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Constance D Lehman - One of the best experts on this subject based on the ideXlab platform.
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Breast cancer screening with digital Breast Tomosynthesis are initial benefits sustained
Radiology, 2020Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Sarah F Mercaldo, Pragya A Dang, Kathryn P Lowry, Constance D LehmanAbstract:The benefits of reduced false-positive examinations and higher specificity with screening digital Breast Tomosynthesis were sustained after the first screening round.
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comparison of upright digital Breast Tomosynthesis guided versus prone stereotactic vacuum assisted Breast biopsy
Radiology, 2019Co-Authors: Manisha Bahl, Mary Maunglay, Helen Anne Dalessandro, Constance D LehmanAbstract:Purpose To compare the performance of upright digital Breast Tomosynthesis (DBT)-guided vacuum-assisted Breast biopsy (VABB) with that of prone stereotactic (PS) VABB. Materials and Methods This retrospective review involved consecutive patients who underwent PS VABB from August 2014 to December 2015 and upright DBT-guided VABB from February 2016 to June 2017. Tissue sampling methods were the same for PS and DBT-guided biopsies. Wilcoxon and Pearson χ2 tests were used to compare the groups. Results During the study period, 439 PS VABBs in 408 patients (mean age, 56.5 years; age range, 32-84 years) and 706 DBT-guided VABBs in 682 patients (mean age, 57.9 years; age range, 23-90 years) were recommended. Technical success was achieved for more lesions with DBT-guided VABB versus PS VABB (99.3% [695 of 700] vs 95.1% [410 of 431], respectively; P < .001). Mean procedure time was shorter with DBT-guided VABB versus PS VABB (12 vs 27 minutes, respectively; P < .001), and fewer exposures were acquired with DBT-guided VABB versus PS VABB (three vs 12, respectively; P < .001). A higher percentage of lesions for which DBT-guided VABB was performed were noncalcified lesions (eg, architectural distortion, asymmetry, and mass) than for PS VABB (29.2% [203 of 695] vs 3.4% [14 of 410], respectively; P < .001). There were no differences in the distribution of histologic results (P = .42). No major complications were observed in either group. Conclusion Upright digital Breast Tomosynthesis-guided vacuum-assisted Breast biopsy has a higher rate of technical success than does prone stereotactic vacuum-assisted biopsy and can be performed in less than half the time and with one-fourth of the exposures. In addition, more architectural distortions and asymmetries are amenable to biopsy with digital Breast Tomosynthesis-guided vacuum-assisted Breast biopsy. © RSNA, 2018.
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the effect of digital Breast Tomosynthesis adoption on facility level Breast cancer screening volume
American Journal of Roentgenology, 2018Co-Authors: Christoph I Lee, Constance D Lehman, Karla Kerlikowske, Louise M Henderson, Tracy Onega, Weiwei Zhu, Jessica C Germino, Ellen S Omeara, J Haas, Brian L SpragueAbstract:OBJECTIVE. The purpose of this study was to determine whether digital Breast Tomosynthesis (DBT) adoption was associated with a decrease in screening mammography capacity across Breast Cancer Scree...
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Breast cancer characteristics associated with 2d digital mammography versus digital Breast Tomosynthesis for screening detected and interval cancers
Radiology, 2017Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Pragya A Dang, Kathryn P Lowry, Shannon Gaffney, Constance D LehmanAbstract:The overall rates of screening-detected and interval cancers are similar with digital mammography (DM) and digital Breast Tomosynthesis (DBT), but a higher proportion of screening-detected cancers are invasive rather than in situ at DBT compared with DM.
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digital Breast Tomosynthesis and the challenges of implementing an emerging Breast cancer screening technology into clinical practice
Journal of The American College of Radiology, 2013Co-Authors: Constance D Lehman, Christoph I LeeAbstract:Emerging imaging technologies, including digital Breast Tomosynthesis, have the potential to transform Breast cancer screening. However, the rapid adoption of these new technologies outpaces the evidence of their clinical and cost-effectiveness. The authors describe the forces driving the rapid diffusion of Tomosynthesis into clinical practice, comparing it with the rapid diffusion of digital mammography shortly after its introduction. They outline the potential positive and negative effects that adoption can have on imaging workflow and describe the practice management challenges when incorporating Tomosynthesis. The authors also provide recommendations for collecting evidence supporting the development of policies and best practices.
