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首页> 外文期刊>Acta Radiologica >Digital breast tomosynthesis (DBT): Initial experience in a clinical setting
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Digital breast tomosynthesis (DBT): Initial experience in a clinical setting

机译：数字化乳房断层合成（DBT）：在临床环境中的初步经验

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Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two false-positive findings. The side-by-side feature analysis showed higher conspicuity scores for tomosynthesis compared to conventional 2D for cancers presenting as spiculated masses and distortions. Conclusion: Tomosynthesis is a promising new technique. Our preliminary clinical experience shows that there is a potential for increasing the sensitivity using this new technique, especially for cancers manifesting as spiculated masses and distortions.
机译：背景：数字化乳房断层合成（DBT）是一种有前途的新技术。一些实验性临床研究已经显示出积极的结果，但是无论是在筛查还是在临床环境中，这种新技术的未来作用和适应症都需要评估。目的：在肩并肩特征分析中比较数字乳房X线照相术和DBT的显着性，并评估相对于标准的最新技术常规成像，DBT是否有潜在的附加价值检测其他恶性肿瘤。材料和方法：该研究获得伦理委员会的批准。共有129名妇女接受了2D数字化乳腺X线摄影，包括补充锥下和放大视图，乳房超声检查（如果需要）以及数字化乳房断层扫描。在临床环境中常规成像的指征包括30例可触及的肿块（23％），54例（42％）的乳房X线筛查结果异常以及45例（35％）的妇女受到监视。根据目前的指南对妇女进行了检查，包括局部放大图，超声检查和穿刺活检（如果有的话）。在常规影像学后几周就对DBT检查进行了解释，而无需了解常规影像学发现。在随后的会议中，三名放射科医生对50例患者的癌症显着性进行了并排特征分析。结果：最先进的常规影像检查对45个乳房进行了穿刺活检，其中20个病变为良性，共诊断出25个癌症。其余84名妇女因正常/明确的良性发现而被解雇，没有进行穿刺活检的指征。随后的DBT解释在这84名女性中有4名发现了可疑的发现，并且必须召回这4名女性以进行断层合成发现的知识后再进行检查。这些延迟的检查导致了两种癌症（将癌症检出率提高了8％）和两个假阳性结果。并排特征分析显示，与常规2D表现为肿块和变形的癌症相比，层析合成的显着性得分更高。结论：断层合成是一种有前途的新技术。我们的初步临床经验表明，使用这种新技术可能会提高敏感性，尤其是对于表现为弥漫性肿块和扭曲的癌症。

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