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One-view digital breast tomosynthesis as a stand-alone modality for breast cancer detection : do we need more?

Rodriguez-Ruiz, Alejandro ; Gubern-Merida, Albert ; Imhof-Tas, Mechli ; Lardenoije, Susanne ; Wanders, Alexander J.T. ; Andersson, Ingvar LU ; Zackrisson, Sophia LU ; Lång, Kristina LU ; Dustler, Magnus LU orcid and Karssemeijer, Nico , et al. (2018) In European Radiology 28(5). p.1938-1948
Abstract

Purpose: To compare the performance of one-view digital breast tomosynthesis (1v-DBT) to that of three other protocols combining DBT and mammography (DM) for breast cancer detection. Materials and methods: Six radiologists, three experienced with 1v-DBT in screening, retrospectively reviewed 181 cases (76 malignant, 50 benign, 55 normal) in two sessions. First, they scored sequentially: 1v-DBT (medio-lateral oblique, MLO), 1v-DBT (MLO) + 1v-DM (cranio-caudal, CC) and two-view DM + DBT (2v-DM+2v-DBT). The second session involved only 2v-DM. Lesions were scored using BI-RADS® and level of suspiciousness (1–10). Sensitivity, specificity, receiver operating characteristic (ROC) and jack-knife alternative free-response ROC (JAFROC) were... (More)

Purpose: To compare the performance of one-view digital breast tomosynthesis (1v-DBT) to that of three other protocols combining DBT and mammography (DM) for breast cancer detection. Materials and methods: Six radiologists, three experienced with 1v-DBT in screening, retrospectively reviewed 181 cases (76 malignant, 50 benign, 55 normal) in two sessions. First, they scored sequentially: 1v-DBT (medio-lateral oblique, MLO), 1v-DBT (MLO) + 1v-DM (cranio-caudal, CC) and two-view DM + DBT (2v-DM+2v-DBT). The second session involved only 2v-DM. Lesions were scored using BI-RADS® and level of suspiciousness (1–10). Sensitivity, specificity, receiver operating characteristic (ROC) and jack-knife alternative free-response ROC (JAFROC) were computed. Results: On average, 1v-DBT was non-inferior to any of the other protocols in terms of JAFROC figure-of-merit, area under ROC curve, sensitivity or specificity (p>0.391). While readers inexperienced with 1v-DBT screening improved their sensitivity when adding more images (69–79 %, p=0.019), experienced readers showed similar sensitivity (76 %) and specificity (70 %) between 1v-DBT and 2v-DM+2v-DBT (p=0.482). Subanalysis by lesion type and breast density showed no difference among modalities. Conclusion: Detection performance with 1v-DBT is not statistically inferior to 2v-DM or to 2v-DM+2v-DBT; its use as a stand-alone modality might be sufficient for readers experienced with this protocol. Key points: • One-view breast tomosynthesis is not inferior to two-view digital mammography.• One-view DBT is not inferior to 2-view DM plus 2-view DBT.• Training may lead to 1v-DBT being sufficient for screening.

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Contribution to journal
publication status
published
subject
keywords
Breast cancer, Digital breast tomosynthesis, Digital mammography, Jack-knife alternative free-response receiver operating characteristic, Receiver operating characteristic
in
European Radiology
volume
28
issue
5
pages
1938 - 1948
publisher
Springer Science and Business Media B.V.
external identifiers
  • scopus:85037710554
  • pmid:29230524
ISSN
0938-7994
DOI
10.1007/s00330-017-5167-3
language
English
LU publication?
yes
id
c66fa912-c302-4271-82f6-34ddd3e25150
date added to LUP
2018-01-04 12:33:24
date last changed
2025-10-14 12:11:10
@article{c66fa912-c302-4271-82f6-34ddd3e25150,
  abstract     = {{<p>Purpose: To compare the performance of one-view digital breast tomosynthesis (1v-DBT) to that of three other protocols combining DBT and mammography (DM) for breast cancer detection. Materials and methods: Six radiologists, three experienced with 1v-DBT in screening, retrospectively reviewed 181 cases (76 malignant, 50 benign, 55 normal) in two sessions. First, they scored sequentially: 1v-DBT (medio-lateral oblique, MLO), 1v-DBT (MLO) + 1v-DM (cranio-caudal, CC) and two-view DM + DBT (2v-DM+2v-DBT). The second session involved only 2v-DM. Lesions were scored using BI-RADS® and level of suspiciousness (1–10). Sensitivity, specificity, receiver operating characteristic (ROC) and jack-knife alternative free-response ROC (JAFROC) were computed. Results: On average, 1v-DBT was non-inferior to any of the other protocols in terms of JAFROC figure-of-merit, area under ROC curve, sensitivity or specificity (p&gt;0.391). While readers inexperienced with 1v-DBT screening improved their sensitivity when adding more images (69–79 %, p=0.019), experienced readers showed similar sensitivity (76 %) and specificity (70 %) between 1v-DBT and 2v-DM+2v-DBT (p=0.482). Subanalysis by lesion type and breast density showed no difference among modalities. Conclusion: Detection performance with 1v-DBT is not statistically inferior to 2v-DM or to 2v-DM+2v-DBT; its use as a stand-alone modality might be sufficient for readers experienced with this protocol. Key points: • One-view breast tomosynthesis is not inferior to two-view digital mammography.• One-view DBT is not inferior to 2-view DM plus 2-view DBT.• Training may lead to 1v-DBT being sufficient for screening.</p>}},
  author       = {{Rodriguez-Ruiz, Alejandro and Gubern-Merida, Albert and Imhof-Tas, Mechli and Lardenoije, Susanne and Wanders, Alexander J.T. and Andersson, Ingvar and Zackrisson, Sophia and Lång, Kristina and Dustler, Magnus and Karssemeijer, Nico and Mann, Ritse M. and Sechopoulos, Ioannis}},
  issn         = {{0938-7994}},
  keywords     = {{Breast cancer; Digital breast tomosynthesis; Digital mammography; Jack-knife alternative free-response receiver operating characteristic; Receiver operating characteristic}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1938--1948}},
  publisher    = {{Springer Science and Business Media B.V.}},
  series       = {{European Radiology}},
  title        = {{One-view digital breast tomosynthesis as a stand-alone modality for breast cancer detection : do we need more?}},
  url          = {{http://dx.doi.org/10.1007/s00330-017-5167-3}},
  doi          = {{10.1007/s00330-017-5167-3}},
  volume       = {{28}},
  year         = {{2018}},
}