Showing papers on "Digital mammography published in 2011"
TL;DR: In this small data set, FFDM appears to be slightly more sensitive than digital breast tomosynthesis for the detection of calcification, however, diagnostic performance as measured by area under the curve using BI-RADS was not significantly different.
Abstract: OBJECTIVE. The purpose of this article is to compare the ability of digital breast tomosynthesis and full field digital mammography (FFDM) to detect and characterize calcifications.MATERIALS AND METHODS. One hundred paired examinations were performed utilizing FFDM and digital breast tomosynthesis. Twenty biopsy-proven cancers, 40 biopsy-proven benign calcifications, and 40 randomly selected negative screening studies were retrospectively reviewed by five radiologists in a crossed multireader multimodal observer performance study. Data collected included the presence of calcifications and forced BI-RADS scores. Receiver operator curve analysis using BI-RADS was performed.RESULTS. Overall calcification detection sensitivity was higher for FFDM (0.84% [95% CI, 0.79–0.88%]) than for digital breast tomosynthesis (0.75% [95% CI, 0.70–0.80%]). In the cancer cohort, 75 (76%) of 99 interpretations identified calcification in both modes. Of those, a BI-RADS score less than or equal to 2 was rendered in three (4%) ...
264 citations
TL;DR: Initial clinical results show that CEDM has better diagnostic accuracy than mammography alone and mammography+ultrasound.
Abstract: Objective
To assess the diagnostic accuracy of Dual-Energy Contrast-Enhanced Digital Mammography (CEDM) as an adjunct to mammography (MX) versus MX alone and versus mammography plus ultrasound (US).
230 citations
TL;DR: It is concluded that the addition of dynamic digital subtraction mammography to conventional mammography can significantly improve diagnostic quality and is particularly pronounced in the case of dense breast tissue.
111 citations
TL;DR: The authors have developed a technique to produce 3D anthropomorphic breast phantoms with known ground truth, yielding highly realistic x-ray images that may serve both qualitative and quantitative performance assessments for 2D and 3D breast x-rays imaging systems.
Abstract: Purpose: Develop a technique to fabricate a 3D anthropomorphic breast phantom with known ground truth for image quality assessment of 2D and 3D breast x-ray imaging systems. Methods: The phantom design is based on an existing computer model that can generate breast voxel phantoms of varying composition, size, and shape. The physical phantom is produced in two steps. First, the portion of the voxel phantom consisting of the glandular tissue, skin, and Cooper's ligaments is separated into sections. These sections are then fabricated by high-resolution rapid prototyping using a single material with 50% glandular equivalence. The remaining adipose compartments are then filled using an epoxy-based resin (EBR) with 100% adipose equivalence. The phantom sections are stacked to form the physical anthropomorphic phantom. Results: The authors fabricated a prototype phantom corresponding to a 450 ml breast with 45% dense tissue, deformed to a 5 cm compressed thickness. Both the rapid prototype (RP) and EBR phantom materials are radiographically uniform. The coefficient of variation (CoV) of the relative attenuation between RP and EBR phantom samples was <1% and the CoV of the signal intensity within RP and EBR phantom samples was <1.5% on average. Digital mammography and reconstructed digital breast tomosynthesis imagesmore » of the authors' phantom were reviewed by two radiologists; they reported that the images are similar in appearance to clinical images, noting there are still artifacts from air bubbles in the EBR. Conclusions: The authors have developed a technique to produce 3D anthropomorphic breast phantoms with known ground truth, yielding highly realistic x-ray images. Such phantoms may serve both qualitative and quantitative performance assessments for 2D and 3D breast x-ray imaging systems.« less
96 citations
TL;DR: The dose benefit of digital screening was demonstrated by the establishment of a comparatively lower diagnostic reference level for the screening programme and the comparison of the dose performance of individual X-ray systems with the diagnostic referencelevel highlights the need for more optimisation within the service.
