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Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

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Abstract

Objectives

To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers.

Methods

Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests.

Results

The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0 .0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0 .0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0 .0282).

Conclusions

DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI.

Key Points

• Digital breast tomosynthesis (DBT) plus mammography was compared with MRI plus mammography.

• DBT had lower sensitivity and higher PPV than MRI.

• DBT had higher diagnostic performance than mammography.

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Acknowledgments

We would like to thank Chris Woo, B.A. for his kind assistance in editing this manuscript. The scientific guarantor of this publication is Jung Min Chang. 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. This research was supported by Core Medical Device R & D Program (10043122) funded by the Ministry of Trade, Industry & Energy (MOTIE), Korea, and grant number (05-2014-0040) from Seoul National University Hospital Research Fund. Hojeong Won kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Approval from the institutional animal care committee was not required because this study is not on animals. Our study subjects or cohorts have not been previously reported. Methodology: retrospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea

    Won Hwa Kim, Jung Min Chang & Woo Kyung Moon

  2. Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

    Hyeong-Gon Moon

  3. Department of Radiology, Gangnan Healthcare Center, Seoul National University Hospital, Seoul, Korea

    Ann Yi

  4. Department of Radiology, Hanyang University College of Medicine, Seoul, Korea

    Hye Ryoung Koo

  5. Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Hye Mi Gweon

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  1. Won Hwa Kim
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Correspondence to Jung Min Chang.

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Kim, W.H., Chang, J.M., Moon, HG. et al. Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers. Eur Radiol 26, 1556–1564 (2016). https://doi.org/10.1007/s00330-015-3998-3

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  • DOI: https://doi.org/10.1007/s00330-015-3998-3

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