• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3521-3526
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• 2016

Digital breast tomosynthesis (DBT) as a breast cancer screening modality, through generation of three-dimensional images during standard mammographic compression, can reduce interference from breast tissue overlap, increasing conspicuity of invasive cancers while concomitantly reducing false-positive results. We here conducted a systematic review on previous studies to synthesize the evidence of DBT efficacy, eventually 18 articles being included in the analysis. The most commonly emerging topics were advantages of DBT screening tool in terms of recall rates, cancer detection rates and cost-effectiveness, preventing unnecessary burdens on women and the healthcare system. Further research is needed to evaluate the potential impact of DBT on longer-term outcomes, such as interval cancer rates and mortality, to better understand the broader clinical and economic implications of its adoption.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.4109-4114
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• 2015

Background: Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer. Materials and Methods: In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods. Results: The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (P<0.05). The area under FFDM ROC curve is 0.805, while that is 0.941 in COMBO pattern. COMBO shows relation of mass with the surrounding tissues, the calcification in the mass, and multiple foci clearly in breast cancer tissues. The optimal sensitivity of cut-off value in COMBO pattern is 82.9%, which is higher than that in FFDM (60%). They share the same specificity which is both 93.2%. Conclusions: Digital Breast Tomosynthesis (DBT) could be used for the BI-RADS classification in breast cancer in clinical.

• Korean Journal of Radiology
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• v.23 no.11
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• pp.1031-1043
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• 2022

Objective: To compare digital breast tomosynthesis (DBT) and MRI as an adjunct to full-field digital mammography (FFDM) for the preoperative evaluation of women with breast cancer based on mammographic density. Materials and Methods: This retrospective study enrolled 280 patients with breast cancer who had undergone FFDM, DBT, and MRI for preoperative local tumor staging. Three radiologists independently sought the index cancer and additional ipsilateral and contralateral breast cancers using either FFDM alone, DBT plus FFDM, or MRI plus FFDM. Diagnostic performances across the three radiologists were compared among the reading modes in all patients and subgroups with dense (n = 186) and non-dense breasts (n = 94) according to mammographic density. Results: Of 280 patients, 46 (16.4%) had 48 additional (39 ipsilateral and nine contralateral) cancers in addition to the index cancer. For index cancers, both DBT plus FFDM and MRI plus FFDM showed sensitivities of 100% in the non-dense group. In the dense group, DBT plus FFDM showed lower sensitivity than that of MRI plus FFDM (94.6% vs. 99.6%, p < 0.001). For additional ipsilateral cancers, DBT plus FFDM showed specificity and positive predictive value (PPV) of 100% in the non-dense group, but sensitivity and negative predictive value (NPV) were not statistically different from those of MRI plus FFDM (p > 0.05). In the dense group, DBT plus FFDM showed higher specificity (98.2% vs. 94.1%, p = 0.005) and PPV (83.1% vs. 65.4%; p = 0.036) than those of MRI plus FFDM, but lower sensitivity (59.9% vs. 75.3%; p = 0.049). For contralateral cancers, DBT plus FFDM showed higher specificity than that of MRI plus FFDM (99.0% vs. 96.7%, p = 0.014), however, the other values did not differ (all p > 0.05) in the dense group. Conclusion: DBT plus FFDM showed an overall higher specificity than that of MRI plus FFDM regardless of breast density, perhaps without substantial loss in sensitivity and NPV in the diagnosis of additional cancers. Thus, DBT may have the potential to be used as a preoperative breast cancer staging tool.

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.886-898
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• 2020

Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.320-331
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• 2023

Mammography has been the standard screening method for breast cancer. In women with suspicious calcifications and architectural distortion identified on mammography or digital breast tomosynthesis only without detected on breast US, stereotactic biopsy and mammography-guided preoperative localization is one of the method for pathologic diagnosis. This review aims to describe the indication, contraindication, technique of stereotactic biopsy, clip placement after stereotactic biopsy, and digital breast tomosynthesis-guided stereotactic biopsy. In addition, this article reviews mammography-guided preoperative localization using a wire or non-wire device.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.274-283
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• 2023

Objective: To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods: A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results: A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40-78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8-19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7-15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%-34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%-24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%-28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%-18.9%; P < 0.001). Conclusion: DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

• Progress in Medical Physics
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• v.23 no.4
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• pp.261-268
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• 2012

Breast cancer is the second leading cause of women cancer death in Korea. The key for reducing disease mortality is early detection. Although digital mammography (DM) has been credited as one of the major reasons for the early detection to decrease in breast cancer mortality observed in the last 20 years, DM is far from perfect for several limitations. Digital breast tomosynthesis (DBT) is expected to overcome some inherent limitations of conventional mammography caused by overlapping of normal tissue and pathological tissue during the standard 2D projections for the improved lesion margin visibility and early breast cancer detection. In this study, we compared a DM system and DBT system acquired with different thickness of breast phantom. We acquired breast phantom data with same average glandular dose (AGD) from 1 mGy to 4 mGy under same experimental condition. The contrast, micro-calcification measurement accuracy and observer study were conducted with breast phantom images. As a result, the higher accuracy of lesion detection with DBT system compared to DM system was demonstrated in this study. Furthermore, the pain of patients caused by severe compression can be reduced with DBT system. In conclusion, the results indicated that DBT system play an important role in breast cancer detection.

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1240-1252
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• 2021

Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

• Journal of the Korea Convergence Society
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• v.10 no.2
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• pp.29-34
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• 2019

In this study, we measure dose against various density and thickness using phantom to compare FFDM to DBT of Digital mammography equipment and evaluate usefulness of DBT through compare the image quality of FFDM and DBT. We use mammography equipment, Selenia Dimensions ; this is able to examine breast by both FFDM and DBT, The results are that when the thickness of phantom is 6cm or more and density is 70% or more and the thickness of phantom is 7cm or more and density is 50% or more, AGD of DBT is lower than that of FFDM. The evaluation results of image quality are that in the tumor and small calcification group that composed by mammary tissue and fat, FFDM is great and in fibrin, DBT is great. But in the all thicknesses of BR3D phantom that reflected overlapped tissue of breasts, DBT is great in calcification group, fibrin and tumor. DBT is greater image quality and lower dose more than FFDM in Thick and high density breast, Therefore, DBT is more useful in Korean women's breast that is characterized dense breast than FFDM.

• Progress in Medical Physics
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• v.25 no.4
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• pp.271-280
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• 2014

Recently, digital breast tomosynthesis (DBT) has been investigated to overcome the limitation of conventional mammography for overlapping anatomical structures and high patient dose with cone-beam computed tomography (CBCT). However incomplete sampling due to limited angle leads to interference on the neighboring slices. Many studies have investigated to reduce artifacts such as interference. Moreover, appropriate filters for tomosynthesis have been researched to solve artifacts resulted from incomplete sampling. The primary purpose of this study is finding appropriate filter scheme with FBP reconstruction for DBT system to reduce artifacts. In this study, we investigated characteristics of various filter schemes with simulation and prototype digital breast tomosynthesis under same acquisition parameters and conditions. We evaluated artifacts and noise with profiles and COV (coefficinet of variation) to study characteristic of filter. As a result, the noise with parameter 0.25 of Spectral filter reduced by 10% in comparison to that with only Ramp-lak filter. Because unbalance of information reduced with decreasing B of Slice thickness filter, artifacts caused by incomplete sampling reduced. In conclusion, we confirmed basic characteristics of filter operations and improvement of image quality by appropriate filter scheme. The results of this study can be utilized as base in research and development of DBT system by providing information that is about noise and artifacts depend on various filter schemes.