Abstract: The primary purpose of this study was to evaluate the impact of digital mammography screening on breast dose by analysing the results of a patient dose survey of the Irish breast screening programme. Results from the survey were used to determine a dose reference level for the screening programme. Approximately, 100 examinations were acquired for each of the digital mammography systems operational in the screening programme. Each examination consisted of two standard views of each breast. The mean glandular dose for each acquired image was calculated. The dose reference level was established by calculating the 95th percentile of the average mean glandular dose for the average compressed breast thickness of the mediolateral oblique views. The overall average mean glandular dose per examination was 2.72 ± 0.04 mGy. The average compressed breast thickness was 61.4 ± 0.03 mm. The average compression force was 109 ± 7 N. A dose reference level value of 1.75 mGy was established for the screening programme. The results of this clinical dose survey provide a valuable indication of the dose performance of modern full field digital mammographic imaging systems. The results demonstrate clearly the dose benefits of digital mammography. The dose benefit of digital screening was further demonstrated by the establishment of a comparatively lower diagnostic reference level for the screening programme. The comparison of the dose performance of individual X-ray systems with the diagnostic reference level highlights the need for more optimisation within the service.
65 citations
TL;DR: It is shown that DBT-based breast imaging in combination with FFDM could result in better performance under the free-response receiver operating characteristic (FROC) paradigm, and each of the radiologists performed better under the combined mode compared with FF DM alone.
Abstract: OBJECTIVE. The purpose of our study was to assess diagnostic performance when retrospectively interpreting full-field digital mammography (FFDM) and breast tomosynthesis examinations under a free-response receiver operating characteristic (FROC) paradigm.MATERIALS AND METHODS. We performed FROC analysis of a previously reported study in which eight experienced radiologists interpreted 125 examinations, including 35 with verified cancers. The FROC paradigm involves detecting, locating, and rating each suspected abnormality. Radiologists reviewed and rated both FFDM alone and a combined display mode of FFDM and digital breast tomosynthesis (DBT) (combined). Observer performance levels were assessed and compared with respect to the fraction of correctly identified abnormalities, the number of reported location-specific findings (both true and false), and their associated ratings. The analysis accounts for the number and locations of findings and the location-based ratings using a summary performance index (Λ...
61 citations
TL;DR: The study demonstrated the feasibility of applying a computerized scheme to detect cases with high risk of developing breast cancer based on computer-detected bilateral mammographic tissue asymmetry.
59 citations
TL;DR: Digital mammography screening would further reduce breast cancer mortality by 4.4%, at a 21% increased overdiagnosis rate, while the consequences of digital screening are sensitive to underlying assumptions on the natural history of DCIS.
58 citations
TL;DR: The realistic appearance of the 3D models of microcalcification clusters, whether malignant or benign clusters, was confirmed for 2D digital mammography images and the breast tomosynthesis datasets; this database of clusters is suitable for use in future observer performance studies related to the detectability of micro CALCification clusters.