Sophia Zackrisson - One of the best experts on this subject based on the ideXlab platform.
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one view Breast Tomosynthesis versus two view mammography in the malmo Breast Tomosynthesis screening trial mbtst a prospective population based diagnostic accuracy study
Lancet Oncology, 2018Co-Authors: Sophia Zackrisson, Pontus Timberg, Kristina Lang, Aldana Rosso, Kristin Johnson, Magnus Dustler, Daniel Fornvik, Hannie Fornvik, Hanna Sartor, Anders TingbergAbstract:Summary Background Digital Breast Tomosynthesis is an advancement of the mammographic technique, with the potential to increase detection of lesions during Breast cancer screening. The main aim of the Malmo Breast Tomosynthesis Screening Trial (MBTST) was to investigate the accuracy of one-view digital Breast Tomosynthesis in population screening compared with standard two-view digital mammography. Methods In this prospective, population-based screening study, of women aged 40–74 years invited to attend national Breast cancer screening at Skane University Hospital, Malmo, Sweden, a random sample was asked to participate in the trial (every third woman who was invited to attend regular screening was invited to participate). Participants had to be able to speak English or Swedish and were excluded from the study if they were pregnant. Participants underwent screening with two-view digital mammography (ie, craniocaudal and mediolateral oblique views) followed by one-view digital Breast Tomosynthesis with reduced compression in the mediolateral oblique view (with a wide Tomosynthesis angle of 50°) at one screening visit. Images were read with masked double reading and scoring by two separate reading groups, one for each method, made up of seven radiologists. Any cancer detected with a malignancy probability score of three or higher by any reader in either group was discussed in a consensus meeting of at least two readers, from which the decision of whether or not to recall the woman for further investigation was made. The primary outcome measures were sensitivity and specificity of Breast cancer detection. Secondary outcome measures were screening performance measures of cancer detection, recall, and interval cancers (cancers clinically detected between screenings), and positive predictive value for screen recalls and negative predictive value of each method. Outcomes were analysed in the per-protocol population. Follow-up of the participants for at least 2 years allowed for identification of interval cancers. This trial is registered with ClinicalTrials.gov , number NCT01091545 . Findings Between Jan 27, 2010, and Feb 13, 2015, of 21 691 women invited, 14 851 (68%) agreed to participate. Three women withdrew consent during follow-up and were excluded from the analyses. 139 Breast cancers were detected in 137 ( Interpretation Breast cancer screening by use of one-view digital Breast Tomosynthesis with a reduced compression force has higher sensitivity at a slightly lower specificity for Breast cancer detection compared with two-view digital mammography and has the potential to reduce the radiation dose and screen-reading burden required by two-view digital Breast Tomosynthesis with two-view digital mammography. Funding The Swedish Cancer Society, The Swedish Research Council, The Breast Cancer Foundation, The Swedish Medical Society, The Crafoord Foundation, The Gunnar Nilsson Cancer Foundation, The Skane University Hospital Foundation, Governmental funding for clinical research, The South Swedish Health Care Region, The Malmo Hospital Cancer Foundation and The Cancer Foundation at the Department of Oncology, Skane University Hospital.
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performance of one view Breast Tomosynthesis as a stand alone Breast cancer screening modality results from the malmo Breast Tomosynthesis screening trial a population based study
European Radiology, 2016Co-Authors: Kristina Lang, Anders Tingberg, Ingvar Andersson, Pontus Timberg, Aldana Rosso, Sophia ZackrissonAbstract:Objective To assess the performance of one-view digital Breast Tomosynthesis (DBT) in Breast cancer screening.
