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Tomosynthesis in the Diagnostic Setting: Changing Rates of BI-RADS Final Assessment over Time
Radiology, 2016-10, Vol.281 (1), p.54
Raghu, Madhavi
Durand, Melissa A
Andrejeva, Liva
Goehler, Alexander
Michalski, Mark H
Geisel, Jaime L
Hooley, Regina J
Horvath, Laura J
Butler, Reni
Forman, Howard P
Philpotts, Liane E
2016
Details
Autor(en) / Beteiligte
Raghu, Madhavi
Durand, Melissa A
Andrejeva, Liva
Goehler, Alexander
Michalski, Mark H
Geisel, Jaime L
Hooley, Regina J
Horvath, Laura J
Butler, Reni
Forman, Howard P
Philpotts, Liane E
Titel
Tomosynthesis in the Diagnostic Setting: Changing Rates of BI-RADS Final Assessment over Time
Ist Teil von
Radiology, 2016-10, Vol.281 (1), p.54
Ort / Verlag
United States
Erscheinungsjahr
2016
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Purpose To evaluate the effect of tomosynthesis in diagnostic mammography on the Breast Imaging Reporting and Data System (BI-RADS) final assessment categories over time. Materials and Methods This retrospective study was approved by the institutional review board. The authors reviewed all diagnostic mammograms obtained during a 12-month interval before (two-dimensional [2D] mammography [June 2, 2010, to June 1, 2011]) and for 3 consecutive years after (tomosynthesis year 1 [2012], tomosynthesis year 2 [2013], and tomosynthesis year 3 [2014]) the implementation of tomosynthesis. The requirement to obtain informed consent was waived. The rates of BI-RADS final assessment categories 1-5 were compared between the 2D and tomosynthesis groups. The positive predictive values after biopsy (PPV3) for BI-RADS category 4 and 5 cases were compared. The mammographic features (masses, architectural distortions, calcifications, focal asymmetries) of lesions categorized as probably benign (BI-RADS category 3) and those for which biopsy was recommended (BI-RADS category 4 or 5) were reviewed. The χ(2) test was used to compare the rates of BI-RADS final assessment categories 1-5 between the two groups, and multivariate logistic regression analysis was performed to compare all diagnostic studies categorized as BI-RADS 3-5. Results There was an increase in the percentage of cases reported as negative or benign (BI-RADS category 1 or 2) with tomosynthesis (58.7% with 2D mammography vs 75.8% with tomosynthesis at year 3, P < .0001). A reduction in the percentage of probably benign (BI-RADS category 3) final assessments also occurred (33.3% with 2D mammography vs 16.4% with tomosynthesis at year 3, P < .0001). Although the rates of BI-RADS 4 or 5 assessments did not change significantly with tomosynthesis (8.0% with 2D mammography vs 7.8% with tomosynthesis at year 3, P = .2), there was a significant increase in the PPV3 (29.6% vs 50%, respectively; P < .0001). These trends increased during the 3 years of tomosynthesis use. Conclusion Tomosynthesis in the diagnostic setting resulted in progressive shifts in the BI-RADS final assessment categories over time, with a significant increase in the proportion of studies classified as normal, a continued decrease in the rate of studies categorized as probably benign, and improved diagnostic confidence in biopsy recommendations. (©) RSNA, 2016.
Sprache
Englisch
Identifikatoren
eISSN: 1527-1315
DOI: 10.1148/radiol.2016151999
Titel-ID: cdi_pubmed_primary_27139264
Format
–
Schlagworte
Adult
,
Aged
,
Aged, 80 and over
,
Breast Neoplasms - diagnostic imaging
,
Female
,
Humans
,
Mammography
,
Middle Aged
,
Predictive Value of Tests
,
Radiographic Image Enhancement - methods
,
Retrospective Studies
,
Sensitivity and Specificity
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