PDF(Pubmed)
Abstract：
Digital breast tomosynthesis (DBT) has been shown to improve both sensitivity and specificity for breast cancer detection compared to full-field digital mammography. However, its performance could be limited for patients with dense breasts. Clinical DBT systems vary in their system designs, one of which is the acquisition angular range (AR), which leads to varied performance for different imaging tasks. In this study, we aim to compare DBT systems with different AR. We used a previously validated cascaded linear system model to investigate the dependence of in-plane breast structural noise (BSN) and detectability of masses on AR. We conducted a pilot clinical study to compare the lesion conspicuity between clinical DBT systems with the narrowest and the widest AR. Patients called back for diagnostic imaging on suspicious findings were imaged with both narrow-angle (NA) and wide-angle (WA) DBT. We analyzed the BSN for clinical images using noise power spectrum (NPS) analysis. A 5-point Likert scale was used in the reader study to compare the lesion conspicuity. Our theoretical calculation results show that increasing AR leads to reduced BSN and improved mass detectability. The NPS analysis on clinical images shows the lowest BSN for WA DBT. The WA DBT provides better lesion conspicuity for masses and asymmetries and shows a greater advantage for non-microcalcification lesions in dense breasts. The NA DBT provides better characterizations for microcalcifications. The WA DBT can downgrade false-positive findings seen on NA DBT. In conclusion, WA DBT could improve the detection of masses and asymmetries for patients with dense breasts.
摘要：
与全视野数字乳房X线照相术相比，数字乳房断层合成（DBT）已被证明可以提高乳腺癌检测的敏感性和特异性。然而,它的表现可能是有限的患者与致密的乳房。临床DBT系统的系统设计各不相同，其中之一是采集角度范围(AR)，这导致不同成像任务的不同性能。在这项研究中,我们的目标是将DBT系统与不同的AR进行比较。我们使用先前验证的级联线性系统模型来研究平面内乳房结构噪声（BSN）和肿块对AR的可检测性的依赖性。我们进行了一项初步临床研究，以比较具有最窄和最宽AR的临床DBT系统之间的病变显著性。对可疑发现进行诊断成像的患者进行了窄角（NA）和广角（WA）DBT成像。我们使用噪声功率谱(NPS)分析临床图像的BSN。读者研究中使用5点Likert量表来比较病变的显著性。我们的理论计算结果表明，增加AR会降低BSN并改善质量检测能力。临床图像上的NPS分析显示了WADBT的最低BSN。WADBT为肿块和不对称性提供了更好的病变显着性，并且在致密乳房的非微钙化病变中显示出更大的优势。NADBT为微钙化提供了更好的表征。WADBT可以降低NADBT上的假阳性结果。总之,WADBT可以改善乳房致密患者对肿块和不对称性的检测。
