在人群乳腺 X 射线摄影筛查中引入单视角断层合成技术：对检出率、间隔癌率和假阳性率的影响。

IF 2.6 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Medical Screening Pub Date : 2024-07-25 DOI:10.1177/09691413241262259

Bolette Mikela Vilmun, George Napolitano, Martin Lillholm, Rikke Rass Winkel, Elsebeth Lynge, Mads Nielsen, Michael Bachmann Nielsen, Jonathan Frederik Carlsen, My von Euler-Chelpin, Ilse Vejborg

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引用次数: 0

摘要

目的评估数字乳腺断层合成（DBT）和全场数字乳腺X光摄影（FFDM）组合与仅全场数字乳腺X光摄影在乳腺癌筛查中的性能终点：这是一项基于人群的前瞻性筛查研究，研究对象包括参加丹麦首都地区乳腺 X 线照相术筛查项目的合格女性（50-69 岁）。所有参加筛查的妇女都接受了 FFDM。一个亚组被连续分配到带有 DBT 的筛查室。所有的 FFDM 和 DBT 都经过独立的双重读片，所有妇女都在筛查日期后接受了为期 2 年的随访，或直到下一次筛查日期（以先到者为准）：分析纳入了 6353 例 DBT + FFDM 和 395 835 例 FFDM，在 2012 年 11 月 1 日至 2018 年 12 月 12 日期间对 196267 名妇女进行了检查。添加 DBT 提高了敏感性：DBT + FFDM 为 89.9%（95% 置信区间（CI）：81.0-95.5），仅 FFDM 为 70.1%（95% CI：68.6-71.6），P = 0.9。筛查出的癌症率在统计上有显著增加：DBT + FFDM 为 11.18/1000，仅 FFDM 为 6.49/1000，P = 0.9。DBT + FFDM 的召回阳性预测值为 39.0%（95% CI：31.9-46.5），仅 FFDM 的召回阳性预测值为 27.3%（95% CI：26.4-28.2），p p = 0.02：DBT + FFDM 在统计学上显著提高了癌症检测率和项目灵敏度。

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Introduction of one-view tomosynthesis in population-based mammography screening: Impact on detection rate, interval cancer rate and false-positive rate.

Objective: To assess performance endpoints of a combination of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) compared with FFDM only in breast cancer screening.

Materials and methods: This was a prospective population-based screening study, including eligible (50-69 years) women attending the Capital Region Mammography Screening Program in Denmark. All attending women were offered FFDM. A subgroup was consecutively allocated to a screening room with DBT. All FFDM and DBT underwent independent double reading, and all women were followed up for 2 years after screening date or until next screening date, whichever came first.

Results: 6353 DBT + FFDM and 395 835 FFDM were included in the analysis and were undertaken in 196 267 women in the period from 1 November 2012 to 12 December 2018. Addition of DBT increased sensitivity: 89.9% (95% confidence interval (CI): 81.0-95.5) for DBT + FFDM and 70.1% (95% CI: 68.6-71.6) for FFDM only, p < 0.001. Specificity remained similar: 98.2% (95% CI: 97.9-98.5) for DBT + FFDM and 98.3% (95% CI: 98.2-98.3) for FFDM only, p = 0.9. Screen-detected cancer rate increased statistically significantly: 11.18/1000 for DBT + FFDM and 6.49/1000 for FFDM only, p < 0.001. False-positive rate was unchanged: 1.75% for DBT + FFDM and 1.73% for FFDM only, p = 0.9. Positive predictive value for recall was 39.0% (95% CI: 31.9-46.5) for DBT + FFDM and 27.3% (95% CI: 26.4-28.2), for FFDM only, p < 0.0005. The interval cancer rate decreased: 1.26/1000 for DBT + FFDM and 2.76/1000 for FFDM only, p = 0.02.

Conclusion: DBT + FFDM yielded a statistically significant increase in cancer detection and program sensitivity.

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来源期刊

Journal of Medical Screening 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.90

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Medical Screening, a fully peer reviewed journal, is concerned with all aspects of medical screening, particularly the publication of research that advances screening theory and practice. The journal aims to increase awareness of the principles of screening (quantitative and statistical aspects), screening techniques and procedures and methodologies from all specialties. An essential subscription for physicians, clinicians and academics with an interest in screening, epidemiology and public health.