Value of digital breast tomosynthesis in diagnosis of radial lesions / 中华放射学杂志

ABSTRACT

Objective:To evaluate the diagnostic value of digital breast tomosynthesis (DBT) and digital mammography (DM) for radial lesions.Methods:The data of 76 patients (78 lesions) with radial lesions confirmed by operation and pathology on DBT between December 2016 and May 2020 in the Affiliated Hospital of Qingdao University were analyzed retrospectively. Taking pathological results as the gold standard, 78 lesions were divided into benign radial lesions ( n=46) and malignant radial lesions ( n=32), and their DBT features were compared. According to the standard of breast imaging report and data system (BI-RADS), the wheel-spoke structure, central density, overall size, central size and surrounding burr length of the two groups of radial lesions were compared on DBT. Results:The detection rates of DM and DBT for 78 radial lesions were 59.0% (46/78) and 100% (78/78), the difference had statistically significant ( P<0.05). The diagnostic accuracy rates of DM and DBT for 78 radial lesions was 65.2% (30/46) and 74.4% (58/78), the difference had no statistically significant ( P>0.05). The sensitivity, specificity, misdiagnosis rates, missed diagnosis rates of DM and DBT in the diagnosis of malignant radial lesions were 64.3%(18/28) and 84.4%(27/32), 66.7% (12/18) and 67.4%(31/46), 33.3%(6/18) and 32.6%(15/46), 35.7%(10/28) and 15.6%(5/32), respectively. The difference was not statistically significant ( P>0.05). There were significant differences in the overall size of lesions [18.0 (14.9, 29.2) mm, 26.5 (20.2, 34.9) mm], central size [3.5 (2.5, 4.5) mm, 4.5 (3.5, 5.5) mm] and peripheral burr length [(11±6) mm, (13±4) mm] between benign and malignant radial lesions on DBT ( P<0.05). When the central size of the lesion was 5 mm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05), and when the overall size of the lesion was 2 cm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05). Conclusion:DBT can improve the detection and diagnosis accuracy of radial lesions, and provide an important basis for clinicians to make surgical treatment decisions.