RSNA, Illinois, United States Of America, 29 November - 04 December 2020, pp.1
Purpose: This study aims to compare tomosynthesis with ABUS in terms of cancer detection, recall rate, PPV as well as grade and molecular subtypes of detected cancers in screening of women with ACR B, C and D type breasts
Materials and Methods: In this prospective study 2678 women were recruited between November 2018 and March 2020. All women had 3D MLO tomosynthesis with 2D synthetic views and 2D CC views for mammography screening. ABUS was performed in with 3 projections for each breast. All images were evaluated by two breast radiologists. The findings and BI-RADS evaluations were recorded. PPV values according to BI-RADS, cancer detection rates and detected cancer biology of both methods were compared.
Results: The mean age was 50,5 (40-88). Cancer detection with ABUS and tomosynthesis were 10,5‰ and 10,8‰ respectively with overall cancer detection rate of 11,6‰. Two cancers (6,5%) were detected only with ABUS while 3 (9,7%) were detected with only tomosynthesis. Two ABUS only detected cancers were both luminal B cancers and all tomosynthesis only detected 3 cancers were DCIS presenting with pure calcifications. PPV values for ABUS and tomosynthesis were: PPV1: 8,6% and 5%, PPV2: 31,1% and 48,3% respectively. When 2D mammograms were compared with tomosynthesis and ABUS, tomosynthesis detected 1,9‰ additional cancers while ABUS detected 2,6‰. Tomosynthesis detected more DCIS cases whereas ABUS detected more invasive cancers.
Conclusion: ABUS can detect all invasive cancers by detecting 8% more biologically aggressive cancers compared to tomosynthesis. ABUS have a value in screening as an additional tool for both mammography and tomosynthesis.