Learning objectives
Many studies published in the last years hasstarted to show that Digital Breast Tomosynthesis (DBT) could be able to overcome some limitations of Digital Mammography (DM),such asthe relatively low sensitivity due to obscuring of breast lesions and the suboptimal specificity due to false positive findings.
Both are often related to tissue overlapping [1].
Even if it is possible to use classical semeiology also for Tomosynthesis studies,
some authors already noticed that even experienced radiologists may have difficulties in interpreting images not only in presence of...
Background
Patients
Between May and November 2012,
23 women underwent Digital Mammography and Ultrasound at our Institution with the identification of 27 suspicious lesions,
confirmed as malignant by percutaneous needle biopsy.
All women underwent DBT to better evaluate the extent of disease.
Written consent was obtained from all patients and the approval of Etichs commitee was also waved.
After surgery,
the diagnosis of malignancy was confirmed.
Imaging
We sequentially performed for each patient DM and DBT of both breasts in the standard cranio-caudal (CC) and mediolateral...
Imaging findings OR Procedure details
The final histological diagnosis of the 27 lesions identified was:
- IDC (invasive ductal carcinoma) for 21 lesions (77,78 %)
- ILC (invasive lobular carcinoma) for 4 lesions (14,81 %)
- DCIS (ductal carcinoma in situ) for 2 lesions (7,41%)
ACR BI-RADS density score in the 23 patients was as follows:
1 = 5 patients (21,74%)
2 = 7 patients (30,43%)
3 = 10 patients (43,48%)
4 = 1 patient (4.35%)
Of the 27 lesions: 12 (44.4%) presented as simple masses,
8 as masses and...
Conclusion
Our study suggests that the same semeiology used for DM can be applied and adapted in DBT evaluation.
Some artefacts intrinsic to DBT,
such as the lucent halo around masses and spiculae,
can be exploited to improve conspicuity of findings,
similarly to what happens for US artefacts.
It is also of note that even normal parenchyma can show different appearance at DBT,
mainly in relation to minor superimposition of the different breast tissues and superior depiction of some normal anatomical structures,
such as blood vessels...
References
1.
Lehman CD,
White E,
Peacock S et al.
Effect of age and breast density on screening mammograms with false positive findings.
Am J Roentgenol 1999;173:1651–1655
2.
Gur D,
Abrams GS,
Chough DM,
et al.
Digital Breast Tomosynthesis: Observer Performance Study AJR 2009;193:586–591
3.
D'Orsi CJ,
Mendelson,
EB,
Ikeda DM,
et al.
Breast Imaging Reporting and Data System: ACR BI-RADS – Breast Imaging Atlas,
Reston,
VA,
American College of Radiology 2003
4.
Hakim CM,
Chough DM,
Ganott MA,
et al.
Digital Breast Tomosynthesis in the...