| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 291.2 KB | Adobe PDF |
Advisor(s)
Abstract(s)
A mamografia digital é, atualmente, o pilar do programa de rastreio do cancro da mama, contudo a densidade mamária afeta negativamente a sua performance de diagnóstico, diminuindo a sua sensibilidade devido ao efeito – designado em Radiologia “efeito máscara”. Com o objetivo de superar este inconveniente, a tomossíntese tem conseguido bons resultados em mulheres com elevada densidade mamária, devido à sua capacidade de reduzir as falsas imagens resultantes da sobreposição dos tecidos. Este estudo pretende explorar a literatura no que diz respeito à integração da tomossíntese nos programas de rastreio para avaliação de mulheres com elevada densidade mamária, com base nos indicadores clínicos: taxa de rechamada – recall rate, fração de falsos positivos (FFP) e taxa de deteção de lesões. Da pesquisa na literatura resultaram 79 estudos, dos quais 11 foram incluídos para análise. Verifica-se que a utilização da tomossíntese mais mamografia está associada à redução da recall rate, em todas as categorias ACR, mas maioritariamente na categoria C, atingindo 8,83% para a tomossíntese e 10,98% para a mamografia e 10,4% para a tomossíntese e 19,9% para a mamografia. A FFP também beneficia duma diminuição, porém, aumenta com o aumento das categorias ACR sendo cerca de 5 vezes superior na categoria D. A taxa de deteção de lesões também aumentou com a adoção da tomossíntese sendo cerca de 1,41 vezes superior em cada 1000 mulheres, e com maior expressão em mulheres com tecido mamário denso. Conclui-se que o uso isolado da tomossíntese ou a sua adição à mamografia demonstra resultados muito positivos, dado que esta modalidade de imagem contribui para a deteção de lesões de menores dimensões e, consequentemente, aumento da taxa de deteção de lesões, aumento da especificidade, diminuição da recall rate e FFP. Por este motivo a tomossíntese demonstra ser uma técnica promissora e pode representar uma resposta eficaz nos programas de rastreio.
ABSTRACT - Digital mammography is currently the pillar of the breast cancer screening program, however, breast density negatively affects its diagnostic performance, decreasing its sensitivity due to the - so-called Radiology - “mask effect”. In order to overcome this inconvenience, tomosynthesis has achieved good results in women with high breast density, due to its ability to reduce false images resulting from overlapping tissues. This study aims to explore the literature regarding the integration of tomosynthesis in screening programs for the evaluation of women with high breast density, based on the clinical indicators: recall rate, a false-positive fraction (FPF), and detection of injuries. The literature search resulted in 79 studies, of which 11 were included for analysis. It appears that the use of tomosynthesis plus mammography is associated with the reduction in the recall rate, in all ACR categories, but mostly in category C, reaching 8,83% for tomosynthesis and 10,98% for mammography, and 10,4% for tomosynthesis and 19,9% for mammography. FPF also benefits from a decrease, however about 5 times higher in category D. The rate of lesion detection also increased with the adoption of tomosynthesis, being about 1,41 times higher in every 1000 women, and with greater expression in women with dense breasts. It is concluded that the isolated use of tomosynthesis or its addition to mammography shows very positive results, since this imaging modality contributes to the detection of smaller lesions and, consequently, an increase in the detection rate of lesions, increased specificity, decrease in recall rate and FFP. For this reason, tomosynthesis proves to be a promising technique and can represent an effective response in screening programs.
ABSTRACT - Digital mammography is currently the pillar of the breast cancer screening program, however, breast density negatively affects its diagnostic performance, decreasing its sensitivity due to the - so-called Radiology - “mask effect”. In order to overcome this inconvenience, tomosynthesis has achieved good results in women with high breast density, due to its ability to reduce false images resulting from overlapping tissues. This study aims to explore the literature regarding the integration of tomosynthesis in screening programs for the evaluation of women with high breast density, based on the clinical indicators: recall rate, a false-positive fraction (FPF), and detection of injuries. The literature search resulted in 79 studies, of which 11 were included for analysis. It appears that the use of tomosynthesis plus mammography is associated with the reduction in the recall rate, in all ACR categories, but mostly in category C, reaching 8,83% for tomosynthesis and 10,98% for mammography, and 10,4% for tomosynthesis and 19,9% for mammography. FPF also benefits from a decrease, however about 5 times higher in category D. The rate of lesion detection also increased with the adoption of tomosynthesis, being about 1,41 times higher in every 1000 women, and with greater expression in women with dense breasts. It is concluded that the isolated use of tomosynthesis or its addition to mammography shows very positive results, since this imaging modality contributes to the detection of smaller lesions and, consequently, an increase in the detection rate of lesions, increased specificity, decrease in recall rate and FFP. For this reason, tomosynthesis proves to be a promising technique and can represent an effective response in screening programs.
Description
Keywords
Mamografia digital Tomossíntese Cancro da mama Digital mammography Tomosynthesis Breast cancer
Citation
Azevedo R, Catarino P, Ribeiro MM. Tomossíntese e mamografia na avaliação de mulheres com elevada densidade mamária: revisão sistemática. Roentgen. 2021;2(1):21-8.
Publisher
Associação NUCLIRAD