title: Use of Tomosynthesis in Intraoperative Digital Specimen Radiography - Is a Reduction of Breast Re-excision Rates Possible?
abstract: Aim:A prospective clinical study was done to see whether it is possible to reduce the rate of re-excisions using digital breast tomosynthesis (DBT) compared commercial FFDM.Material and Method:Between 1/2011 and 5/2011 we diagnosed an invasive breast cancer (BI-RADS 5) in 100 patients. After histological verification we performed breast-conserving therapy with intraoperative imaging using one of 2 different systems: 1. Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, Tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm, range: 50°, 25 projections, time for scanning > 20 s, geometry: same scanning scope, reconstruction: filtered back projection; or 2. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm as the standard. The 100 radiograms obtained with both systems were prospectively shown on a monitor to 3 radiologists.Results:Out of a total of 100 patients with histologically proven breast cancer (BI-RADS 6) no re-excision was necessary in 78 patients. A retrospective analysis (n = 22) demonstrated an increase in sensitivity of tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e., in 8 patients re-excision would not have been necessary with tomosynthesis.Conclusion:Tomosynthesis has a significant higher sensitivity (p < 0.05) compared with a commercial FFDM system. Studies with higher numbers of patients will be necessary to evaluate this method.
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen.
authors.forename: R
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.affiliation: Radiological Practice Roth and Weissenburg, Roth.
authors.forename: G
authors.initials: G
authors.lastname: Dilbat
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Gynaecology and Obstetrics, Erlangen.
authors.forename: M R
authors.initials: MR
authors.lastname: Bani
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Gynaecology and Obstetrics, Erlangen.
authors.forename: M P
authors.initials: MP
authors.lastname: Lux
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen.
authors.forename: M
authors.initials: M
authors.lastname: Meier-Meitinger
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen.
authors.forename: E
authors.initials: E
authors.lastname: Wenkel
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Erlangen.
authors.forename: S
authors.initials: S
authors.lastname: Schwab
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Gynaecology and Obstetrics, Erlangen.
authors.forename: M W
authors.initials: MW
authors.lastname: Beckmann
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Erlangen.
authors.forename: M
authors.initials: M
authors.lastname: Uder
authors.affiliation: Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen.
authors.forename: B
authors.initials: B
authors.lastname: Adamietz
keywords: breast; mammary gland tumor; mammographic density