The role of tomosynthesis in evaluation of suspicious solid breast lesion in comparison with mammography and ultrasonography in patients over 30 years old

Riham AbdelAal Mohamed, A. Yassen, Abdullah Ahmed
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Abstract

Background Digital breast tomosynthesis (DBT) has been developed to improve the detection and characterization of breast lesions and to overcome the limitations of digital mammography. The aim of this work was to highlight the value of DBT in evaluation of suspicious solid breast lesions in comparison with mammography and ultrasonography in patients over 30 years old. Patients and methods This prospective study included a total of 50 females who had 54 suspicious solid breast lesions, and all patients were evaluated by mammography, tomosynthesis, and ultrasound. Their age ranging from 30 to 90 years old with mean age±SD was 58.8±12.7 years. All radiological findings were compared with the final histopathology diagnosis, which was the gold standard for our study. Results The sensitivity of tomosynthesis was 96%, the specificity was 75%, the positive predictive value (PPV) was 98%, the negative predictive value (NPV) was 60%, and the accuracy was 94%. While the sensitivity of digital mammography was 92%, the specificity was 50%, the PPV was 95%, the NPV was 33%, and the accuracy was 88%. Breast ultrasound showed the highest sensitivity in our study where the sensitivity of ultrasound was 98%, the specificity was 100%, the PPV was 100%, the NPV was 80%, and the accuracy was 98%. Conclusion DBT technique can improve the clinical performance of mammography by increasing the sensitivity and specificity. It overcomes the limitation of mammography caused by tissue overlapping. Thus, it can provide better tissue visualization by its characteristic capability of producing three-dimensional nonoverlapped tissue information.
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在30岁以上患者中,层析合成与乳房x光检查和超声检查对可疑实性乳腺病变的评价
数字乳腺断层合成(DBT)的发展是为了提高乳腺病变的检测和表征,克服数字乳房x线摄影的局限性。这项工作的目的是强调DBT在评估可疑的实性乳房病变的价值,并将其与30岁以上患者的乳房x光检查和超声检查进行比较。患者和方法本前瞻性研究共纳入50例女性,共54例可疑实性乳腺病变,所有患者均通过乳房x线摄影、断层合成和超声进行评估。年龄30 ~ 90岁,平均年龄±SD为58.8±12.7岁。所有的影像学结果与最终的组织病理学诊断相比较,这是我们研究的金标准。结果该方法的敏感性为96%,特异性为75%,阳性预测值为98%,阴性预测值为60%,准确率为94%。数字乳房x线摄影的灵敏度为92%,特异性为50%,PPV为95%,NPV为33%,准确率为88%。乳腺超声在我们的研究中灵敏度最高,超声灵敏度为98%,特异度为100%,PPV为100%,NPV为80%,准确率为98%。结论DBT技术可提高乳腺x线造影的敏感性和特异性,提高临床诊断效果。它克服了乳房x光检查因组织重叠造成的局限性。因此,它具有产生三维不重叠组织信息的特性,可以提供更好的组织可视化。
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