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factors affecting recall rate and false positive fraction in Breast cancer screening with Breast Tomosynthesis a statistical approach
The Breast, 2015Co-Authors: Aldana Rosso, Kristina Lang, Ingemar F Petersson, Sophia ZackrissonAbstract:In this study, we investigate which factors affect the false positive fraction (FPF) for digital Breast Tomosynthesis (DBT) compared to digital mammography (DM) in a screening population by using classification and regression trees (C&RT) and binary marginal generalized linear models. The data was obtained from the Malmo Breast Tomosynthesis Screening Trial, which aimed to compare the performance of DBT to DM in Breast cancer screening. By using data from the first half of the study population (7500 women), a tree with the recall probability for different groups was calculated. The effect of age and Breast density on the FPF was estimated using a binary marginal generalized linear model. Our results show that Breast density and Breast cancer were the main factors influencing recall. The FPF is mainly affected by Breast density and increases with Breast density for DBT and DM. In conclusion, the results obtained with C&RT are easy to interpret and similar to those obtained using binary marginal generalized linear models. The FPF is approximately 40% higher for DBT compared to DM for all Breast density categories.
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Breast Tomosynthesis and digital mammography a comparison of diagnostic accuracy
British Journal of Radiology, 2012Co-Authors: Tony Svahn, Debra M Ikeda, Sophia Zackrisson, Dev P Chakraborty, Soren Mattsson, Ingvar AnderssonAbstract:Objective Our aim was to compare the ability of radiologists to detect Breast cancers using one-view Breast Tomosynthesis (BT) and two-view digital mammography (DM) in an enriched population of diseased patients and benign and/or healthy patients. Methods All participants gave informed consent. The BT and DM examinations were performed with about the same average glandular dose to the Breast. The study population comprised patients with subtle signs of malignancy seen on DM and/or ultrasonography. Ground truth was established by pathology, needle biopsy and/or by 1-year follow-up by mammography, which retrospectively resulted in 89 diseased Breasts (1 Breast per patient) with 95 malignant lesions and 96 healthy or benign Breasts. Two experienced radiologists, who were not participants in the study, determined the locations of the malignant lesions. Five radiologists, experienced in mammography, interpreted the cases independently in a free-response study. The data were analysed by the receiver operating c...
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the diagnostic accuracy of dual view digital mammography single view Breast Tomosynthesis and a dual view combination of Breast Tomosynthesis and digital mammography in a free response observer performance study
Radiation Protection Dosimetry, 2010Co-Authors: Tony Svahn, Anders Tingberg, Ingvar Andersson, Debra M Ikeda, Daniel Fornvik, Dev P Chakraborty, Soren Mattsson, Sune Svensson, Sophia ZackrissonAbstract:The purpose of the present study was to compare the diagnostic accuracy of dual-view digital mammography (DM), single-view Breast Tomosynthesis (BT) and BT combined with the contralateral DM view. Patients with subtle lesions were selected to undergo BT examinations. Two radiologists who are non-participants in the study and have experience in using DM and BT determined the locations and extents of lesions in the images. Five expert mammographers interpreted the cases using the free-response paradigm. The task was to mark and rate clinically reportable findings suspicious for malignancy and clinically relevant benign findings. The marks were scored with reference to the outlined regions into lesion localization or non-lesion localization, and analysed by the jackknife alternative free-response receiver operating characteristic method. The analysis yielded statistically significant differences between the combined modality and dual-view DM (p < 0.05). No differences were found between single-view BT and dual-view DM or between single-view BT and the combined modality. (Less)
Emily F. Conant - One of the best experts on this subject based on the ideXlab platform.
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five consecutive years of screening with digital Breast Tomosynthesis outcomes by screening year and round
Radiology, 2020Co-Authors: Emily F. Conant, Elizabeth S Mcdonald, Susan P Weinstein, Katrina E Korhonen, Samantha P Zuckerman, J A Birnbaum, J D Tobey, Rebecca A HubbardAbstract:The sensitivity of digital Breast Tomosynthesis (DBT) was higher than that of digital mammography (DM) in each of the first 5 years after implementation of DBT. DBT also helped detect a higher prop...
