Lesion detection in digital breast tomosynthesis: human reader experiments indicate no benefit from the integration of information from multiple planes

Journal of medical imaging, vol. 10, pp. 1–11

Abstract

PurposeIn digital breast tomosynthesis (DBT), radiologists need to review a stack of 20 to 80 tomosynthesis images, depending upon breast size. This causes a significant increase in reading time. However, it is currently unknown whether there is a perceptual benefit to viewing a mass in the 3D tomosynthesis volume. To answer this question, this study investigated whether adjacent lesion-containing planes provide additional information that aids lesion detection for DBT-like and breast CT-like (bCT) images.MethodHuman reader detection performance was determined for low-contrast targets shown in a single tomosynthesis image at the center of the target (2D) or shown in the entire tomosynthesis image stack (3D). Using simulations, targets embedded in simulated breast backgrounds, and images were generated using a DBT-like (50 deg angular range) and a bCT-like (180 deg angular range) imaging geometry. Experiments were conducted with spherical and capsule-shaped targets. Eleven readers reviewed 1600 images in two-alternative forced-choice experiments. The area under the receiver operating characteristic curve (AUC) and reading time were computed for the 2D and 3D reading modes for the DBT and bCT imaging geometries and for both target shapes.ResultsSpherical lesion detection was higher in 2D mode than in 3D, for both DBT- and bCT-like images (DBT: AUC2D = 0.790, AUC3D = 0.735, P = 0.03; bCT: AUC2D = 0.869, AUC3D = 0.716, P < 0.05), but equivalent for capsule-shaped signals (DBT: AUC2D = 0.891, AUC3D = 0.915, P = 0.19; bCT: AUC2D = 0.854, AUC3D = 0.847, P = 0.88). Average reading time was up to 134% higher for 3D viewing (P < 0.05).ConclusionsFor the detection of low-contrast lesions, there is no inherent visual perception benefit to reviewing the entire DBT or bCT stack. The findings of this study could have implications for the development of 2D synthetic mammograms: a single synthesized 2D image designed to include all lesions present in the volume might allow readers to maintain detection performance at a significantly reduced reading time.

Authors 6

1. Christiana Balta corresponding

   Radboud University Medical Center · Dutch Expert Centre for Screening · Canon (Netherlands)

   Affiliation as printed

   Dutch Expert Ctr. for Screening (LRCB)

   Dutch Expert Ctr. for Screening (LRCB) (The Netherlands)

   Now at Canon Medical Systems Europe, Zilverstraat 1, 2718 RP Zoetermeer, The Netherlands

   Radboud Univ. Medical Ctr. (The Netherlands)

2. Ingrid Reiser

   University of Chicago

   Affiliation as printed

   The Univ. of Chicago

   The Univ. of Chicago (United States)

3. Mireille J. M. Broeders

   Radboud University Medical Center · Dutch Expert Centre for Screening

   Affiliation as printed

   Dutch Expert Ctr. for Screening (LRCB)

   Dutch Expert Ctr. for Screening (LRCB) (The Netherlands)

   Radboud Univ. Medical Ctr. (The Netherlands)

4. Wouter J. H. Veldkamp Aachen Leiden Univ. Medical Ctr Leiden Univ. Medical Ctr. (The Netherlands)

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden Univ. Medical Ctr

   Leiden Univ. Medical Ctr. (The Netherlands)

5. Ruben E. van Engen

   Dutch Expert Centre for Screening

   Affiliation as printed

   Dutch Expert Ctr. for Screening (LRCB)

   Dutch Expert Ctr. for Screening (LRCB) (The Netherlands)

6. Ioannis Sechopoulos corresponding

   Radboud University Medical Center · Dutch Expert Centre for Screening · Canon (Netherlands) · University of Twente

   Affiliation as printed

   Dutch Expert Ctr. for Screening (LRCB)

   Dutch Expert Ctr. for Screening (LRCB) (The Netherlands)

   Now at Canon Medical Systems Europe, Zilverstraat 1, 2718 RP Zoetermeer, The Netherlands

   Radboud Univ. Medical Ctr. (The Netherlands)

   Twente Medical Ctr., Univ. Twente (The Netherlands)