Computer Simulation Study Favors Tomosynthesis over Digital Mammography

MedicalResearch.com Interview with:

Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993

Aldo Badano, Ph.D.
Deputy Director, Division of Imaging, Diagnostics, and Software Reliability
Office of Science and Engineering Laboratories
Center for Devices and Radiological Health Silver Spring, MD 20993 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Expensive and lengthy clinical trials can delay regulatory evaluation of innovative technologies, affecting patient access to high-quality medical products. Although computational modeling is increasingly being used in product development, it is rarely at the center of regulatory applications.

Within this context, the VICTRE project attempted to replicate a previously conducted imaging clinical trial using only computational models. The VICTRE trial involved no human subjects and no clinicians. All trial steps were conducted in silico. The fundamental question the article addresses is whether in silico imaging trials are at a mature development stage to play a significant role in the regulatory evaluation of new medical imaging systems. The VICTRE trial consisted of in silico imaging of 2986 virtual patients comparing digital mammography (DM) and digital breast tomosynthesis (DBT) systems.

The improved lesion detection performance favoring DBT for all breast sizes and lesion types was consistent with results from a comparative trial using human patients and radiologists.  Continue reading

Digital Breast Tomosynthesis + Synthetic 2D Mammography Detects More Breast Cancers

MedicalResearch.com Interview with:
Dr. Solveig Hofvind, Dr. Philos.
Cancer Registry of Norway
Majorstuen, Oslo

MedicalResearch.com: What is the background for this study?

Response: To test out Digital Breast Tomosynthesis (DBT) in combination with synthethic images (SM) as a screening tool for breast cancer.

We screened the women in Oslo with DBT+SM using equipment from Hologic, while women in the neighboring counties were screened with Digital Mammography.

MedicalResearch.com: What are the main findings? 

Response: We found a 50% higher rate of screen-detected breast cancer among women screened with DBT+SM compared with  Digital Mammography

Both the rate of invasive breast cancer and ductal carcinoma in situ was higher. Tumors detected with DBT+SM were smaller and less aggressive compared to those detected with Digital Mammography.
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We found no differences in recall rates between the two groups.

MedicalResearch.com: What should readers take away from your report?

Response: Screening with Digital Breast Tomosynthesis and Synthetic 2D Mammography detects more breast cancer as Digital Mammography. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We need to follow the women for interval breast cancer, but also the rate of screen-detected breast cancer and the characteristics of the tumors in the next screening round. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The pro and cons of implementing Digital Breast Tomosynthesis and Synthetic 2D Mammography in a screening setting need further investigation, according to cost-effectiveness, also in a financial perspective. 

Citations: 

Radiology. 2018 Mar 1:171361. doi: 10.1148/radiol.2018171361. [Epub ahead of print]

Digital Breast Tomosynthesis and Synthetic 2D Mammography versus Digital Mammography: Evaluation in a Population-based Screening Program.

Hofvind S1, Hovda T1, Holen ÅS1, Lee CI1, Albertsen J1, Bjørndal H1, Brandal SHB1, Gullien R1, Lømo J1, Park D1, Romundstad L1, Suhrke P1, Vigeland E1, Skaane P1. 

 

 

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Tomosynthesis Reduces Mammogram Call-Backs for Additional Testing

MedicalResearch.com Interview with Dr. Brian Haas MD Department of Diagnostic Radiology,Yale University School of Medicine, New Haven, CT
Dr. Brian Haas MD
Department of Diagnostic Radiology,Yale University School of Medicine, New Haven, CT

MedicalResearch.com: What are the main findings of the study?

Dr. Haas: We found that tomosynthesis helped to reduce the number of women who undergo a screening mammogram and are called back for additional imaging and testing. Specifically, the greatest reductions in patients being called back were seen in younger patients and those with dense breasts. Tomosynthesis is analogous to a 3D mammogram, and improves contrast of cancers against the background breast parenchyma.
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Detecting Infiltrating Breast Ductal Carcinoma: Tomosynthesis in High Risk Patients

MedicalResearch.com Interview with:
Sarah H. O’Connell M.D.
PGY-4
Yale New Haven Hospital
Yale School of Medicine Department of Diagnostic Radiology

MedicalResearch.com:  What are the main findings of the study?

Answer: The purpose of our study was to evaluate the visibility of cancers in women at high-risk for breast cancer on 2D mammography compared to digital breast tomosynthesis.

In other words, how would the use of tomosynthesis contribute to cancer visualization in this population  of patients?

We evaluated the cancers seen in both high-risk patients, those with a >20% lifetime risk of breast cancer, and intermediate risk  patients, those with a 15-20% lifetime risk of breast cancer, for a total of 56 cancers.

We found that 41% (23/56) cancers were better seen on tomosynthesis and 4% (2/56) were only seen on tomosynthesis. The majority of the cancers seen better or only on tomosynthesis  presented as masses rather than as calcifications alone which were better seen on 2D mammography.
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