Addition of Contrast-enhanced Mammography to Tomosynthesis for Breast Cancer Detection in Women with a Personal History of Breast Cancer: Prospective TOCEM Trial Interim Analysis.

Background Digital breast tomosynthesis (DBT) is often inadequate for screening women with a personal history of breast cancer (PHBC). The ongoing prospective Tomosynthesis or Contrast-Enhanced Mammography, or TOCEM, trial includes three annual screenings with both DBT and contrast-enhanced mammography (CEM). Purpose To perform interim assessment of cancer yield, stage, and recall rate when CEM is added to DBT in women with PHBC.

Effect of the Availability of Prior Full-Field Digital Mammography and Digital Breast Tomosynthesis Images on the Interpretation of Mammograms.

Purpose: To assess the effect of and interaction between the availability of prior images and digital breast tomosynthesis (DBT) images in decisions to recall women during mammogram interpretation.

Materials And Methods: Verbal informed consent was obtained for this HIPAA-compliant institutional review board-approved protocol. Eight radiologists independently interpreted twice deidentified mammograms obtained in 153 women (age range, 37-83 years; mean age, 53.

Comparison of two-dimensional synthesized mammograms versus original digital mammograms alone and in combination with tomosynthesis images.

Purpose: To assess interpretation performance and radiation dose when two-dimensional synthesized mammography (SM) images versus standard full-field digital mammography (FFDM) images are used alone or in combination with digital breast tomosynthesis images.

Materials And Methods: A fully crossed, mode-balanced multicase (n = 123), multireader (n = 8), retrospective observer performance study was performed by using deidentified images acquired between 2008 and 2011 with institutional review board approved, HIPAA-compliant protocols, during which each patient signed informed consent. The cohort included 36 cases of biopsy-proven cancer, 35 cases of biopsy-proven benign lesions, and 52 normal or benign cases (Breast Imaging Reporting and Data System [BI-RADS] score of 1 or 2) with negative 1-year follow-up results.

Dose reduction in digital breast tomosynthesis (DBT) screening using synthetically reconstructed projection images: an observer performance study.

Rationale And Objectives: The aim of this study was to retrospectively compare the interpretive performance of synthetically reconstructed two-dimensional images in combination with digital breast tomosynthesis (DBT) versus full-field digital mammography (FFDM) plus DBT.

Materials And Methods: Ten radiologists trained in reading tomosynthesis examinations interpreted retrospectively, under two modes, 114 mammograms. One mode included the directly acquired full-field digital mammograms combined with DBT, and the other included synthetically reconstructed projection images combined with DBT.

Agreement of the order of overall performance levels under different reading paradigms.

Rationale And Objectives: To investigate consistency of the orders of performance levels when interpreting mammograms under three different reading paradigms.

Materials And Methods: We performed a retrospective observer study in which nine experienced radiologists rated an enriched set of mammography examinations that they personally had read in the clinic ("individualized") mixed with a set that none of them had read in the clinic ("common set"). Examinations were interpreted under three different reading paradigms: binary using screening Breast Imaging Reporting and Data System (BI-RADS), receiver-operating characteristic (ROC), and free-response ROC (FROC).

Binary and multi-category ratings in a laboratory observer performance study: a comparison.

The authors investigated radiologists, performances during retrospective interpretation of screening mammograms when using a binary decision whether to recall a woman for additional procedures or not and compared it with their receiver operating characteristic (ROC) type performance curves using a semi-continuous rating scale. Under an Institutional Review Board approved protocol nine experienced radiologists independently rated an enriched set of 155 examinations that they had not personally read in the clinic, mixed with other enriched sets of examinations that they had individually read in the clinic, using both a screening BI-RADS rating scale (recall/not recall) and a semi-continuous ROC type rating scale (0 to 100). The vertical distance, namely the difference in sensitivity levels at the same specificity levels, between the empirical ROC curve and the binary operating point were computed for each reader.

The "laboratory" effect: comparing radiologists' performance and variability during prospective clinical and laboratory mammography interpretations.

Purpose: To compare radiologists' performance during interpretation of screening mammograms in the clinic with their performance when reading the same mammograms in a retrospective laboratory study.

