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.
The results showed a total of 160 lesions; 108 were malignant and 52 benign. Of the malignant lesions, there were:
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 cancers||90.0%||93.8%|
|Positive predictive values for additional disease||78.8%||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.