Can digital breast tomosynthesis perform better than standard digital mammography work-up in breast cancer assessment clinic?
Purpose: To compare the efficacy of use of digital breast tomosynthesis (DBT) with standard digital mammography (DM) workup views in the breast cancer assessment clinic.Materials and Methods: The Tomosynthesis Assessment Clinic trial (TACT), conducted between 16 October 2014 and 19 April 2016, is an...
| Published in: | European Radiology Vol. 28; no. 12; pp. 5182 - 5195 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , |
| Format: | diagnostic images research tables/charts randomized controlled trial Journal Article |
| Published: |
Springer Nature
Dec2018
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132880996&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132880996 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Dec2018 vid: 28 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 132880996 132880996 NLM29846804 132880996 10.1007/s00330-018-5473-4 NLM29846804 132880996 ppf: 5182 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Can digital breast tomosynthesis perform better than standard digital mammography work-up in breast cancer assessment clinic? aug: au: Mall, S. Noakes, J. Kossoff, M. Lee, W. McKessar, M. Goy, A. Duncombe, J. Roberts, M. Giuffre, B. Miller, A. Bhola, N. Kapoor, C. Shearman, C. DaCosta, G. Choi, S. Sterba, J. Kay, M. Bruderlin, K. Winarta, N. Donohue, K. affil: Faculty of Health Sciences, University of Sydney, 75 East Street, Room M204, Lidcombe, New South Wales, Australia sug: subj: Mammography Methods Radiographic Image Enhancement Methods Health Screening Methods Breast Neoplasms Diagnosis ROC Curve Incidence Female Human Breast Neoplasms Epidemiology Australia Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Scales Female ab: Purpose: To compare the efficacy of use of digital breast tomosynthesis (DBT) with standard digital mammography (DM) workup views in the breast cancer assessment clinic.Materials and Methods: The Tomosynthesis Assessment Clinic trial (TACT), conducted between 16 October 2014 and 19 April 2016, is an ethics-approved, monocenter, multireader, multicase split-plot reading study. After written informed consent was obtained, 144 females (age > 40 years) who were recalled to the assessment clinic were recruited into TACT. These cases (48 cancers) were randomly allocated for blinded review of (1) DM workup and (2) DBT, both in conjunction with previous DM from the screening examination. Fifteen radiologists of varying experience levels in the Australia BreastScreen Program were included in this study, wherein each radiologist read 48 cases (16 cancers) in 3 non-overlapping blocks. Diagnostic accuracy was measured by means of sensitivity, specificity, and positive (PPV) and negative predictive values (NPV). The receiver-operating characteristic area under the curve (AUC) was calculated to determine radiologists' performances.Results: Use of DBT (AUC = 0.927) led to improved performance of the radiologists (z = 2.62, p = 0.008) compared with mammography workup (AUC = 0.872). Similarly, the sensitivity, specificity, PPV, and NPV of DBT (0.93, 0.75, 0.64, 0.96) were higher than those of the workup (0.90, 0.56, 0.49, 0.92). Most radiologists (80%) performed better with DBT than standard workup. Cancerous lesions on DBT appeared more severe (U = 33,172, p = 0.02) and conspicuous (U = 24,207, p = 0.02). There was a significant reduction in the need for additional views (χ2 = 17.63, p < 0.001) and recommendations for ultrasound (χ2 = 8.56, p = 0.003) with DBT.Conclusions: DBT has the potential to increase diagnostic accuracy and simplify the assessment process in the breast cancer assessment clinic.Key Points: • Use of DBT in the assessment clinic results in increased diagnostic accuracy. • Use of DBT in the assessment clinic improves performance of radiologists and also increases the confidence in their decisions. • DBT may reduce the need for additional views, ultrasound imaging, and biopsy. pubtype: Academic Journal doctype: diagnostic images research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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