Effect of Breast Density on Screening Recall with Digital Breast Tomosynthesis

乳房密度对数字乳房断层合成筛查回忆的影响

• 批准号: 8465846
• 负责人: Despina Kontos
• 金额: $ 24.73万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-04 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8465846
• 关键词: Address; Advisory Committees; Age; Back; Biopsy; Breast; Breast Cancer Detection; Breast Cancer Risk Factor; Clinical; Clinical Trials; Complement; Complex; Coupled; Data; Descriptor; Diagnosis; Diagnostic; Diagnostic Imaging; Digital Mammography; Dose; Drops; Face; Family; Goals; Image; Image Analysis; Imagery; Imaging Techniques; Imaging technology; Individual; Lesion; Logistic Regressions; Mammary Gland Parenchyma; Mammography; Measures; Menopause; Modeling; Normal tissue morphology; Odds Ratio; Pattern; Performance; Process; Protocols documentation; Radiation; Recommendation; Recording of previous events; Risk; Role; Sensitivity and Specificity; Series; Source; Specificity; Technology; Texture; Tissues; Translations; Woman; base; breast density; cancer diagnosis; clinical practice; density; design; digital; imaging modality; improved; indexing; next generation; prospective; radiologist; screening; vector

DESCRIPTION (provided by applicant): Currently, call-back rates for screening mammography in the U.S. are high at about 10%. Due to the effect of tissue superimposition on the 2D projection images, many women, especially women with dense breasts, are recalled for additional imaging of "pseudo-lesions", essentially suspicious-looking superimpositions of normal tissues which, after diagnostic workup, prove to be normal. Digital breast tomosynthesis (DBT) is a new 3D x-ray imaging modality in which tomographic breast images are reconstructed from multiple low-dose source projections. In DBT, the effects of tissue superposition are largely removed from the image set, thereby providing superior breast tissue visualization compared to mammography. Early clinical trials suggest up to a 40% reduction in false positive recalls when DBT is incorporated in the screening setting. There is however, a higher radiation dose when DBT is incorporated into the screening paradigm. Therefore this potential benefit of DBT must be carefully weighed against a potential increase of dose. The identification of a subset of women who would benefit most from DBT imaging is critical. To address this concern, our study will compare the effect of breast density and overall breast parenchymal complexity on the recall decision in breast cancer screening with digital mammography (DM) versus DBT. Our hypothesis is that complex parenchymal patterns (i.e., dense and/or texturally complex breasts) have a higher likelihood of being recalled for false positive findings with DM than when DBT is incorporated in the screening process. Towards this end, we propose to develop an imaging index for characterizing breast parenchymal tissue complexity. Currently, there is no standard lexicon to comprehensively reflect parenchymal complexity. Breast density is the only such image-based descriptor in the standard mammography BIRADS lexicon. Therefore, we propose to combine the standard density measures with advanced image texture features into a quantitative breast complexity index (BCI) that can be used to identify a subset of women who would benefit most from DBT screening. The rapidly evolving technology and the potential for superior performance will determine the role of DBT in clinical practice. If our hypothesis proves to be true, DBT could replace or complement DM for the screening of women with dense and/or texturally complex breasts, to reduce unnecessary recalls and additional diagnostic imaging procedures.

描述（由申请人提供）：目前，美国乳房X线摄影的呼叫回声率很高，约为10％。由于组织叠加对2D投影图像的影响，许多女性，尤其是乳房密集的女性，都被召回以进行“伪造质量”的额外成像，这实际上是对正常组织的可疑叠加，这些组织在诊断工作后证明是正常的。数字乳房断层合成（DBT）是一种新的3D X射线成像模式，其中层析成像乳房图像是从多种低剂量源投影中重建的。在DBT中，组织叠加的作用在很大程度上从图像集中去除，从而与乳房X线摄影相比提供了优质的乳房组织可视化。早期的临床试验表明，当DBT纳入筛查环境中时，假阳性召回率降低了40％。但是，当将DBT纳入筛选范式中时，有更高的辐射剂量。因此，必须仔细权衡DBT的这种潜在优势，以与剂量的潜在增加。从DBT成像中受益最大的一部分女性的识别至关重要。为了解决这一问题，我们的研究将比较乳房密度和整体乳腺实质复杂性对用数字乳腺摄影（DM）与DBT进行乳腺癌筛查中的召回决定的影响。我们的假设是，复杂的实质模式（即致密和/或质地复杂的乳房）的可能性高于与DM相比，与DBT合并到筛选过程中时，被召回的假阳性发现的可能性更高。为此，我们建议开发一个成像指数，以表征乳房实质组织复杂性。当前，没有标准词典可以全面反映实质的复杂性。乳房密度是标准乳房X线摄影Birads词典中唯一基于图像的描述符。因此，我们建议将标准密度度量与先进的图像纹理特征结合到定量乳房复杂性指数（BCI）中，该指数可用于识别一部分女性，这些女性将从DBT筛查中受益最多。快速发展的技术和出色的性能的潜力将决定DBT在临床实践中的作用。如果我们的假设被证明是正确的，DBT可以代替或补充DM，以筛查具有密集和/或质地复杂乳房的女性，以减少不必要的召回和其他诊断成像程序。