Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2019, Vol. 41 ›› Issue (5): 667-672.doi: 10.3881/j.issn.1000-503X.10938

• Original Articles • Previous Articles     Next Articles

Comparison of the Diagnostic Values of Dynamic Enhanced Magnetic Resonance Imaging,Digital Breast Tomosynthesis,and Digital Mammography for Early Breast Cancer

XU Aqiao1,WENG Xiaobo1,ZHENG Jing1,LI Zhiqing2,WANG Xiaoling3,ZHANG Shengjian4()   

  1. 1 Department of Radiology
    2 Department of Pathology,Shaoxing Center Hospital,Shaoxing,Zhejiang 312030,China
    3 Department of Radiology,Shaoxing People’s Hospital,Shaoxing,Zhejiang 312000,China;
    4 Department of Radiology,Tumor Hospital Affiliated to Fudan University,Shanghai 200032,China
  • Received:2018-10-18 Online:2019-10-30 Published:2019-11-08
  • Contact: Shengjian ZHANG E-mail:zhangshengjian@yeah.net
  • Supported by:
    Supported by Shaoxing Public Welfare Technology Application Research Program(2018C30140);Zhejiang Medical Research Program(2018KY8299)

Abstract:

Objective To compare the values of dynamic enhanced magnetic resonance imaging(DCE-MRI),digital breast tomosynthesis(DBT),and digital mammography(DM)in the early detection and diagnosis of breast cancer.Methods We retrospectively analyzed the clinical and imaging data of 65 cases with early breast cancer confirmed by surgical pathology from June 2017 to December 2018.All patients underwent breast DCE-MRI,DM and DBT before surgery.The receiver operating characteristic(ROC)curves were drawn,with the pathological results as the gold standard,to evaluate the diagnostic performance of different examination methods.The areas under ROC curves(AUCs)were compared using Z test.The differences among DCE-MRI,DBT and DM in detecting early breast cancer were compared using chi-square test in terms of positive rates,accuracy,sensitivity,and specificity.Pearson correlation analysis was performed to assess the accuracy of these imaging methods in detecting the size of early breast cancer.Results The AUCs of DCE-MRI,DBT,and DM based on the BI-RADS classification for early diagnosis of breast cancer were 0.910,0.832,and 0.700,respectively(z=2.132,P=0.001);the sensitivity of DCE-MRI,DBT,and DM for early breast cancer was 92.3%,70.8%,and 52.5%,the specificity was 65.0%,85.0%,and 79.3%,and the accuracy was 83.1%,70.8%,and 50.8%,indicating that DCE-MRI(χ 2=15.330,P=0.0001) and DBT(χ 2=5.450,P=0.020) had significantly higher diagnostic accuracy than DM.The measurement results of DM,DBT,and DCE-MRI were positively correlated with the pathological measurements(r=0.781,r=0.847,r=0.946;all P<0.01). Conclusions DCE-MRI and DBT have higher positive rates and accuracies than DM in detecting early breast cancer.Medical institutions where DCE-MRI is still not available can use DBT to improve the early detection of breast cancer.

Key words: breast cancer, magnetic resonance imaging, digital mammography, digital breast tomosynthesis

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