How Close Is DBT-ABVS Accuracy to MRI for Breast Cancer Screening?

October 17, 2018

Tomosynthesis plus breast volume scanner could be replacement for breast cancer staging if MRI cannot be performed.

Digital breast tomosynthesis plus automated breast volume scanner (DBT-ABVS) provides acceptable accuracy in staging breast cancer when MRI is unavailable or unfeasible, according to a study published in the European Journal of Radiology.

Researchers from Italy performed a retrospective study to investigate if DBT-ABVS would be comparable to MR imaging in staging breast cancer. Seventy-three patients participated in the study.

All patients underwent preoperative DBT, ABVS, and 1.5 T MRI. Two radiologists recorded the number, site, and breast imaging-reporting and data system (BI-RADS) category of breast findings during two independent reading strategies.

Related article: Tomosynthesis Plus Mammography May be Superior to Mammography Alone in Screening

The results showed a total of 160 lesions; 108 were malignant and 52 benign. Of the malignant lesions, there were:

  • 53 unifocal lesions
  • 15 multifocal lesions
  • 4 multicentric lesions
  • 1 bilateral lesion

The diagnostic accuracy of DBT-ABVS versus MRI was comparable for all cancers, although sensitivity and positive predictive values were lower:

Diagnostic accuracy for all cancers90.0%93.8%
Sensitivity76.5%91.7%
Positive predictive values for additional disease78.8%93.4%

Compared to MRI, ABVS + DBT missed six lesions, including two invasive cancers and one extensive intravascular invasion associated to ductal carcinoma in situ. Bland-Altman analysis showed ABVS to agree with MRI at a higher extent than DBT in assessing cancer size.

The researchers concluded that although the DBT-ABVS was less performing than MRI in staging breast cancer, it showed acceptable diagnostic accuracy, and could be an option if MRI is unavailable or unfeasible.