Performance of Photon-Counting Breast Computed Tomography, Digital Mammography, and Digital Breast Tomosynthesis in Evaluating Breast Specimens

• Published in: Academic radiology Vol. 24; no. 2; pp. 184 - 190
• Main Authors: Rößler, Ann-Christin, Kalender, Willi, Kolditz, Daniel, Steiding, Christian, Ruth, Veikko, Preuss, Caroline, Peter, Sandra Christina, Brehm, Barbara, Hammon, Matthias, Schulz-Wendtland, Rüdiger, Wenkel, Evelyn
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2017
• Subjects: Adult; Aged; Breast - diagnostic imaging; Breast - pathology; Breast computed tomography; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Calcinosis - diagnostic imaging; Calcinosis - pathology; digital breast tomosynthesis; digital mammography; Female; Humans; Mammography - methods; Middle Aged; Multimodal Imaging - methods; photon-counting detector; Photons; Radiographic Image Enhancement - methods; Radiology; ROC Curve; Sensitivity and Specificity; specimen; Tomography, X-Ray Computed - methods; digital breast tomosynthesis; Breast computed tomography; photon-counting detector; digital mammography; specimen
• ISSN: 1076-6332; 1878-4046
• DOI: 10.1016/j.acra.2016.09.017

Rationale and Objectives This study compared a novel photon-counting breast computed tomography (pcBCT) system with digital mammography (DM) and digital breast tomosynthesis (DBT) systems. For this reason, surgical specimens were examined with all three techniques and rated by three observers. Materials and Methods A total of 30 surgical specimens were investigated with DM, DBT, and pcBCT; the associated images were shown to three experienced radiologists. Findings (22 microcalcifications and 23 mass lesions) were recorded and compared to the results of the pathological examination. Sensitivity and specificity for detection of microcalcifications and lesions were calculated and displayed using receiver operating characteristic curves. Results Sensitivity for microcalcifications was 82% for DM, 70% for DBT, and 85% for pcBCT. Specificity for microcalcifications was 71% for DM, 75% for DBT, and 83% for pcBCT. Sensitivity for lesions was 45% for DM, 62% for DBT, and 65% for pcBCT. Specificity for lesions was 76% for DM, 62% for DBT, and 76% for pcBCT. Conclusions pcBCT showed a comparable or superior performance compared to the clinically approved DM and DBT systems. Mass lesion detectability can be increased further by the use of contrast media.