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Mackenzie A, Thomson EL, Mitchell M, et al. Virtual clinical trial to compare cancer detection using combinations of 2D mammography, digital breast tomosynthesis and synthetic 2D imaging. Eur Radiol. 2021;doi: 10.1007/s00330-021-08197-x.
Mackenzie, A., Thomson, E. L., Mitchell, M., Elangovan, P., van Ongeval, C., Cockmartin, L., Warren, L. M., Wilkinson, L. S., Wallis, M. G., Given-Wilson, R. M., Dance, D. R., & Young, K. C. (2021). Virtual clinical trial to compare cancer detection using combinations of 2D mammography, digital breast tomosynthesis and synthetic 2D imaging. European radiology, . https://doi.org/10.1007/s00330-021-08197-x
Mackenzie, Alistair, et al. "Virtual clinical trial to compare cancer detection using combinations of 2D mammography, digital breast tomosynthesis and synthetic 2D imaging." European radiology vol. (2021). doi: https://doi.org/10.1007/s00330-021-08197-x
Mackenzie A, Thomson EL, Mitchell M, Elangovan P, van Ongeval C, Cockmartin L, Warren LM, Wilkinson LS, Wallis MG, Given-Wilson RM, Dance DR, Young KC. Virtual clinical trial to compare cancer detection using combinations of 2D mammography, digital breast tomosynthesis and synthetic 2D imaging. Eur Radiol. 2021 Jul 30; doi: 10.1007/s00330-021-08197-x. Epub 2021 Jul 30. PMID: 34331118.
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Eur Radiol. 2021 Jul 30; doi: 10.1007/s00330-021-08197-x. Epub 2021 Jul 30.

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

European radiology

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

Affiliations

  1. National Coordinating Centre for the Physics in Mammography, Royal Surrey NHS Foundation Trust, Guildford, UK. [email protected].
  2. National Coordinating Centre for the Physics in Mammography, Royal Surrey NHS Foundation Trust, Guildford, UK.
  3. Department of Physics, University of Surrey, Guildford, UK.
  4. Department of Radiology, UZ Leuven, Herestraat 49, B-3000, Leuven, Belgium.
  5. Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
  6. Oxford Breast Imaging Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  7. Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge & NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
  8. Department of Radiology, St George's Healthcare NHS Trust, London, UK.

PMID: 34331118 DOI: 10.1007/s00330-021-08197-x

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.

© 2021. European Society of Radiology.

Keywords: Cancer; Mammography; Screening

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