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digital Breast Tomosynthesis concepts and clinical practice
Radiology, 2019Co-Authors: Alice Chong, Elizabeth S Mcdonald, Susan P Weinstein, Emily F. ConantAbstract:Digital Breast Tomosynthesis (DBT) is emerging as the standard of care for Breast imaging based on improvements in both screening and diagnostic imaging outcomes. The additional information obtained from the Tomosynthesis acquisition decreases the confounding effect of overlapping tissue, allowing for improved lesion detection, characterization, and localization. In addition, the quasi three-dimensional information obtained from the reconstructed DBT data set allows a more efficient imaging work-up than imaging with two-dimensional full-field digital mammography alone. Herein, the authors review the benefits of DBT imaging in screening and diagnostic Breast imaging.
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Breast cancer conspicuity on simultaneously acquired digital mammographic images versus digital Breast Tomosynthesis images
Radiology, 2019Co-Authors: Katrina E Korhonen, Emily F. Conant, Elizabeth S Mcdonald, Marie Synnestvedt, Eric A Cohen, Susan P WeinsteinAbstract:For cancers visible at only one mammographic view, they are more often seen at the craniocaudal view than the mediolateral oblique view for both digital mammography and digital Breast Tomosynthesis.
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strategies to increase cancer detection review of true positive and false negative results at digital Breast Tomosynthesis screening
Radiographics, 2016Co-Authors: Katrina E Korhonen, Susan P Weinstein, Elizabeth S Mcdonald, Emily F. ConantAbstract:Although digital Breast Tomosynthesis improves Breast cancer detection, it is critical for radiologists to be cognizant of differences in cancer conspicuity both within the modality itself and between mammographic views; understanding differences in lesion conspicuity and learning strategies to reduce diagnostic errors can help readers improve the clinical outcomes of imaging with DBT.
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baseline screening mammography performance of full field digital mammography versus digital Breast Tomosynthesis
American Journal of Roentgenology, 2015Co-Authors: Elizabeth S Mcdonald, Mitchell D. Schnall, Anne Marie Mccarthy, Amana L Akhtar, Marie Synnestvedt, Emily F. ConantAbstract:OBJECTIVE. Baseline mammography studies have significantly higher recall rates than mammography studies with available comparison examinations. Digital Breast Tomosynthesis reduces recalls when compared with digital mammographic screening alone, but many sites operate in a hybrid environment. To maximize the effect of screening digital Breast Tomosynthesis with limited resources, choosing which patient populations will benefit most is critical. This study evaluates digital Breast Tomosynthesis in the baseline screening population. MATERIALS AND METHODS. Outcomes were compared for 10,728 women who underwent digital mammography screening, including 1204 (11.2%) baseline studies, and 15,571 women who underwent digital Breast Tomosynthesis screening, including 1859 (11.9%) baseline studies. Recall rates, cancer detection rates, and positive predictive values were calculated. Logistic regression estimated the odds ratios of recall for digital mammography versus digital Breast Tomosynthesis for patients undergo...
Anders Tingberg - One of the best experts on this subject based on the ideXlab platform.
