近日，一项发表在American Journal of Roentgenology杂志上的研究证实：与二维数字化乳腺X线摄影（DM）相比，用数位化乳房断层合成技术( Digital Breast Tomosynthesis, DBT ) 进行乳房摄影筛检，能得到较高的癌症检出率，不但从总体上看能增加乳腺癌的检出率，同时能增加浸润性乳腺癌的检出率。 在这项研究报告中，研究人员对超过59,000例患者进行筛查研究。结果是惊人的：3D DBT与2D DM 筛查相比，乳腺癌总体上的检出率增加28.6％，浸润性癌患者检出率增加了43.8％。 研究报告的作者Julianne Greenberg说：我们观察到3D DBT筛查后，乳腺癌总体上而言检出率增加，浸润性乳腺癌检出率有一个更大显著的增加。我们的结果可能是一个代表性研究，揭示断层合成技术对乳腺癌筛查有积极作用。 Clinical Performance Metrics of 3D Digital Breast Tomosynthesis Compared With 2D Digital Mammography for Breast Cancer Screening in Community Practice Julianne S. Greenberg1, Marcia C. Javitt2, Jason Katzen1, Sara Michael3 and Agnes E. Holland1 OBJECTIVE. The objective of our study was to assess the clinical performance of combined 2D-3D digital breast tomosynthesis (DBT), referred to as “3D DBT,” compared with 2D digital mammography (DM) alone for screening mammography in a community-based radiology practice. MATERIALS AND METHODS. Performance outcomes measures were assessed for 14 radiologists who interpreted more than 500 screening mammography 3D DBT studies after the initiation of tomosynthesis. Outcomes from screening mammography during the study period between August 9, 2011, and November 30, 2012, using 3D DBT (n = 23,149 patients) versus 2D DM (n = 54,684 patients) were compared. RESULTS. For patients screened with 3D DBT, the relative change in recall rate was 16.1% lower than for patients screened with 2D DM (p > 0.0001). The overall cancer detection rate (CDR), expressed as number of cancers per 1000 patients screened, was 28.6% greater (p = 0.035) for 3D DBT (6.3/1000) compared with 2D DM (4.9/1000). The CDR for invasive cancers with 3D DBT (4.6/1000) was 43.8% higher (p = 0.0056) than with 2D DM (3.2/1000). The positive predictive value for recalls from screening (PPV1) was 53.3% greater (p = 0.0003) for 3D DBT (4.6%) compared with 2D DM (3.0%). No significant difference in the positive predictive value for biopsy (PPV3) was found for 3D DBT versus 2D DM (22.8% and 23.8%, respectively) (p = 0.696). CONCLUSION. In community-based radiology practice, mammography screening with 3D DBT yielded lower recall rates, an increased CDR for cancer overall, and an increased CDR for invasive cancer compared with 2D DM. The PPV1 was significantly greater in the group screened using 3D DBT. |
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