title: Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers.
abstract: OBJECTIVE
  To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers.
  
  
  METHODS
  Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests.
  
  
  RESULTS
  The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0 .0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0 .0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0 .0282).
  
  
  CONCLUSIONS
  DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI.
  
  
  CONCLUSIONS
  • Digital breast tomosynthesis (DBT) plus mammography was compared with MRI plus mammography. • DBT had lower sensitivity and higher PPV than MRI. • DBT had higher diagnostic performance than mammography.
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.
authors.forename: Won Hwa
authors.initials: WH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. imchangjm@gmail.com.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyeong-Gon
authors.initials: HG
authors.lastname: Moon
authors.affiliation: Department of Radiology, Gangnan Healthcare Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ann
authors.initials: A
authors.lastname: Yi
authors.affiliation: Department of Radiology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hye Ryoung
authors.initials: HR
authors.lastname: Koo
authors.affiliation: Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hye Mi
authors.initials: HM
authors.lastname: Gweon
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D055815:Young Adult
keywords: Breast neoplasms/pathology; Imaging; Magnetic resonance imaging; Sensitivity and specificity; Three-dimensional, mammography