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one view Breast Tomosynthesis versus two view mammography in the malmo Breast Tomosynthesis screening trial mbtst a prospective population based diagnostic accuracy study
Lancet Oncology, 2018Co-Authors: Sophia Zackrisson, Pontus Timberg, Kristina Lang, Aldana Rosso, Kristin Johnson, Magnus Dustler, Daniel Fornvik, Hannie Fornvik, Hanna Sartor, Anders TingbergAbstract:Summary Background Digital Breast Tomosynthesis is an advancement of the mammographic technique, with the potential to increase detection of lesions during Breast cancer screening. The main aim of the Malmo Breast Tomosynthesis Screening Trial (MBTST) was to investigate the accuracy of one-view digital Breast Tomosynthesis in population screening compared with standard two-view digital mammography. Methods In this prospective, population-based screening study, of women aged 40–74 years invited to attend national Breast cancer screening at Skane University Hospital, Malmo, Sweden, a random sample was asked to participate in the trial (every third woman who was invited to attend regular screening was invited to participate). Participants had to be able to speak English or Swedish and were excluded from the study if they were pregnant. Participants underwent screening with two-view digital mammography (ie, craniocaudal and mediolateral oblique views) followed by one-view digital Breast Tomosynthesis with reduced compression in the mediolateral oblique view (with a wide Tomosynthesis angle of 50°) at one screening visit. Images were read with masked double reading and scoring by two separate reading groups, one for each method, made up of seven radiologists. Any cancer detected with a malignancy probability score of three or higher by any reader in either group was discussed in a consensus meeting of at least two readers, from which the decision of whether or not to recall the woman for further investigation was made. The primary outcome measures were sensitivity and specificity of Breast cancer detection. Secondary outcome measures were screening performance measures of cancer detection, recall, and interval cancers (cancers clinically detected between screenings), and positive predictive value for screen recalls and negative predictive value of each method. Outcomes were analysed in the per-protocol population. Follow-up of the participants for at least 2 years allowed for identification of interval cancers. This trial is registered with ClinicalTrials.gov , number NCT01091545 . Findings Between Jan 27, 2010, and Feb 13, 2015, of 21 691 women invited, 14 851 (68%) agreed to participate. Three women withdrew consent during follow-up and were excluded from the analyses. 139 Breast cancers were detected in 137 ( Interpretation Breast cancer screening by use of one-view digital Breast Tomosynthesis with a reduced compression force has higher sensitivity at a slightly lower specificity for Breast cancer detection compared with two-view digital mammography and has the potential to reduce the radiation dose and screen-reading burden required by two-view digital Breast Tomosynthesis with two-view digital mammography. Funding The Swedish Cancer Society, The Swedish Research Council, The Breast Cancer Foundation, The Swedish Medical Society, The Crafoord Foundation, The Gunnar Nilsson Cancer Foundation, The Skane University Hospital Foundation, Governmental funding for clinical research, The South Swedish Health Care Region, The Malmo Hospital Cancer Foundation and The Cancer Foundation at the Department of Oncology, Skane University Hospital.
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performance of one view Breast Tomosynthesis as a stand alone Breast cancer screening modality results from the malmo Breast Tomosynthesis screening trial a population based study
European Radiology, 2016Co-Authors: Kristina Lang, Anders Tingberg, Ingvar Andersson, Pontus Timberg, Aldana Rosso, Sophia ZackrissonAbstract:Objective To assess the performance of one-view digital Breast Tomosynthesis (DBT) in Breast cancer screening.
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the diagnostic accuracy of dual view digital mammography single view Breast Tomosynthesis and a dual view combination of Breast Tomosynthesis and digital mammography in a free response observer performance study
Radiation Protection Dosimetry, 2010Co-Authors: Tony Svahn, Anders Tingberg, Ingvar Andersson, Debra M Ikeda, Daniel Fornvik, Dev P Chakraborty, Soren Mattsson, Sune Svensson, Sophia ZackrissonAbstract:The purpose of the present study was to compare the diagnostic accuracy of dual-view digital mammography (DM), single-view Breast Tomosynthesis (BT) and BT combined with the contralateral DM view. Patients with subtle lesions were selected to undergo BT examinations. Two radiologists who are non-participants in the study and have experience in using DM and BT determined the locations and extents of lesions in the images. Five expert mammographers interpreted the cases using the free-response paradigm. The task was to mark and rate clinically reportable findings suspicious for malignancy and clinically relevant benign findings. The marks were scored with reference to the outlined regions into lesion localization or non-lesion localization, and analysed by the jackknife alternative free-response receiver operating characteristic method. The analysis yielded statistically significant differences between the combined modality and dual-view DM (p < 0.05). No differences were found between single-view BT and dual-view DM or between single-view BT and the combined modality. (Less)
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the diagnostic accuracy of dual view digital mammography single view Breast Tomosynthesis and a dual view combination of Breast Tomosynthesis and digital mammography in a free response observer performance study
Radiation Protection Dosimetry, 2010Co-Authors: Tony Svahn, Anders Tingberg, Ingvar Andersson, Debra M Ikeda, Daniel Fornvik, Dev P Chakraborty, Soren Mattsson, Sune Svensson, Sophia ZackrissonAbstract:The purpose of the present study was to compare the diagnostic accuracy of dual-view digital mammography (DM), single-view Breast Tomosynthesis (BT) and BT combined with the opposite DM view. Patients with subtle lesions were selected to undergo BT examinations. Two radiologists who are non-participants in the study and have experience in using DM and BT determined the locations and extents of lesions in the images. Five expert mammographers interpreted the cases using the free-response paradigm. The task was to mark and rate clinically reportable findings suspicious for malignancy and clinically relevant benign findings. The marks were scored with reference to the outlined regions into lesion localization or non-lesion localization, and analysed by the jackknife alternative free-response receiver operating characteristic method. The analysis yielded statistically significant differences between the combined modality and dual-view DM (p < 0.05). No differences were found between single-view BT and dual-view DM or between single-view BT and the combined modality.
