DBT,the diagnostic values of V-preview images alone/or plus DBT were not significantly different(Z=0.187 and 0.226,P=0.851 and 0.821), but compared with V-preview, the diagnostic values of V-preview images plus DBT revealed significant difference(Z=3.546,P<0.01).The area under ROC for V-preview plus DBT were 0.899,and the sensitivity,specificity,and accuracy were 90.5%,89.3%,and 89.3%,separately.For the average glandular dose, there was no significant difference between FFDM (1.48 ± 0.52) mGy and DBT (1.56 ± 0.39) mGy examination(t=1.714,P=0.087).Conclusion Synthesized 2D images from DBT,which may eliminate the need for FFDM,in combination with DBT can improve the diagnostic efficiency.

Comparison of full field digital mammography and digital breast tomosynthesis in predicting size of ductal carcinoma in situ / 中国医学影像技术

Objective To compare the accuracy of full field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in predicting size of ductal carcinoma in situ (DCIS).Methods Totally 30 women pateints with DCIS confirmed by histology were analyzed retrospectively.Two radiologists measured the size of the lesions on FFDM,DBT images respectively,and compared with pathological results.Two kinds of inspection methods correlation with pathology were compared with Pearson correlation analysis.Results Size of DCIS measured by doctor 1 and doctor 2 between FFDM and histology had correlation (r=0.857,0.818,both P＜0.01),and those between DBT and histology also had correlation (r=0.924,0.885,both P＜0.01).Intraclass correlation coefficient (ICC) of two doctors was 0.947 on FFDM,and 0.908 on DBT.Conclusion DBT provides a better estimation of the size of DCIS.Two physicians had high consistency for lesion size evaluation.For DCIS with microcalcifications,both FFDM and DBT provide smaller estimations compared with pathology,thus a bigger surgical resection of lesion is needed.

Value of digital tomosynthesis for physical examination of chest / 医疗卫生装备

Objective To investigate the significance of digital tomosynthesis (DTS) for suspicions lesions in the physical examination of the chest.Methods Totally 1 000 physical examinees were divided into two groups,with 500 younger ones in one group and the remained 500 ones in the other.The examinees underwent examination with digital X-ray radiography,and then the suspicious cases went through DTS examination to analyze the detection rate of pulmonary positive results.Results There were 110 suspected cases found by digital X-ray radiography,including 8 young ones and 102 old ones.The suspected cases went through DTS examination,and totally 92 nodules were found including 4 ones in the young persons and 88 ones in old persons.CT examination found 89 carcinomatous nodules in the 92 ones.Conclusion DTS examination can detect the lesion of the physical examinee,and lays a foundation for early diagnosis and treatment.

Digital breast tomosynthesis technique (DBT) versus full field digital mammography (FFDM) for the diagnosis of breast mass-like lesions / 中华普通外科杂志

Objective To evaluate the diagnostic value of breast mass-like lesions by digital breast tomosynthesis technique (DBT) versus full field digital mammography (FFDM).Methods 182 breast mass cases undergoing respectively DBT and FFDM diagnosis were reviewed to evaluate the the sensitivity,specificity and accuracy,breast BI-RADS classification and differences of edge character.Results Of the 182 cases,101 cases were malignant,81 cases were benign.DBT and FFDM in malignant mass detection rate were 95.0％ and 95.0％ respectively,the benign tumor detection rate were 80.2％ and 80.2％ respectively,the difference was statistically significant (P ＜ 0.05).The diagnostic sensitivity was 93.1％ (94/101) and 82.2％ (83/101),specificity was 66.7％ (54/81) and 53.1％ (43/81),accuracy was 81.3％ (148/182) and 69.2％ (126/182),all the differences were statistically significant (P ＜ 0.05).The BI-RADS classification difference of the malignant mass was statistically significant (x2 =12.912,P =0.044 5),and the benign mass was also statistically significant (x2 =12.739,P =0.026 0).The clear edge benign tumors detected by DBT and FFDM respectively were 65 and 45 cases (x2 =10.224,P =0.001 4).The spicule sign detected by DBT and FFDM respectively in malignant tumors were 71 and 50 cases (x2 =8.244,P =0.004 1).Conclusion DBT compared to traditional FFDM photography improves the lesion visibility,increases the diagnostic sensitivity and specificity,conducing to the identification of benign and malignant lesions.

A comparative study of diagnostic performance between digital breast tomosynthesis and conventional imaging methods / 中国癌症杂志

Background and purpose:Breast cancer is the most common malignancy in women. The new technology of mammography is helpful in breast cancer diagnosis. This study aimed to compare the efficacy of digital breast tomosynthesis (DBT) with conventional imaging methods in the diagnosis of benign and malignant breast lesions.Methods:During the period from Mar. 2015 to Dec. 2015, 227 patients with suspected lesions (by palpation or sonography) underwent further imaging exam in our hospital. The sonography, full-field digital mammography (FFDM), DBT and breast MRI were performed on all the patients. A double-blind assessment was carried out according to BI-RADS (version 2013) by experienced radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of all methods, referring to the pathological data as the golden standard; the difference in the efficiency of DBT from the other methods was determined byZ-test.Results:Thirty patients were excluded for the unsatisfactory images, and 205 lesions (132 malignant and 73 benign lesions) were detected in the remaining 197 patients. Area under the curve (AUC) of sonography, FFDM, DBT, DBT+FFDM and MRI based on the BI-RADS were 0.8308, 0.8592, 0.9167, 0.9198, and 0.9354, respectively. The AUC of DBT was significantly higher than those of sonography (Z=7.36,P=0.0067) and FFDM (Z=4.89,P=0.0271), while there was no significantly difference between DBT and MRI (Z=0.02,P=0.9002) or FFDM+DBT (Z=0.69,P=0.4048).Conclusion:DBT could significantly improve the diagnostic performance for breast lesions compared with sonography and FFDM, providing a comparable efficiency to MRI. As a new mammography technology, DBT has good clinical application prospect.