Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Peters, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Stork, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Kemper, Joern UNSPECIFIED UNSPECIFIED UNSPECIFIED Grinstein, Olga UNSPECIFIED UNSPECIFIED UNSPECIFIED Puesken, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Stahlhut, Leandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Kinner, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Krug, Kathrin Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language ENHANCED SPECTRAL MAMMOGRAPHY; RADIATION-EXPOSURE; PROJECTION IMAGES; CALCIFICATIONS; PHANTOM; COMBINATION; CLUSTERS; DBT Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23573