Materials And Methods: This study was conducted under an institutional review board-approved, HIPAA-compliant protocol; the need for informed consent was waived. Nine experienced radiologists rated an enriched set of mammograms that they had personally read in the clinic (the "reader-specific" set) mixed with an enriched "common" set of mammograms that none of the participants had previously read in the clinic by using a screening Breast Imaging Reporting and Data System (BI-RADS) rating scale.

Multiview-based computer-aided detection scheme for breast masses.

In this study, we developed and tested a new multiview-based computer-aided detection (CAD) scheme that aims to maintain the same case-based sensitivity level as a single-image-based scheme while substantially increasing the number of masses being detected on both ipsilateral views. An image database of 450 four-view examinations (1800 images) was assembled. In this database, 250 cases depicted malignant masses, of which 236 masses were visible on both views and 14 masses were visible only on one view.

A multisite telemammography system for remote management of screening mammography: an assessment of technical, operational, and clinical issues.

Objective: This paper describes a high-quality, multisite telemammography system to enable "almost real-time" remote patient management while the patient remains in the clinic. One goal is to reduce the number of women who would physically need to return to the clinic for additional imaging procedures (termed "recall") to supplement "routine" imaging of screening mammography.

Materials And Methods: Mammography films from current and prior (when available) examinations are digitized at three remote sites and transmitted along with other pertinent information across low-level communication systems to the central site.

Trends in recall, biopsy, and positive biopsy rates for screening mammography in an academic practice.

Purpose: To retrospectively evaluate whether recall, biopsy, and positive biopsy rates for a group of radiologists who met requirements of Mammography Quality Standards Act of 1992 (MQSA) demonstrated any change over time during a 27-month period (nine consecutive calendar quarters).

Materials And Methods: Institutional review board approved study protocol, and informed consent was waived. All screening mammograms that had been interpreted by MQSA-qualified radiologists between January 1, 2001, and March 31, 2003, were reviewed.

Detection and classification performance levels of mammographic masses under different computer-aided detection cueing environments.

Rationale And Objectives: The authors evaluated the impact of different computer-aided detection (CAD) cueing conditions on radiologists' performance levels in detecting and classifying masses depicted on mammograms.

Materials And Methods: In an observer performance study, eight radiologists interpreted 110 subtle cases six times under different display conditions to detect depicted masses and classify them as benign or malignant. Forty-five cases depicted biopsy-proven masses and 65 were negative.

Recall and detection rates in screening mammography.

Background: The authors investigated the correlation between recall and detection rates in a group of 10 radiologists who had read a high volume of screening mammograms in an academic institution.

Methods: Practice-related and outcome-related databases of verified cases were used to compute recall rates and tumor detection rates for a group of 10 Mammography Quality Standard Act (MQSA)-certified radiologists who interpreted a total of 98,668 screening mammograms during the years 2000, 2001, and 2002. The relation between recall and detection rates for these individuals was investigated using parametric Pearson (r) and nonparametric Spearman (rho) correlation coefficients.

Changes in breast cancer detection and mammography recall rates after the introduction of a computer-aided detection system.

Background: Computer-aided mammography is rapidly gaining clinical acceptance, but few data demonstrate its actual benefit in the clinical environment. We assessed changes in mammography recall and cancer detection rates after the introduction of a computer-aided detection system into a clinical radiology practice in an academic setting.

Methods: We used verified practice- and outcome-related databases to compute recall rates and cancer detection rates for 24 Mammography Quality Standards Act-certified academic radiologists in our practice who interpreted 115,571 screening mammograms with (n = 59,139) or without (n = 56,432) the use of a computer-aided detection system.

Computer-aided detection in mammography: an assessment of performance on current and prior images.

Rationale And Objectives: The authors assessed and compared the performance of a computer-aided detection (CAD) scheme for the detection of masses and microcalcification clusters on a set of images collected from two consecutive ("current" and "prior") mammographic examinations.

Materials And Methods: A previously developed CAD scheme was used to assess two consecutive screening mammograms from 200 cases in which the current mammogram showed a mass or cluster of microcalcifications that resulted in breast biopsy. The latest prior examinations had been initially interpreted as negative or definitely benign findings (Breast Imaging Reporting and Data System rating, 1 or 2).