Abstract：
We aimed to determine the value of standalone and supplemental automated breast ultrasound (ABUS) in detecting cancers in an opportunistic screening setting with digital breast tomosynthesis (DBT) and compare this combined screening method to DBT and ABUS alone in women older than 39 years with BI-RADS B-D density categories. In this prospective opportunistic screening study, 3466 women aged 39 or older with BI-RADS B-D density categories and with a mean age of 50 were included. The screening protocol consisted of DBT mediolateral-oblique views, 2D craniocaudal views, and ABUS with three projections for both breasts. ABUS was evaluated blinded to mammography findings. Statistical analysis evaluated diagnostic performance for DBT, ABUS, and combined workflows. Twenty-nine cancers were screen-detected. ABUS and DBT exhibited the same cancer detection rates (CDR) at 7.5/1000 whereas DBT + ABUS showed 8.4/1000, with ABUS contributing an additional CDR of 0.9/1000. Standalone ABUS outperformed DBT in detecting 12.5% more invasive cancers. DBT displayed better accuracy (95%) compared to ABUS (88%) and combined approach (86%). Sensitivities for DBT and ABUS were the same (84%), with DBT + ABUS showing a higher rate (94%). DBT outperformed ABUS in specificity (95% vs. 88%). DBT + ABUS exhibited a higher recall rate (14.89%) compared to ABUS (12.38%) and DBT (6.03%) (p < .001). Standalone ABUS detected more invasive cancers compared to DBT, with a higher recall rate. The combined approach showed a higher CDR by detecting one additional cancer per thousand.
摘要：
我们旨在确定独立和辅助自动乳腺超声（ABUS）在数字乳腺断层合成（DBT）的机会性筛查环境中检测癌症的价值，并将这种联合筛查方法与39岁以上女性的DBT和ABUS进行比较具有BI-RADSB-D密度类别。在这项前瞻性机会性筛查研究中，包括3466名年龄在39岁或以上，具有BI-RADSB-D密度类别且平均年龄为50岁的女性。筛查方案包括DBT中外侧斜视图，2D头尾视图，和ABUS对两个乳房都有三个突起。ABUS被评估为不知道乳房X线照相术结果。统计分析评估了DBT的诊断性能，ABUS,和组合的工作流。屏幕检测到29种癌症。ABUS和DBT在7.5/1000表现出相同的癌症检出率(CDR),而DBT+ABUS表现为8.4/1000,ABUS贡献0.9/1000的额外CDR。独立ABUS在检测更多的侵袭性癌症方面优于DBT12.5%。与ABUS（88％）和组合方法（86％）相比，DBT显示出更好的准确性（95％）。DBT和ABUS的灵敏度相同（84%），DBT+ABUS显示较高的比率(94%)。DBT的特异性优于ABUS（95%与88%）。DBT+ABUS的召回率(14.89%)高于ABUS(12.38%)和DBT(6.03%)(p<.001)。与DBT相比，独立ABUS检测到更多侵袭性癌症，召回率较高。通过检测每千种额外的癌症,组合方法显示出更高的CDR。
