Peters, Sabine, Hellmich, Martin, Stork, Alexander, Kemper, Joern, Grinstein, Olga, Puesken, Michael, Stahlhut, Leandra, Kinner, Sonja, Maintz, David and Krug, Kathrin Barbara (2017). Comparison of the Detection Rate of Simulated Microcalcifications in Full-Field Digital Mammography, Digital Breast Tomosynthesis, and Synthetically Reconstructed 2-Dimensional Images Performed With 2 Different Digital X-ray Mammography Systems. Invest. Radiol., 52 (4). S. 206 - 216. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-0210

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Abstract

Objective: The aim of this study was to compare the microcalcification detectability in an anthropomorphic phantom model regarding number, size, and shape in full-field digitalmammography (FFDM), synthetically reconstructed 2-dimensional (Synthetic-2D) images, and digital breast tomosynthesis (DBT) performed with 2 different x-ray mammography systems. Materials and Methods: Simulated microcalcifications of different numbers (0 to > 39), sizes (diameter, 100-800 mu m), and shapes (round vs heterogeneous) were scattered by random distribution on 50 film phantoms each divided in 4 quadrants. The FFDM and DBT x-rays were taken from each of these 50 films with both x-ray mammography systems (SenoClaire; GE Healthcare, Selenia Dimensions, Hologic) using an anthropomorphic scattering body and automatic exposure control. The resulting exposure factors were similar to a clinical setting. The synthetically reconstructed 2D images were generated automatically on both systems. All FFDM, Synthetic-2D, and DBT images were interpreted in randomized order and independently of each other by 6 radiologists using a structured questionnaire. Results: The number categories of simulated microcalcifications were correctly evaluated in 55.3% of instances (quadrant by reader) in FFDM, 50.9% in the Synthetic-2D views, and 59.5% in DBT, summarized for 200 quadrants per reader for each Device A and B, respectively. Full-field digital mammography was superior to Synthetic-2D (mean difference, 4%; 95% confidence interval [ CI], 2%-7%; P < 0.001), and DBT was superior to both FFDM (mean difference, 4%; 95% CI, 2%-7%; P = 0.002) and Synthetic-2D (mean difference, 9%; 95% CI, 6%-11%; P < 0.001). This trend was consistent in all subgroup analyses. The number of the smallest microcalcifications (100-399 mu m) was correctly evaluated in 25.2% of the FFDM, in 14.2% for Synthetic-2D, and in 28.3% of the DBT images. Underestimations of the number of simulated microcalcifications were more common than overestimations. Regarding the size categories of simulated microcalcifications, the rates of correct assessments were in 45.4% of instances in FFDM, 39.9% in the Synthetic-2D views, and 43.6% in DBT, summarized for 200 quadrants per reader and both imaging devices. Conclusions: In the presented in vitro environment using an anthropomorphic phantom model, standard full-field digital x-ray mammography was superior to synthetically reconstructed 2-dimensional images in the detection of simulated microcalcifications. In view of these results, it is questionable whether Synthetic-2D images can replace FFDM in clinical examinations at the present time. Further investigations are needed to assess the clinical impact of the in vitro results.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Peters, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellmich, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stork, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kemper, JoernUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grinstein, OlgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Puesken, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stahlhut, LeandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kinner, SonjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maintz, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krug, Kathrin BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-235735
DOI: 10.1097/RLI.0000000000000334
Journal or Publication Title: Invest. Radiol.
Volume: 52
Number: 4
Page Range: S. 206 - 216
Date: 2017
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1536-0210
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ENHANCED SPECTRAL MAMMOGRAPHY; RADIATION-EXPOSURE; PROJECTION IMAGES; CALCIFICATIONS; PHANTOM; COMBINATION; CLUSTERS; DBTMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/23573

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