Aims and objectives
Use of Digital Breast Tomosynthesis (DBT) is increasing in clinical practice thanks to its ability toreduce breast tissue overlapping [1].
DBT is useful in particular in the identification of masses anddistortions,
[2] and it seems to have a good performance also with microcalcifications [3],
even if thelatter topic is still discussed [4].
In order to better characterize microcalcifications clustersand to have a direct comparison with previous images,
a 2D mammography is still acquired beforeDBT.
Thus,
patients have to undergo two examinations with a double radiation...
Methods and materials
In this retrospective study 127 consecutive patients (mean age: 56 years,
range 50-74 years) thatunderwent both DM and DBT with 2D-CP,
were included.
DBT parameterswere:
• W-target X-ray source
• Rh/Ag filter
• a-Se digital detector (ANRAD,
LMAM)
• Angular range: ±20°; 13 projections
• Reconstructed voxel: 0.085×0.085x1.0 mm
• Sensitive area: 24x30 cm2
• Iterative reconstruction with Total Variation (TV) regularisation
AEC dose: 1 DM view x 1.6; central dose responsible for 1/3 of the total dose delivered.
Reasons to perform the examinations were...
Results
A total of 125 patients with 72 lesions were included in the study (Figure 1).
Imaging finding aredescribed in Table 1.
Breast density distribution according to the two readers and two reading modalities is described in Table 2.
Intra-reader agreement was very good for both R1 (k= 0.990) and R2 (k= 0.907).
Also inter-readeragreement was good for both DM (k= 0.692) and 2D-CP (k= 0.607).
Area Under the Curve (AUC) ranged from 0.729 to 0.823 for Set-A and Set-C; from 0.894 to 0.904 forset-B and...
Conclusion
Diagnostic accuracy of 2D-CP alone and with DBT is comparable to that of DM alone and with DBT,and can be an alternative to avoid the acquisition of DM.
A limitation of 2D-CP,
as a low-dose DM,
isthat small masses can be undervalued; in our initial experience,
all this lesions can be clearly identifiedon DBT,
so this does not reduce the overall accuracy of the examination.
This low dose mammography acquired using a variable dose geometry can be used to substitue DM inpatients who undergo DBT,...
References
Baker JA,
Lo JY Breast tomosynthesis: state-of-the-art and review of the literature Acad Radiol.2011;18(10):1298-310
Diekmann F,
Bick U Breast tomosynthesis Semin Ultrasound CT MR 2011; 32(4): 281-7
Kopans D,
Gavenonis S,
Halpern E Calcifications in the breast and digital breast tomosynthesisBreast J.
2011; 17(6): 638-4
Tagliafico A,
Mariscotti G,
Durando M,
Stevanin C,
Tagliafico G,
Martino L,
Bignotti B,
Calabrese M,Houssami N.
Characterisation of microcalcification clusters on 2D digital mammography (FFDM) anddigital breast tomosynthesis (DBT): does DBT underestimate microcalcification clusters? Results of amulticentre study.
Eur...