Breast Tomosynthesis
Section snippets
What Is Tomosynthesis?
The standard procedure for the early detection of breast cancer is mammography. Many studies have been performed to test this procedure under different conditions. Several studies show that at least when using mammography as a stand-alone procedure, the sensitivity of the technique is quite low, especially in dense breast tissue. This finding is true for both digital and film-screen mammography, although the sensitivity of digital mammography is slightly superior to that of film-screen
Summary of Publications on Tomosynthesis
The first highly recognized article regarding breast tomosynthesis was published by Niklason et al4 in 1997. This article was published very early in the development of the field (at least 1-2 years before digital mammography became widespread in clinical procedures), and it took quite a long time for many more articles regarding breast tomosynthesis to appear. In 2006, more than 5 original articles dealing with breast tomosynthesis (there were more review articles before, but no clinical data)
Examples of Tomosynthesis
Our experiences with tomosynthesis led us to believe that it helps solve problems for both benign and malignant lesions.
Conclusions
Digital mammography has been well-evaluated for the diagnosis of breast cancer. The scientific data show that mammography alone, especially in dense breast parenchyma, has its weaknesses. These weaknesses are due to the low contrast of tumors in comparison with the surrounding parenchyma and the overlying structures that mask tumors. The initial results from tomosynthesis studies show a tendency for better imaging and higher accuracy and lower recall rates with tomosynthesis. These findings are
References (28)
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Diagnostic performance of digital versus film mammography for breast-cancer screening
N Engl J Med
(2005) - et al.
Digital mammography: what do we and what don't we know?
Eur Radiol
(2007) - et al.
Tomosynthesis and contrast-enhanced digital mammography: recent advances in digital mammography
Eur Radiol
(2007) - et al.
Digital tomosynthesis in breast imaging
Radiology
(1997) - et al.
A comparison of reconstruction algorithms for breast tomosynthesis
Med Phys
(2004) - et al.
Task-based performance analysis of FBP, SART and ML for digital breast tomosynthesis using signal CNR and Channelised Hotelling Observers
Med Image Anal
(2010) - et al.
Evaluation of digital breast tomosynthesis reconstruction algorithms using synchrotron radiation in standard geometry
Med Phys
(2010) - et al.
Breast tomosynthesis: accuracy of tumor measurement compared with digital mammography and ultrasonography
Acta Radiol
(2010) - et al.
Digital breast tomosynthesis versus digital mammography: a clinical performance study
Eur Radiol
(2010) - et al.
Classification of clusters of microcalcifications in digital breast tomosynthesis
Conf Proc IEEE Eng Med Biol Soc
(2010)
The diagnostic accuracy of dual-view digital mammography, single-view breast tomosynthesis and a dual-view combination of breast tomosynthesis and digital mammography in a free-response observer performance study
Radiat Prot Dosimetry
Breast tomosynthesis in clinical practice: initial results
Eur Radiol
A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging
Med Phys
Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography
AJR Am J Roentgenol
Cited by (27)
Breast cancer screening: An evidence-based update
2015, Medical Clinics of North AmericaCitation Excerpt :Despite such uncertainty and lack of data on outcomes, CAD is widely used with screening mammography.26 With digital breast tomosynthesis, a rotating gantry takes images of the breast from various angles to create a 3-dimensional view.27 This technology, which has been approved by the US Food and Drug Administration, is now a standard feature in newer digital mammography units and rapidly diffusing into US community practice.28
X-ray phase-contrast tomosynthesis for improved breast tissue discrimination
2014, European Journal of RadiologyCitation Excerpt :Compared to CT, tomosynthesis uses only a sparse number of projection angles to produce a quasi 3-D aspect of the object. It is currently applied in addition to conventional mammography to reduce the masking of tumors by superposition artifacts [4]. In breast CT measurements the trade off between resolution and dose hinders a clear depiction of micro calcifications [5], while overlying soft-tissue structures are successfully resolved leading to a superior performance in detecting masses compared to mammography [2,6].
Current breast imaging modalities, advances, and impact on breast care
2013, Obstetrics and Gynecology Clinics of North AmericaCitation Excerpt :The primary benefit of DBT to patients lies in the combination of improved detection and confidence. Additional benefits are the potential to decrease recall rates, as noted earlier, with the decreasing mean glandular dose through obviating additional views,19,23,25,33 decreasing the benign biopsy rate through decreased false-positives,23 and more accurate BI-RADS classification at initial screening or diagnostic examination.25 Research using ultrasound to detect breast masses began in the 1950s with John Wild.37
Digital tomosynthesis: A new future for breast imaging?
2013, Clinical RadiologyCitation Excerpt :Assessment of lesion size by DBT is similar to28 or more accurate than 2D mammography61 and compared with 2D mammography, specifically DBT has been shown to have better accuracy for lesions larger than 1 mm.62 Mammographic breast density is a risk factor for developing breast cancer,8–10,35,53,63–67 but so far its usefulness has not been fully exploited and the presence of increased density on 2D breast images is often seen as a problem, reducing sensitivity by up to 50%.8–10,68–72 Compared with 2D mammography, DBT has been reported to improve sensitivity,32,35,73,74 specificity,75 and lesion size measurement accuracy61 in women with radiographically dense breasts.
Tomosynthesis in X-ray: Proven additional value?
2012, European Journal of RadiologyForecasting, uncertainty and risk; perspectives on clinical decision-making in preventive and curative medicine
2019, International Journal of ForecastingCitation Excerpt :Gøtzsche (2012) also highlights the potential harms that can arise due to over-diagnosis and overtreatment. Perhaps driven by the inconclusive nature of the debate regarding the benefits of mammography, one recent addition to the breast screening armoury is digital breast tomosynthesis (DBT), a tool which produces images that are similar in both quality and definition to CT scans (Diekmann & Bick, 2011). This relatively novel screening process is showing encouraging results, particularly in women with dense breast tissue, among whom it is especially difficult to accurately distinguish breast abnormalities using traditional or digital mammography techniques, leading to more recalls (Takahashi, Lee, & Johnson, 2017).