Abstract: Purpose: This work proposes a new method of building 3D models of microcalcification clusters and describes the validation of their realistic appearance when simulated into 2D digital mammograms and into breast tomosynthesis images. Methods: A micro-CT unit was used to scan 23 breast biopsy specimens of microcalcification clusters with malignant and benign characteristics and their 3D reconstructed datasets were segmented to obtain 3D models of microcalcification clusters. These models were then adjusted for the x-ray spectrum used and for the system resolution and simulated into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. Six radiologists were asked to distinguish between 40 real and 40 simulated clusters of microcalcifications in two separate studies on 2D mammography and tomosynthesis datasets. Receiver operating characteristic (ROC) analysis was used to test the ability of each observer to distinguish between simulated and real microcalcification clusters. The kappa statistic was applied to assess how often the individual simulated and real microcalcification clusters had received similar scores (''agreement'') on their realistic appearance in both modalities. This analysis was performed for all readers and for the real and the simulated groupmore » of microcalcification clusters separately. ''Poor'' agreement would reflect radiologists' confusion between simulated and real clusters, i.e., lesions not systematically evaluated in both modalities as either simulated or real, and would therefore be interpreted as a success of the present models. Results: The area under the ROC curve, averaged over the observers, was 0.55 (95% confidence interval [0.44, 0.66]) for the 2D study, and 0.46 (95% confidence interval [0.29, 0.64]) for the tomosynthesis study, indicating no statistically significant difference between real and simulated lesions (p > 0.05). Agreement between allocated lesion scores for 2D mammography and those for the tomosynthesis series was poor. Conclusions: The realistic appearance of the 3D models of microcalcification clusters, whether malignant or benign clusters, was confirmed for 2D digital mammography images and the breast tomosynthesis datasets; this database of clusters is suitable for use in future observer performance studies related to the detectability of microcalcification clusters. Such studies include comparing 2D digital mammography to breast tomosynthesis and comparing different reconstruction algorithms.« less
57 citations
TL;DR: The NPWE method is a validated alternative to CDMAM scoring for use in the image quality specification, quality control and optimization of digital x-ray systems for screening mammography.
Abstract: Assessment of image quality for digital x-ray mammography systems used in European screening programs relies mainly on contrast-detail CDMAM phantom scoring and requires the acquisition and analysis of many images in order to reduce variability in threshold detectability. Part II of this study proposes an alternative method based on the detectability index (d') calculated for a non-prewhitened model observer with an eye filter (NPWE). The detectability index was calculated from the normalized noise power spectrum and image contrast, both measured from an image of a 5 cm poly(methyl methacrylate) phantom containing a 0.2 mm thick aluminium square, and the pre-sampling modulation transfer function. This was performed as a function of air kerma at the detector for 11 different digital mammography systems. These calculated d' values were compared against threshold gold thickness (T) results measured with the CDMAM test object and against derived theoretical relationships. A simple relationship was found between T and d', as a function of detector air kerma; a linear relationship was found between d' and contrast-to-noise ratio. The values of threshold thickness used to specify acceptable performance in the European Guidelines for 0.10 and 0.25 mm diameter discs were equivalent to threshold calculated detectability indices of 1.05 and 6.30, respectively. The NPWE method is a validated alternative to CDMAM scoring for use in the image quality specification, quality control and optimization of digital x-ray systems for screening mammography.
57 citations
TL;DR: This paper showed that parenchymal texture features are more strongly correlated with breast percent density at digital breast tomosynthesis (DBT) than at digital mammography, suggesting that DBT image texture analysis can provide more informative imaging features with which to characterize parenchiymal patterns.
Abstract: Our results demonstrate that parenchymal texture features are more strongly correlated with breast percent density at digital breast tomosynthesis (DBT) than at digital mammography, suggesting that DBT image texture analysis can provide more informative imaging features with which to characterize parenchymal patterns.
TL;DR: The overall accuracy of the two techniques was virtually equal despite the radiologist's very limited experience with tomosynthesis images and vast experience with two-dimensional mammography.
Abstract: BackgroundIn two-dimensional mammography, a well-known problem is over- and underlying tissue which can either obstruct a lesion or create a false-positive result. Tomosynthesis, with an ability to layer the tissue in the image, has the potential to resolve these issues.PurposeTo compare the diagnostic quality, sensitivity and specificity of a single tomosynthesis mammography image and a traditional two-view set of two-dimensional mammograms and to assess the comfort of the two techniques.Material and MethodsOne hundred and forty-four women, mainly chosen because of suspicious features on standard mammograms (76 malignant), had a single tomosynthesis image taken of one breast using a novel photon counting system. On average, the dose of the tomosynthesis images was 0.63 times that of the two-view images and the compression force during the procedure was halved. The resulting images were viewed by two radiologists and assessed both individually and comparing the two techniques.ResultsIn 56% of the cases th...
