title: Impact of prior mammograms on combined reading of digital mammography and digital breast tomosynthesis.
abstract: Background Although digital breast tomosynthesis (DBT) is an emerging technique yielding higher sensitivity and specificity compared to digital mammography (DM) alone, relative contribution of prior mammograms on the interpretation of DBT combined with DM has not been investigated. Purpose To retrospectively compare the diagnostic performances of DM, DM + DBT, and DM + DBT with prior mammograms. Material and Methods Three breast radiologists independently reviewed images of 116 patients with 24 cancers in the sequential order of DM, DM + DBT, and DM + DBT with prior mammograms using Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Results The average areas under the receiver operating characteristic curve (AUC) of DM, DM + DBT, and DM + DBT with prior mammograms were 0.712, 0.777, and 0.816, respectively. Adding prior mammograms did not significantly affect the AUC of DM + DBT ( P = 0.108), whereas adding DBT significantly increased the AUC of DM ( P = 0.009). Sensitivity for DM, DM + DBT, and DM + DBT with prior mammograms was 58.3%, 69.4%, and 69.4%, and specificities were 84.1%, 85.9%, and 93.8%, respectively. Addition of DBT significantly increased the sensitivity ( P = 0.0090) of DM. Prior mammograms significantly improved the specificity of DM + DBT ( P = 0.0004), whereas adding prior mammogram did not affect sensitivity of DM + DBT ( P = 1.000). Conclusion DBT significantly increases the overall sensitivity and diagnostic performance of DM. Prior mammograms significantly increase the specificity of DM + DBT but have no significant effect on sensitivity and overall diagnostic performance.
authors.affiliation: 1 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Won Hwa
authors.initials: WH
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.affiliation: 2 Department of Radiology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Ryoung
authors.initials: HR
authors.lastname: Koo
authors.affiliation: 3 Department of Radiology, Kyung Hee University Hospital, Republic of Korea.
authors.forename: Mirinae
authors.initials: M
authors.lastname: Seo
authors.affiliation: 1 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Min Sun
authors.initials: MS
authors.lastname: Bae
authors.affiliation: 4 Department of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Joongyub
authors.initials: J
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Digital mammography; breast neoplasms; diagnostic performance; digital breast tomosynthesis; sensitivity and specificity