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Breast Tomosynthesis accuracy of tumor measurement compared with digital mammography and ultrasonography
Acta Radiologica, 2010Co-Authors: Daniel Fornvik, Anders Tingberg, Tony Svahn, Pontus Timberg, Sophia Zackrisson, Otto Ljungberg, Ingvar AnderssonAbstract:Background: Mammographic tumor size measurement can be difficult because Breast structures are superimposed onto a two-dimensional (2D) plane, potentially obscuring the tumor outline. Breast Tomosynthesis (BT) is a 3D X-ray imaging technique in which low-dose images are acquired over a limited angular range at a total dose comparable to digital mammography (DM). These low-dose images are used to mathematically reconstruct a 3D image volume of the Breast, thus reducing the problem of superimposed tissue.Purpose: To investigate whether Breast cancer size can be more accurately assessed with Breast Tomosynthesis than with digital mammography and ultrasonography (US), by reducing the disturbance effect of the projected anatomy.Material and Methods: A prototype BT system was used. The main inclusion criterion for BT examination was subtle but suspicious findings of Breast cancer on 2D mammography. Sixty-two women with 73 Breast cancers were included. BT, DM, and US sizes were measured independently by experien...
Pragya A Dang - One of the best experts on this subject based on the ideXlab platform.
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Breast cancer screening with digital Breast Tomosynthesis are initial benefits sustained
Radiology, 2020Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Sarah F Mercaldo, Pragya A Dang, Kathryn P Lowry, Constance D LehmanAbstract:The benefits of reduced false-positive examinations and higher specificity with screening digital Breast Tomosynthesis were sustained after the first screening round.
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comparing tumor characteristics and rates of Breast cancers detected by screening digital Breast Tomosynthesis and full field digital mammography
American Journal of Roentgenology, 2020Co-Authors: Pragya A Dang, Aijia Wang, Gunjan M Senapati, Ronilda Lacson, Ramin Khorasani, Catherine S GiessAbstract:OBJECTIVE. The purpose of this study was to compare the cancer detection rates (CDRs), tumor types, and characteristics between screening digital Breast Tomosynthesis (DBT) and screening full-field...
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utility of Breast mri for further evaluation of equivocal findings on digital Breast Tomosynthesis
American Journal of Roentgenology, 2018Co-Authors: Bethany L Niell, Pragya A Dang, Kandarp Bhatt, Kathryn L HumphreyAbstract:OBJECTIVE. The purpose of this study is to evaluate the utility of MRI as a problem-solving tool for equivocal findings on diagnostic digital mammography (DM) and digital Breast Tomosynthesis (DBT)...
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Breast cancer characteristics associated with 2d digital mammography versus digital Breast Tomosynthesis for screening detected and interval cancers
Radiology, 2017Co-Authors: Manisha Bahl, Anne Marie Mccarthy, Pragya A Dang, Kathryn P Lowry, Shannon Gaffney, Constance D LehmanAbstract:The overall rates of screening-detected and interval cancers are similar with digital mammography (DM) and digital Breast Tomosynthesis (DBT), but a higher proportion of screening-detected cancers are invasive rather than in situ at DBT compared with DM.