TL;DR: Based on results of the first screening rounds, it is concluded that the digital mammography screening program in North Rhine-Westphalia performs well and complies with the European guidelines.
Abstract: SUMMARY: In this review, we describe the history, evidence, and current practice of mammography screening in Europe and the newly implemented screening program in Germany. We report results of the first screening rounds in North Rhine-Westphalia and compare these with reference values set by the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis. Finally, we summarize and compare performance indicators of the organized screening program in England, Italy, North Rhine-Westphalia and The Netherlands. Based on results of the first screening rounds, we conclude that the digital mammography screening program in North Rhine-Westphalia performs well and complies with the European guidelines. Besides relatively low attendance rates of approximately 53%, implementation of the German organized breast cancer screening program was successful.
TL;DR: In this review, various techniques for imaging breast tumor vasculature are discussed and Dynamic contrast enhanced magnetic resonance imaging is the most-used imaging modality, but it has problems with detecting ductal carcinoma in situ and contrast enhanced digital mammography can detect DCIS, but requires the use of ionizing radiation.
Abstract: Breast cancer is one of the major causes of morbidity and mortality in western women. Current screening and diagnostic imaging modalities, like x-ray mammography and ultrasonography, focus on morphological changes of breast tissue. However, these techniques still miss some cancers and often falsely detect cancer. The sensitivity and specificity for detecting the disease can probably be improved by focusing on the consequences of tumor angiogenesis: the increased microvessel density with altered vascular characteristics. In this review, various techniques for imaging breast tumor vasculature are discussed. Dynamic contrast enhanced magnetic resonance imaging is the most-used imaging modality in this field. It has a proven high sensitivity, but a low specificity and cannot be applied in all women. Moreover, it has problems with detecting ductal carcinoma in situ (DCIS). On the contrary, contrast enhanced digital mammography can detect DCIS, but requires the use of ionizing radiation. Contrast enhanced ultrasound provides real-time information about true intravascular blood volume and flow. However, this technique still has difficulties with discriminating benign from malignant tissue. Moreover, these three imaging modalities all require the injection of contrast agents. Two relatively new techniques that do not use external contrast agents are diffuse optical imaging and photoacoustic imaging. Both visualize the increased concentration of hemoglobin in malignant tissue and thereby provide a high intrinsic contrast.
TL;DR: The technical evaluation section of the study showed that the digital mammography systems were well set up and exhibiting typical performance for the detector technology employed in the respective systems.
Abstract: In many European countries, image quality for digital x-ray systems used in screening mammography is currently specified using a threshold-detail detectability method. This is a two-part study that proposes an alternative method based on calculated detectability for a model observer: the first part of the work presents a characterization of the systems. Eleven digital mammography systems were included in the study; four computed radiography (CR) systems, and a group of seven digital radiography (DR) detectors, composed of three amorphous selenium-based detectors, three caesium iodide scintillator systems and a silicon wafer-based photon counting system. The technical parameters assessed included the system response curve, detector uniformity error, pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Approximate quantum noise limited exposure range was examined using a separation of noise sources based upon standard deviation. Noise separation showed that electronic noise was the dominant noise at low detector air kerma for three systems; the remaining systems showed quantum noise limited behaviour between 12.5 and 380 µGy. Greater variation in detector MTF was found for the DR group compared to the CR systems; MTF at 5 mm−1 varied from 0.08 to 0.23 for the CR detectors against a range of 0.16–0.64 for the DR units. The needle CR detector had a higher MTF, lower NNPS and higher DQE at 5 mm−1 than the powder CR phosphors. DQE at 5 mm−1 ranged from 0.02 to 0.20 for the CR systems, while DQE at 5 mm−1 for the DR group ranged from 0.04 to 0.41, indicating higher DQE for the DR detectors and needle CR system than for the powder CR phosphor systems. The technical evaluation section of the study showed that the digital mammography systems were well set up and exhibiting typical performance for the detector technology employed in the respective systems.
