Dose Reduction and Performance Enhancement During DBT Screening

DBT 筛查期间的剂量减少和性能增强

• 批准号: 8089217
• 负责人: Margarita L Zuley
• 金额: $ 24.39万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8089217
• 关键词: 3-Dimensional; Address; Algorithms; Breast; Breast Cancer Detection; Data; Data Set; Detection; Diagnostic; Digital Mammography; Dose; Eligibility Determination; Environment; Goals; Image; Mammary Gland Parenchyma; Mammography; Measures; Methods; Modality; Modeling; Negative Finding; Performance; Population; Procedures; Radiation; Reading; Reporting; Resolution; Screening Result; Screening procedure; Series; System; Technology; Testing; Tissues; Woman; Work; calcification; digital; imaging modality; improved; public health relevance; radiologist; reconstruction; two-arm study

DESCRIPTION (provided by applicant): Digital Breast Tomosynthesis (DBT) enables 3-D reconstruction of multiple levels of breast tissue from a series of 2-D projections acquired at different angles. Its main advantage is that it generates a volumetric dataset that allows resolution of tissue superposition ambiguities that are often present in projection mammograms. DBT is currently being investigated for use as a primary screening modality but issues related to radiation exposure and detection performance remain. In a previous retrospective observer performance we found that DBT in combination with Full Field Digital Mammography (FFDM) reduced recall rates by 30% while maintaining sensitivity, compared to FFDM alone, but the combined examination doubled radiation exposure. When DBT alone was compared to FFDM the reduction was only 10%. A 30% reduction in recall rates would be sufficient to justify incorporating DBT into screening protocols, but not if it requires doubling the radiation exposure over that of FFDM. The intent of this proposal is to determine whether the 30% reduction can be achieved without acquiring separate FFDM and DBT studies by using a synthetic FFDM, comprised of a high-resolution (70-5m) projection of appropriately reconstructed DBT data, as a substitute for the directly acquired FFDM. To test this we will develop algorithms for deriving the synthetic FFDM from the DBT data and then perform an observer performance study that measures performance of 1) FFDM alone followed by FFDM combined with traditional DBT, and 2) traditional DBT alone followed by DBT combined with the synthetic FFDM. Mode 1 has previously been shown to provide the performance gains discussed above, but requires twice the radiation dose of mode 2. The two study arms enable us to measure performance of FFDM alone, FFDM + DBT, DBT alone, and DBT + synthetic FFDM. The performance study will have 8 radiologists read 100 cases in both modes and report BIRADS scores and ROC-type scores. Each case will include an FFDM and a DBT acquired in a single procedure on our Hologic DBT system. This work will be significant because, if our goal of replacing the FFDM acquisition with a projection derived from the DBT data is successful, then it will be possible to achieve the 30% reduction in recall rates without the increased radiation exposure. PUBLIC HEALTH RELEVANCE: Breast tomosynthesis is a recently introduced imaging modality that can significantly reduce recall rates, while maintaining screening sensitivity, if used in conjunction with mammography in a screening environment. However, this combined exam doubles the radiation exposure over that required for mammography alone. This project tests various strategies for incorporating DBT into breast cancer screening environments that may be able to retain the performance improvements without the increase in radiation exposure. This could greatly reduce the number of women unnecessarily recalled because of a false positive screening result.

描述（由申请人提供）：数字乳房断层合成（DBT）可以从以不同角度获取的一系列2-D投影进行3-D重建。它的主要优点是它生成了一个体积数据集，该数据集允许分辨组织叠加的模棱两可，这些模棱两可通常存在于投影乳房X线照片中。目前正在研究DBT作为主要筛查方式，但与辐射暴露和检测性能有关的问题仍然存在。在先前的回顾性观察者表现中，我们发现与单独的FFDM相比，DBT与完整的数字乳腺摄影（FFDM）结合使用，在保持灵敏度的同时，将召回率降低了30％，但联合检查的综合检查加倍辐射暴露。将单独的DBT与FFDM进行比较时，还原仅为10％。召回率降低30％将足以证明将DBT纳入筛查方案的合理性，但如果需要将辐射暴露在FFDM上的辐射暴露增加一倍。该提案的目的是确定是否可以通过使用合成FFDM获得单独的FFDM和DBT研究来实现30％的降低，该合成FFDM由高分辨率（70-5M）的投影组成，可适当重建的DBT数据，作为直接获得FFDM的替代品。为了测试这一点，我们将开发从DBT数据得出合成FFDM的算法，然后执行观察者性能研究，该研究测量性能的性能为1）单独的FFDM，然后是FFDM与传统DBT合并，以及2）单独使用DBT，然后是DBT，然后与合成FFDM合并。先前已显示模式1提供了上面讨论的性能增长，但需要两倍的模式2的辐射剂量。两个研究臂使我们能够单独测量FFDM，FFDM + DBT，DBT，DBT和DBT +合成FFDM的性能。绩效研究将有8位放射科医生在模式下读取100例病例，并报告Birads得分和ROC型得分。每种情况都将包括在我们的Hologic DBT系统中的单个过程中获得的FFDM和DBT。这项工作将是重要的，因为如果我们用DBT数据获得的投影取代FFDM采集的目标是成功的，那么就可以实现30％的召回率降低，而不会增加辐射暴露。 公共卫生相关性：乳房合成是一种最近引入的成像方式，如果在筛查环境中与乳房X线摄影结合使用，可以显着降低召回率，同时保持筛查敏感性。但是，这种结合检查使单独的乳房X线摄影所需的辐射暴露增加了一倍。该项目测试了将DBT纳入乳腺癌筛查环境中的各种策略，这些策略可能能够保留性能改善而不会增加辐射暴露。由于结果较好的筛查结果，这可能会大大减少不必要的召回的女性人数。