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Eur Radiol. 2017 Dec;27(12):5185-5195. doi: 10.1007/s00330-017-4911-z. Epub 2017 Jul 4.

The role of cone-beam breast-CT for breast cancer detection relative to breast density.

Author information

1
Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. susanne.wienbeck@med.uni-goettingen.de.
2
Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
3
Diagnostic Breast Center Göttingen, Göttingen, Germany.
4
Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
5
Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.

Abstract

OBJECTIVES:

To evaluate the impact of breast density on the diagnostic accuracy of non-contrast cone-beam breast computed tomography (CBBCT) in comparison to mammography for the detection of breast masses.

METHODS:

A retrospective study was conducted from August 2015 to July 2016. Fifty-nine patients (65 breasts, 112 lesions) with BI-RADS, 5th edition 4 or 5 assessment in mammography and/or ultrasound of the breast received an additional non-contrast CBBCT. Independent double blind reading by two radiologists was performed for mammography and CBBCT imaging. Sensitivity, specificity and AUC were compared between the modalities.

RESULTS:

Breast lesions were histologically examined in 85 of 112 lesions (76%). The overall sensitivity for CBBCT (reader 1: 91%, reader 2: 88%) was higher than in mammography (both: 68%, p<0.001), and also for the high-density group (p<0.05). The specificity and AUC was higher for mammography in comparison to CBBCT (p<0.05 and p<0.001). The interobserver agreement (ICC) between the readers was 90% (95% CI: 86-93%) for mammography and 87% (95% CI: 82-91%) for CBBCT.

CONCLUSIONS:

Compared with two-view mammography, non-contrast CBBCT has higher sensitivity, lower specificity, and lower AUC for breast mass detection in both high and low density breasts.

KEY POINTS:

• Overall sensitivity for non-contrast CBBCT ranged between 88%-91%. • Sensitivity was higher for CBBCT than mammography in both density types (p<0.001). • Specificity was higher for mammography than CBBCT in both density types (p<0.05). • AUC was larger for mammography than CBBCT in both density types (p<0.001).

KEYWORDS:

Breast; Breast density; Cone-beam breast-CT; Mammography; Ultrasound

PMID:
28677053
DOI:
10.1007/s00330-017-4911-z
[Indexed for MEDLINE]

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