TL;DR: Computer-aided detection with full-field digital mammography (FFDM) showed 100% sensitivity in identifying cancers manifesting as microcalcifications only and high sensitivity 86% for other mammographic appearances of cancer.
TL;DR: The information captured by the standard PD measure was quantified as it relates to calibrated mammograms and used to develop an automated method for measuring breast density, an initial step for developing an automated measure built on an established calibration platform.
TL;DR: Recall rate and cancer detection rate increase for at least 2 years after the transition to digital screening mammography and PPV is significantly reduced after digital transition, primarily in patients with microcalcifications.
Abstract: There may be a consistent increase in cancer detection rate with digital mammography over at least 2 years.
01 May 2011
TL;DR: In this article, a method have been developed to make a supporting tool to easy and less time consuming of identification of abnormal masses in digital mammography images, the identification technique is divided into two distinct parts; Formation of Homogeneous Blocks and Color Quantization after preprocessing.
Abstract: In this work a method have been develop to make a supporting tool to easy and less time consuming of identification of abnormal masses in digital mammography images. The identification technique is divided into two distinct parts; Formation of Homogeneous Blocks and Color Quantization after preprocessing. The type of masses, orientation of masses, shape and distribution of masses, size of masses, position of masses, density of masses, symmetry between two pair etc are clearly sited after proposed method is executed on raw mammogram for easy and early detection abnormalities.
TL;DR: None of the units assessed were found to have perfect correlation between measured and readout thickness, and the method to establish a simple method to determine breast readout accuracy on mammography units was established.
Abstract: PURPOSE: To establish a simple method to determine breast readout accuracy on mammography units. METHODS: A thickness measuring device (TMD) was used in conjunction with a breast phantom. This phantom had compression characteristics similar to human female breast tissue. The phantom was compressed, and the thickness was measured using TMD and mammography unit readout. Measurements were performed on a range of screen film mammography (SFM) and full-field digital mammography (FFDM) units (8 units in total; 6 different models/manufacturers) for two different sized paddles and two different compression forces (60 N and 100 N).
RESULTS: The difference between machine readout and TMD for the breast area, when applying 100 N compression force, for non-flexible paddles was largest for GE Senographe DMR+ (24 cm x 30 cm paddle: +14.3%). For flexible paddles the largest difference occurred for Hologic Lorad Selenia (18 cm x 24 cm paddle: +26.0%).
CONCLUSIONS: None of the units assessed were found to have perfect correlation between measured and readout thickness. TMD measures and thickness readouts were different for the duplicate units from two different models/manufacturers.
TL;DR: PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics.
Abstract: Objectives
To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women.
TL;DR: The sensitivity and specificity of breast tomosynthesis (BT) will be compared with conventional two-dimensional digital mammography (DM) for breast cancer screening in a population-based study.
Abstract: Experiences gained so far using tomosynthesis for breast cancer screening will be reported. A short summary of results from preparatory studies will also be presented. The sensitivity and specificity of breast tomosynthesis (BT) will be compared with conventional two-dimensional digital mammography (DM) for breast cancer screening in a population-based study. Over 2000 women have been examined so far with BT and DM. The BT reading is significantly more time-consuming than the DM reading. Preparatory studies have shown that BT has a higher diagnostic precision and higher accuracy of size measurements and stage determination than DM. There is potential to use lower compression force with BT compared with DM, without decreasing the diagnostic accuracy. BT might play an important role in clinical as well as screening mammography. A large-scale population-based study to investigate BT as a screening modality is underway.
TL;DR: The lower false-positive risk with use of digital mammography should be taken into account when balancing the risks and benefits of breast cancer screening.
Abstract: While cancer detection did not differ in women screened with screen-film mammography (SFM) or digital mammography (DM), the recall rate and false-positive risk were lower with DM than with SFM after adjustment was made for the woman’s screening mammogram, radiology unit screening round, age at screening, and time trends.
