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Comparison of digital mammography and digital breast tomosynthesis in the detection of architectural distortion

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Abstract

Objectives

To compare interobserver variability (IOV), reader confidence, and sensitivity/specificity in detecting architectural distortion (AD) on digital mammography (DM) versus digital breast tomosynthesis (DBT).

Methods

This IRB-approved, HIPAA-compliant reader study used a counterbalanced experimental design. We searched radiology reports for AD on screening mammograms from 5 March 2012–27 November 2013. Cases were consensus-reviewed. Controls were selected from demographically matched non-AD examinations. Two radiologists and two fellows blinded to outcomes independently reviewed images from two patient groups in two sessions. Readers recorded presence/absence of AD and confidence level. Agreement and differences in confidence and sensitivity/specificity between DBT versus DM and attendings versus fellows were examined using weighted Kappa and generalised mixed modeling, respectively.

Results

There were 59 AD patients and 59 controls for 1,888 observations (59 × 2 (cases and controls) × 2 breasts × 2 imaging techniques × 4 readers). For all readers, agreement improved with DBT versus DM (0.61 vs. 0.37). Confidence was higher with DBT, p = .001. DBT achieved higher sensitivity (.59 vs. .32), p < .001; specificity remained high (>.90). DBT achieved higher positive likelihood ratio values, smaller negative likelihood ratio values, and larger ROC values.

Conclusions

DBT decreases IOV, increases confidence, and improves sensitivity while maintaining high specificity in detecting AD.

Key points

• Digital breast tomosynthesis decreases interobserver variability in the detection of architectural distortion.

• Digital breast tomosynthesis increases reader confidence in the detection of architectural distortion.

• Digital breast tomosynthesis improves sensitivity in the detection of architectural distortion.

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Abbreviations

AD:

Architectural distortion

DM:

Digital mammography

DBT:

Digital breast tomosynthesis

IOV:

Interobserver variability

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Authors and Affiliations

  1. Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA

    Elizabeth H. Dibble, Ana P. Lourenco, Grayson L. Baird, Robert C. Ward, A. Stanley Maynard & Martha B. Mainiero

  2. Lifespan Biostatistics Core, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA

    Grayson L. Baird

Authors
  1. Elizabeth H. Dibble
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  2. Ana P. Lourenco
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  3. Grayson L. Baird
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  4. Robert C. Ward
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  5. A. Stanley Maynard
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  6. Martha B. Mainiero
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Corresponding author

Correspondence to Elizabeth H. Dibble.

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Guarantor

The scientific guarantor of this publication is Ana P. Lourenco, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Experimental

• Performed at one institution

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Dibble, E.H., Lourenco, A.P., Baird, G.L. et al. Comparison of digital mammography and digital breast tomosynthesis in the detection of architectural distortion. Eur Radiol 28, 3–10 (2018). https://doi.org/10.1007/s00330-017-4968-8

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  • DOI: https://doi.org/10.1007/s00330-017-4968-8

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