Digital Breast Tomosynthesis: A Decade of Practice in Review

技术 层析合成 乳腺摄影术 数字乳腺摄影术 乳腺癌 医学 医学物理学 随机对照试验 活检 放射科 癌症 内科学
作者
Debra L. Monticciolo
出处
期刊:Journal of The American College of Radiology [Elsevier]
卷期号:20 (2): 127-133 被引量:3
标识
DOI:10.1016/j.jacr.2022.08.005
摘要

Digital breast tomosynthesis (DBT), introduced in 2011, was thought to be a further evolution of full-field digital mammography (DM). Assessing DBT presents unique challenges. The widely variable settings in which DBT has been applied affect outcomes. In initial studies comparing DM-DBT with DM, outcomes for cancer detection rates (CDRs) and recall rates have been mixed. CDR improves most in biennial screening settings, with little or no improvement in annual screening. Recall rates improve most where rates are highest; no improvement is seen in European prospective trials. Adoption of synthesized mammography (SM), derived from the tomosynthesis acquisition and intended to avoid the DM exposure, has been slow because of inferior image quality. Despite this, SM-DBT has shown equivalent outcomes measures to DM-DBT. An important exception is the To-Be randomized controlled trial, which showed that SM-DBT was equivalent to DM in CDR, not better. To date, interval cancer rate, a surrogate for mortality reduction, has not been shown to be improved by DBT. We may have reached the limit of morphological assessment in x-ray technique. Its use may evolve with advancements in technology as use of contrast agents expands, algorithms for SM progress, and tomosynthesis-guided biopsy proliferates. Our expectations of the contributions of DBT will evolve as well.
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