title: Stereoscopic digital mammography: improved specificity and reduced rate of recall in a prospective clinical trial.
abstract: OBJECTIVE
  To compare stereoscopic digital mammography (DM) with standard DM for the rate of patient recall and the detection of cancer in a screening population at elevated risk for breast cancer.
  
  
  METHODS
  Starting in September 2004 and ending in December 2007, this prospective HIPAA-compliant, institutional review board-approved screening trial, with written informed consent, recruited female patients at elevated risk for breast cancer (eg, personal history of breast cancer or breast cancer in a close relative). A total of 1298 examinations from 779 patients (mean age, 58.6 years; range, 32-91 years) comprised the analyzable data set. A paired study design was used, with each enrolled patient serving as her own control. Patients underwent both DM and stereoscopic DM examinations in a single visit, findings of which were interpreted independently by two experienced radiologists, each using a Breast Imaging Reporting and Data System (BI-RADS) assessment (BI-RADS category 0, 1, or 2). All patients determined to have one or more findings with either or both modalities were recalled for standard diagnostic evaluation. The results of 1-year follow-up or biopsy were used to determine case truth.
  
  
  RESULTS
  Compared with DM, stereoscopic DM showed significantly higher specificity (91.2% [1167 of 1279] vs 87.8% [1123 of 1279]; P = .0024) and accuracy (90.9% [1180 of 1298] vs 87.4% [1135 of 1298]; P = .0023) for detection of cancer. Sensitivity for detection of cancer was not significantly different for stereoscopic DM (68.4% [13 of 19]) compared with DM (63.2% [12 of 19], P .99). The recall rate for stereoscopic DM was 9.6% (125 of 1298) and that for DM was 12.9% (168 of 1298) (P = .0018).
  
  
  CONCLUSIONS
  Compared with DM, stereoscopic DM significantly improved specificity for detection of cancer, while maintaining comparable sensitivity. The recall rate was significantly reduced with stereoscopic DM compared with DM.
  
  
  BACKGROUND
  http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120382/-/DC1.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Upper Gate Dr NE, Suite C1104, Atlanta, GA 30322, USA. carl.dorsi@emoryhealthcare.org
authors.forename: Carl J
authors.initials: CJ
authors.lastname: D'Orsi
authors.forename: David J
authors.initials: DJ
authors.lastname: Getty
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Pickett
authors.forename: Ioannis
authors.initials: I
authors.lastname: Sechopoulos
authors.forename: Mary S
authors.initials: MS
authors.lastname: Newell
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Gundry
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Bates
authors.forename: Robert M
authors.initials: RM
authors.lastname: Nishikawa
authors.forename: Edward A
authors.initials: EA
authors.lastname: Sickles
authors.forename: Andrew
authors.initials: A
authors.lastname: Karellas
authors.forename: Ellen M
authors.initials: EM
authors.lastname: D'Orsi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity