在乳腺癌筛查中有或不带有整齐合成的合成乳腺X线摄影与全场数字乳房摄影的诊断性能，乳腺癌筛查：系统评价和荟萃分析
Diagnostic performance of tomosynthesis plus synthetic mammography versus full-field digital mammography with or without tomosynthesis in breast cancer screening: A systematic review and meta-analysis
影响因子:4.70000
分区:医学2区 / 肿瘤学2区
发表日期:2025 Mar 01
作者:
Wasim Hamad, Michael J Michell, Jonathan P Myles, Fiona J Gilbert, Yan Chen, Huajie Jin, John Loveland, Mark Halling-Brown, Keshthra Satchithananda, Juliet Morel, Rema Wasan, Caroline Taylor, Nisha Sharma, Alexandra Valencia, Will Teh, Faisal Majid, Ronald M De Visser, Asif Iqbal, Stephen W Duffy
摘要
具有全场数字乳房X线摄影（FFDM）的数字乳房合成（DBT）使女性暴露于更高的辐射剂量。合成2D乳房X线照片（S2D）是由DBT构成的二维图像。与单独使用或与DBT相比，我们旨在评估单独使用或与DBT合并时的S2D性能。如果他们招募筛查参与者并报告了S2D表现，则包括研究。如果他们纳入了有症状的患者，则排除研究，而成像是出于诊断目的，或者参与者患有乳腺癌病史。在可用的地方进行了用于癌症检测率（CDR）的荟萃分析和特异性。在单个研究中计算了成像方式的性能差异，并通过荟萃分析汇总。在确定的3241个记录中，审查中包括17项研究，荟萃分析中有13项。在报告DBT Plus S2D与FFDM的单个研究中，CDR的估计综合差异以及DBT Plus S2D与DBT Plus FFDM的报告为2.03（95％CI 0.81-3.25）（分别为95％CI 0.81-3.25）和-0.15（95％CI -1.1.17至0.86）。在比较DBT Plus S2D和FFDM的研究中，特异性百分比的估计差异为1.13（95％CI -0.06至2.31）。在比较DBT加S2D和DBT加FFDM的研究中，特异性的估计差异为1.08（95％CI 0.59-1.56）。 DBT Plus S2D与FFDM加上DPT相当的准确性，并且仅与FFDM相比改善了癌症检测。在乳腺癌筛查中将S2D与DBT整合在一起是安全的，并且可以保留性能。
Abstract
Digital breast tomosynthesis (DBT) with full-field digital mammography (FFDM) exposes women to a higher radiation dose. A synthetic 2D mammogram (S2D) is a two-dimensional image constructed from DBT. We aim to evaluate the S2D performance when used alone or combined with DBT compared to FFDM alone or with DBT. Studies were included if they recruited screening participants and reported on S2D performance. Studies were excluded if they included symptomatic patients, imaging was for diagnostic purposes, or if participants had a breast cancer history. Meta-analyses for cancer detection rates (CDR) and Specificities were conducted where available. Differences in the performance of imaging modalities were calculated within individual studies, and these were pooled by meta-analysis. Out of 3241 records identified, 17 studies were included in the review and 13 in the meta-analysis. The estimated combined difference in CDRs per thousand among individual studies that reported on DBT plus S2D vs. FFDM and those reporting on DBT plus S2D versus DBT plus FFDM was 2.03 (95% CI 0.81-3.25) and - 0.15 (95% CI -1.17 to 0.86), respectively. The estimated difference in percent specificities was 1.13 (95% CI -0.06 to 2.31) in studies comparing DBT plus S2D and FFDM. In studies comparing DBT plus S2D and DBT plus FFDM, the estimated difference in specificities was 1.08 (95% CI 0.59-1.56). DBT plus S2D showed comparable accuracy to FFDM plus DPT and improved cancer detection to FFDM alone. Integrating S2D with DBT in breast cancer screening is safe and preserves performance.