Performance of Digital Breast Tomosynthesis, Synthetic Mammography, and Digital Mammography in Breast Cancer Screening: A Systematic Review and Meta-Analysis

被引：48

作者：

Alabousi, Mostafa ^{[1
]}

Wadera, Akshay ^{[1
]}

Al-Ghita, Mohammed Kashif ^{[2
]}

Al-Ghetaa, Rayeh Kashef ^{[3
]}

Salameh, Jean-Paul ^{[4
]}

Pozdnyakov, Alex ^{[5
]}

Zha, Nanxi ^{[1
]}

Samoilov, Lucy ^{[1
]}

Sharifabadi, Anahita Dehmoobad ^{[1
]}

Sadeghirad, Behnam ^{[6
]}

Freitas, Vivianne ^{[7
]}

McInnes, Matthew D. F. ^{[8
]}

Alabousi, Abdullah ^{[9
]}

机构：

[1] McMaster Univ, Dept Radiol, Hamilton, ON, Canada

[2] Western Univ, Fac Biomed Sci, London, ON, Canada

[3] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[4] Univ Ottawa, Dept Radiol, Ottawa, ON, Canada

[5] McMaster Univ, Fac Med, Hamilton, ON, Canada

[6] McMaster Univ, Michael G DeGroote Inst Pain Res & Care, Dept Hlth Res Methods Evidence & Impact HEI, Hamilton, ON, Canada

[7] Univ Toronto, Joint Dept Med Imaging, Toronto, ON, Canada

[8] Univ Ottawa, Ottawa Hosp Res Inst, Dept Radiol & Epidemiol, Clin Epidemiol Program, Ottawa, ON, Canada

[9] McMaster Univ, St Josephs Healthcare Hamilton, Dept Radiol, 50 Charlton Ave E, Hamilton, ON L8N 4A6, Canada

来源：

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2021年 / 113卷 / 06期

关键词：

SYNTHESIZED 2-DIMENSIONAL MAMMOGRAPHY; FALSE-POSITIVE DETECTION; CLINICAL-PERFORMANCE; 2D MAMMOGRAPHY; IMPLEMENTATION; 2D-MAMMOGRAPHY; 3D-MAMMOGRAPHY; RISK; RECOMMENDATIONS; COMBINATION;

D O I：

10.1093/jnci/djaa205

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Our objective was to perform a systematic review and meta-analysis comparing the breast cancer detection rate (CDR), invasive CDR, recall rate, and positive predictive value 1 (PPV1) of digital mammography (DM) alone, combined digital breast tomosynthesis (DBT) and DM, combined DBT and synthetic 2-dimensional mammography (S2D), and DBT alone. Methods: MEDLINE and Embase were searched until April 2020 to identify comparative design studies reporting on patients undergoing routine breast cancer screening. Random effects model proportional meta-analyses estimated CDR, invasive CDR, recall rate, and PPV1. Meta-regression modeling was used to compare imaging modalities. All statistical tests were 2sided. Results: Forty-two studies reporting on 2 606 296 patients (13 003 breast cancer cases) were included. CDR was highest in combined DBT and DM (6.36 per 1000 screened, 95% confidence interval [CI] = 5.62 to 7.14, P < .001), and combined DBT and S2D (7.40 per 1000 screened, 95% CI = 6.49 to 8.37, P < .001) compared with DM alone (4.68 per 1000 screened, 95% CI = 4.28 to 5.11). Invasive CDR was highest in combined DBT and DM (4.53 per 1000 screened, 95% CI = 3.97 to 5.12, P = .003) and combined DBT and S2D (5.68 per 1000 screened, 95% CI = 4.43 to 7.09, P < .001) compared with DM alone (3.42 per 1000 screened, 95% CI = 3.02 to 3.83). Recall rate was lowest in combined DBT and S2D (42.3 per 1000 screened, 95% CI = 37.4 to 60.4, P<.001). PPV1 was highest in combined DBT and DM (10.0%, 95% CI = 8.0% to 12.0%, P = .004), and combined DBT and S2D (16.0%, 95% CI = 10.0% to 23.0%, P < .001), whereas no difference was detected for DBT alone (7.0%, 95% CI = 6.0% to 8.0%, P = .75) compared with DM alone (7.0%, 95.0% CI = 5.0% to 8.0%). Conclusions: Our findings provide evidence on key performance metrics for DM, DBT alone, combined DBT and DM, and combined DBT and S2D, which may inform optimal application of these modalities for breast cancer screening.

引用

页码：680 / 690

页数：11

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