The role of cone-beam breast-CT for breast cancer detection relative to breast density

TY - JOUR

T1 - The role of cone-beam breast-CT for breast cancer detection relative to breast density

AU - Wienbeck, Susanne

AU - Uhlig, Johannes

AU - Luftner-Nagel, Susanne

AU - Zapf, Antonia

AU - Surov, Alexey

AU - von Fintel, Eva

AU - Stahnke, Vera

AU - Lotz, Joachim

AU - Fischer, Uwe

PY - 2017/12

Y1 - 2017/12

N2 - OBJECTIVES: To evaluate the impact of breast density on the diagnostic accuracy of non-contrast cone-beam breast computed tomography (CBBCT) in comparison to mammography for the detection of breast masses.METHODS: A retrospective study was conducted from August 2015 to July 2016. Fifty-nine patients (65 breasts, 112 lesions) with BI-RADS, 5th edition 4 or 5 assessment in mammography and/or ultrasound of the breast received an additional non-contrast CBBCT. Independent double blind reading by two radiologists was performed for mammography and CBBCT imaging. Sensitivity, specificity and AUC were compared between the modalities.RESULTS: Breast lesions were histologically examined in 85 of 112 lesions (76%). The overall sensitivity for CBBCT (reader 1: 91%, reader 2: 88%) was higher than in mammography (both: 68%, p<0.001), and also for the high-density group (p<0.05). The specificity and AUC was higher for mammography in comparison to CBBCT (p<0.05 and p<0.001). The interobserver agreement (ICC) between the readers was 90% (95% CI: 86-93%) for mammography and 87% (95% CI: 82-91%) for CBBCT.CONCLUSIONS: Compared with two-view mammography, non-contrast CBBCT has higher sensitivity, lower specificity, and lower AUC for breast mass detection in both high and low density breasts.KEY POINTS: • Overall sensitivity for non-contrast CBBCT ranged between 88%-91%. • Sensitivity was higher for CBBCT than mammography in both density types (p<0.001). • Specificity was higher for mammography than CBBCT in both density types (p<0.05). • AUC was larger for mammography than CBBCT in both density types (p<0.001).

AB - OBJECTIVES: To evaluate the impact of breast density on the diagnostic accuracy of non-contrast cone-beam breast computed tomography (CBBCT) in comparison to mammography for the detection of breast masses.METHODS: A retrospective study was conducted from August 2015 to July 2016. Fifty-nine patients (65 breasts, 112 lesions) with BI-RADS, 5th edition 4 or 5 assessment in mammography and/or ultrasound of the breast received an additional non-contrast CBBCT. Independent double blind reading by two radiologists was performed for mammography and CBBCT imaging. Sensitivity, specificity and AUC were compared between the modalities.RESULTS: Breast lesions were histologically examined in 85 of 112 lesions (76%). The overall sensitivity for CBBCT (reader 1: 91%, reader 2: 88%) was higher than in mammography (both: 68%, p<0.001), and also for the high-density group (p<0.05). The specificity and AUC was higher for mammography in comparison to CBBCT (p<0.05 and p<0.001). The interobserver agreement (ICC) between the readers was 90% (95% CI: 86-93%) for mammography and 87% (95% CI: 82-91%) for CBBCT.CONCLUSIONS: Compared with two-view mammography, non-contrast CBBCT has higher sensitivity, lower specificity, and lower AUC for breast mass detection in both high and low density breasts.KEY POINTS: • Overall sensitivity for non-contrast CBBCT ranged between 88%-91%. • Sensitivity was higher for CBBCT than mammography in both density types (p<0.001). • Specificity was higher for mammography than CBBCT in both density types (p<0.05). • AUC was larger for mammography than CBBCT in both density types (p<0.001).

KW - Journal Article

U2 - 10.1007/s00330-017-4911-z

DO - 10.1007/s00330-017-4911-z

M3 - SCORING: Journal article

C2 - 28677053

VL - 27

SP - 5185

EP - 5195

JO - EUR RADIOL

JF - EUR RADIOL

SN - 0938-7994

IS - 12

ER -