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: 8831453
• 负责人: Despina Kontos
• 金额: $ 26.31万
• 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 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8831453
• 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 Breast Tomosynthesis; 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; breast imaging; cancer diagnosis; clinical practice; density; design; imaging modality; improved; indexing; next generation; personalized screening; 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 光检查筛查的召回率很高，约为 10%。由于组织叠加对 2D 投影图像的影响，许多女性，尤其是乳房致密的女性，会被召回进行额外的“假性病变”成像，这些正常组织本质上是看起来可疑的叠加，在诊断检查后证明，正常一点。数字乳腺断层合成 (DBT) 是一种新的 3D X 射线成像方式，其中乳腺断层图像是根据多个低剂量源投影重建的。在 DBT 中，组织叠加的影响在很大程度上从图像集中消除，从而提供比乳房 X 光检查更出色的乳房组织可视化。早期临床试验表明，当 DBT 纳入筛查环境时，误报召回率最多可减少 40%。然而，当 DBT 纳入筛查范式时，辐射剂量会更高。因此，必须仔细权衡 DBT 的潜在益处与潜在的剂量增加。确定最能从 DBT 成像中受益的女性子集至关重要。为了解决这个问题，我们的研究将比较乳腺密度和整体乳腺实质复杂性对数字乳腺 X 线摄影 (DM) 与 DBT 乳腺癌筛查回忆决策的影响。我们的假设是，与 DBT 纳入筛查过程相比，复杂的实质模式（即致密和/或结构复杂的乳房）更有可能因 DM 假阳性结果而被召回。为此，我们建议开发一种成像指数来表征乳腺实质组织的复杂性。目前，还没有一个标准词典来全面反映实质复杂性。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测量与高级图像纹理特征结合成定量乳房复杂性指数（BCI），该指数可用于识别从 DBT 筛查中受益最多的女性子集。快速发展的技术和卓越性能的潜力将决定 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 可以取代或补充 DM，用于筛查乳房致密和/或结构复杂的女性，以减少不必要的召回和额外的诊断成像程序。