18 Sep 2011
TL;DR: A novel multi-class fuzzy c-means (FCM) algorithm for fully-automated identification and quantification of breast density, optimized for the imaging characteristics of digital mammography is presented.
Abstract: The relative fibroglandular tissue content in the breast, commonly referred to as breast density, has been shown to be the most significant risk factor for breast cancer after age. Currently, the most common approaches to quantify density are based on either semi-automated methods or visual assessment, both of which are highly subjective. This work presents a novel multi-class fuzzy cmeans (FCM) algorithm for fully-automated identification and quantification of breast density, optimized for the imaging characteristics of digital mammography. The proposed algorithm involves adaptive FCM clustering based on an optimal number of clusters derived by the tissue properties of the specific mammogram, followed by generation of a final segmentation through cluster agglomeration using linear discriminant analysis. When evaluated on 80 bilateral screening digital mammograms, a strong correlation was observed between algorithm-estimated PD% and radiological ground-truth of r=0.83 (p<0.001) and an average Jaccard spatial similarity coefficient of 0.62. These results show promise for the clinical application of the algorithm in quantifying breast density in a repeatable manner.
TL;DR: The evidence and the current role of new breast imaging technologies in screening are highlighted, focusing on those that have broader application in population screening, including digital mammography, breast ultrasound in women with dense breasts, and computer-aided detection.
13 Apr 2011
TL;DR: A method have been develop to make a supporting tool to easy and less time consuming of identification of abnormal masses in digital mammography images.
Abstract: Mammography is at present one of the available method for early detection of masses or abnormalities which is related to breast cancer. The most common said abnormalities that may indicate breast cancer are masses and calcifications. The challenge is to early and accurately detect to overcome the development of breast cancer, which affects more and more women throughout the world. Masses appear in a mammogram as fine, granular clusters, which are often difficult to identify in a raw mammogram. Digital mammogram is one of the best technologies currently being used for diagnosing breast cancer. Breast cancer is diagnosed at advanced stages with the help of the digital mammogram image. In the paper a method have been develop to make a supporting tool to easy and less time consuming of identification of abnormal masses in digital mammography images. The identification technique is divided into two distinct parts i.e. Formation of Homogeneous Blocks and Color Quantization after preprocessing. The type of masses, orientation of masses, shape and distribution of masses, size of masses, position of masses, density of masses, symmetry between two pair etc are clearly sited after proposed method is executed on raw mammogram for easy and early detection abnormality.
TL;DR: Despite a higher B 3 rate of minimally invasive biopsies with "uncertain malignant potential" in digital screening, the benign surgical biopsy rate is not disproportionally increased compared with analog screening programs.
Abstract: PURPOSE: To evaluate the rate, the histological spectrum and the positive predictive value (PPV) for malignancy of minimally invasive biopsies with ”uncertain malignant potential (B3)” in digital mammography screening. METHODS AND MATERIALS: Consecutive data of 37 178 participants of one digital unit of the German screening program were included. RESULTS: The B 3 rate was 15.1 % (148 / 979). The frequencies of lesion subtypes were as follows: atypical epithelial proliferation of ductal type (AEPDT) 35.1 % (52 / 148), radial scar (RS) 28.4 % (42 / 148), papillary lesions (PAP) 20.3 % (30 / 148), lobular carcinoma in situ 8.8 % (13 / 148), flat epithelial atypia 5.4 % (8 / 148), and mucocele-like lesions 2.0 % (3 / 148). The PPV for malignancy in surgical excisions was overall 0.28 (25 / 91); in detail 0.40 (19 / 47) for AEPDT, 0.20 (5 / 25) for RS, 0.08 (1 / 12) for PAP. CONCLUSION: Despite a higher B 3 rate of minimally invasive biopsies with ”uncertain malignant potential” in digital screening, the benign surgical biopsy rate is not disproportionally increased compared with analog screening programs. Together with defined management protocols, this results in an increased cancer detection rate per screening participant with surgical excision.
