News from AAPM show; comments on CAD study

Brian Casey
Aug 1, 2011

Dear AuntMinnie Member,

This week we're featuring coverage from the American Association of Physicists in Medicine (AAPM) meeting under way in Vancouver, Canada.

In one AAPM study, Texas researchers found that switching from analog to digital mammography increases the repeat rate for mammograms; the extra exams to some extent offset the reduction in radiation dose provided by digital mammography, although overall dose was still lower. Learn more by clicking here.

In another study, Canadian investigators looked at quality control software they developed to improve the consistency and reliability of digital mammography. In a pilot test of the software, the group analyzed the application's ability to manage quality control across multiple breast imaging facilities. Get the rest of the story by clicking here.

Comments on CAD study

Mammography saw the publication of several controversial studies last week, one of which stated that the use of computer-aided detection (CAD) didn't improve the accuracy of screening mammography, and also increased recall rates.

This week we're offering commentary on the study by several breast imaging experts, who point out some of the flaws in the study, such as its reliance on CAD technology that's now 5 to 10 years old.

Still, breast imaging specialists could learn a thing or two from the study, despite its flaws. Find out what by clicking here, or visit our Women's Imaging Digital Community.

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(A) Free-response receiver operating characteristic (FROC) curve for DBT-DINO and DINOv2 (Meta AI) on the detection task. DINOv2 achieved higher sensitivity than DBT-DINO across most false-positive thresholds. (B) Detection rates of DBT-DINO and DINOv2 for lesions that were ultimately found to be benign (n = 70) and lesions that were found to be cancerous (n = 66). Error bars represent 95% CIs estimated via patient-level bootstrapping with 1000 repetitions. Both models showed similar detection rates for cancerous lesions, whereas DINOv2 detected more benign lesions than DBT-DINO. (C) Example bounding box predictions for DBT-DINO and DINOv2 on the detection test set. Each image is a single two-dimensional section from a three-dimensional digital breast tomosynthesis volume; the first column shows a mediolateral oblique view, and the second and third columns show craniocaudal views. Both models struggled to detect very small lesions, such as the 3-mm-diameter lesion shown in the first column. FP = false positive.
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Images in a 70-year-old asymptomatic woman with a prior excisional biopsy in the left breast yielding lobular carcinoma in situ 3 years earlier. Screening contrast-enhanced mammography (CEM) was performed, which was considered a prevalence screen as the woman had no prior breast MRI in the past 3 years and no prior CEM. (A) Low-energy (26–30 kVp) mediolateral oblique (MLO) and (B) craniocaudal (CC) views show surgical clips but no abnormality. (C) Recombined MLO and (D) CC images show an enhancing mass in the medial left breast (arrows). Biopsy revealed invasive lobular carcinoma. Size was 0.2 cm; tumor grade II/III; negative lymph nodes; and estrogen receptor–positive, progesterone receptor–positive, and human epidermal growth factor receptor 2–negative.
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