Purpose

To acknowledge the significance of Joint Clinical Application of Digital Mammary Gland 3D Tomosynthesis with MRI for Diagnosis of Breast Cancer, and study their efficient clinical usage.

Methods

Randomly choose 271 female patients, study 542 sides of Digital Mammary Gland 3D Tomosynthesis and MR images, comparing the diagnosis and pathology from the 253 patients, then analyzing and comparing them with MRI results. Implementing digital mammography under standard mode of Hologic mammary gland machine, to get the corresponding 2D and 3D images. At the same time, all of them were examined on a 3.0T MR system (MR 3.0T Twinspeed signa hdxt, GE Healthcare, America) with multiple-b-value diffusion-weighted imaging (DWI) scans. The following imaging parameters were used for FS AX T2 IDEAL sequence (FOV=33×33cm, slice thickness=5.0mm, Echo Train Length=19, bandwidth=62.5, matrix=320×224, TE=85ms, TR=5440ms). The following imaging parameters were used for STIR AX DWI sequence (FOV=40×40cm, slice thickness=8.0mm, TE=Minimum, TR=4000, Inv. Time=160, NEX=2.0, matrix=128×128). The following imaging parameters were used for AX VIBRANT+C sequence (FOV=30×30cm, slice thickness=2.0mm, flip angle=15, bandwidth=62.5, matrix=388×256). GE AW4.6 workstation was used to calculate the value of ADC, ADC standard, D, D*, f, and to generate time-signal intensity curve (TIC). All parameters between benign and malignant breast lesions were compared by Mann-Whitney U test. Finally, we promote an analysis of breast cancer focus based on 114 cases of female patients identified by histopathology. The diagnostic performance of different parameters was evaluated by receiver operating characteristic curve analysis.

Results and Discussion

After analyzing and comparing Digital 3D Tomosynthesis (Fig.1, Fig.2), MRI diagnosis (Fig.3) with the pathology from 253 patients, among which 130 patients were diagnosed with breast cancer and their pathology indicate positive, 16 cases’ pathological indicate negative; 11 patients were diagnosed with non-breast cancer, and 96 cases’ pathology indicate negative. This study shows that a 92.2% sensitivity rate of Digital Mammary Gland 3D Tomosynthesis technology for diagnosis of breast cancer, 85.7% of specificity, 89.3% of the coincidence rate, positive predictive value is 89%, and negative predictive value is 89.7%; A 89.7% sensitivity rate of MRI technology for diagnosis of breast cancer, 84.2% of specificity, 87.6% of the coincidence rate, positive predictive value is 87.4%, and negative predictive value is 86.4%.(Table 1)Finally the joint clinical application of Digital Mammary Gland 3D Tomosynthesis with MRI could not only reduce the false positive and negative rate, but also improve the test sensitivity and specificity^1,2.

Conclusion

The sensitivity, specificity and accuracy of Digital Mammary Gland 3D Tomosynthesis technology are superior to MRI. Breast MR Examination is the effective method of breast cancer,so joint clinical application of Digital Mammary Gland 3D Tomosynthesis Technology with MRI is more valuable and efficient for diagnosis of breast cancer.

Acknowledgements

No acknowledgement found.

References

1. Park A M,Franken EA, Garg M, et al. Breast tomosynthesis: Present considerations and Future applications[J],Riadiographics ,2007(27):231-240.
2.Fischmann A, Siegmann KC, Wersebe A, et al. Comparison of full-filed digital mammography and full-screen mammography :image quality and lesion detection[J].Radiology ,2005,78(928):312-317.