TL;DR: This preliminary investigation demonstrates that breast tomosynthesis acquired with variable dose distribution exhibits inherent 3D reconstruction advantages for structure noise removal and provides a 2D projection with a physical image quality close to that of standard mammography.
Abstract: The complexity of anatomical structure within the breast represents the ultimate limit to signal detection on a mammogram. To increase lesion conspicuity Digital Breast Tomosynthesis (DBT) has been recently proposed and several manufacturers are currently performing clinical trials. In this study we investigate the potential of DBT with variable dose distribution by using a phantom in which details of interest are within a heterogeneous background. To compare the performance of a commercial digital mammography unit and a DBT prototype, 2D and 3D images of the breast phantom were obtained at similar dose levels. As expected, DBT showed superior performance over digital mammography. Although certain details of interest are not detectable with digital mammography, DBT can reveal their signal by reducing the complexity of tissue structures. Additionally, the potential of the central projection in variable dose DBT is similar to the standard projection obtained with digital mammography. Finally, the uniform and variable dose approaches provided almost identical reconstructed slices. This preliminary investigation demonstrates that breast tomosynthesis acquired with variable dose distribution exhibits inherent 3D reconstruction advantages for structure noise removal and provides a 2D projection with a physical image quality close to that of standard mammography.
TL;DR: The differences in the AUCs and the p-value suggest that multiview stereoscopy has a statistically significant advantage over mammography in the detection of simulated breast masses, and highlights the dominance of anatomical noise compared to quantum noise for breast mass detection.
Abstract: Purpose: Mammography is known to be one of the most difficult radiographic exams to interpret. Mammography has important limitations, including the superposition of normal tissue that can obscure a mass, chance alignment of normal tissue to mimic a true lesion and the inability to derive volumetric information. It has been shown that stereomammography can overcome these deficiencies by showing that layers of normal tissue lay at different depths. If standard stereomammography (i.e., a single stereoscopic pair consisting of two projection images) can significantly improve lesion detection, how will multiview stereoscopy (MVS), where many projection images are used, compare to mammography? The aim of this study was to assess the relative performance of MVS compared to mammography for breast mass detection. Methods: The MVS image sets consisted of the 25 raw projection images acquired over an arc of approximately 45 deg. using a Siemens prototype breast tomosynthesis system. The mammograms were acquired using a commercial Siemens FFDM system. The raw data were taken from both of these systems for 27 cases and realistic simulated mass lesions were added to duplicates of the 27 images at the same local contrast. The images with lesions (27 mammography and 27 MVS) and the imagesmore » without lesions (27 mammography and 27 MVS) were then postprocessed to provide comparable and representative image appearance across the two modalities. All 108 image sets were shown to five full-time breast imaging radiologists in random order on a state-of-the-art stereoscopic display. The observers were asked to give a confidence rating for each image (0 for lesion definitely not present, 100 for lesion definitely present). The ratings were then compiled and processed using ROC and variance analysis. Results: The mean AUC for the five observers was 0.614{+-}0.055 for mammography and 0.778{+-}0.052 for multiview stereoscopy. The difference of 0.164{+-}0.065 was statistically significant with a p-value of 0.0148. Conclusions: The differences in the AUCs and the p-value suggest that multiview stereoscopy has a statistically significant advantage over mammography in the detection of simulated breast masses. This highlights the dominance of anatomical noise compared to quantum noise for breast mass detection. It also shows that significant lesion detection can be achieved with MVS without any of the artifacts associated with tomosynthesis.« less
TL;DR: Cancer detection rates were significantly higher for full-field digital mammography than for screen-film mammography, especially for women <50, and cancers detected as clustering microcalcifications.
Abstract: Objective
To compare the diagnostic performance of full-field digital mammography (FFDM) with screen-film mammography (SFM) in a corporate screening programme including younger women.