Objective: To compare the diagnostic efficiency of lesion in dense breast between cone beam breast computer tomography (CBBCT) and mammography. Methods: From May 2012 to August 2014, 160 patients with 165 breasts who underwent mammography and CBBCT examinations were included in this study. The diagnostic results of CBBCT and mammography were reviewed and compared with pathological results. Results: In the 165 breast, 24 were dense breasts and 141 were dense breasts. The diagnostic results were similar in 109 lesions, but different in 56 lesions. According to the analysis of the 165 breasts using receiver operation characteristics (ROC) curve, the area under the ROC curves (AUC) of CBBCT and mammography were 0.923 (95%CI: 0.878-0.967, P<0.05) and 0.959 (95%CI: 0.926-0.992, P<0.05), respectively. With Breast Imaging-Reporting and Data System (BI-RADS) 4b as the critical value, the sensitivity and specificity were 70.0% and 98.7% using mammography, and 83.3% and 97.3% using CBBCT, respectively. The AUC of CBBCT and mammography of the 141 dense breasts was 0.919(95%CI: 0.868-0.969, P<0.05) and 0.973(95%CI: 0.947-0.999, P<0.05), respectively. With BI-RADS 4b as the critical value, the sensitivity and specificity were 69.0% and 98.6% by mammography, and 83.1% and 98.6% by CBBCT, respectively. Conclusions: CBBCT showed higher sensitivity and specificity in the diagnosis of breast malignant tumors compared to mammography. It is expected to be applied to breast cancer detection in the future, especially in dense breast.
目的： 比较锥光束乳腺CT与乳腺X线摄影对致密类乳腺中病灶的诊断效能。 方法： 收集同时接受乳腺X线摄影和锥光束乳腺CT检查的160例患者(165个乳腺)的影像和病理资料，比较乳腺X线摄影和锥光束乳腺CT的诊断结果，结合病理诊断结果评价两种影像检查方法在全部乳腺及致密类乳腺中的诊断效能。 结果： 165个乳腺中，非致密类乳腺24个，致密类乳腺141个。乳腺X线摄影和锥光束乳腺CT诊断结果一致者109个，不一致者56个。受试者工作特征(ROC)曲线分析显示，对于全部165个乳腺，乳腺X线摄影诊断的曲线下面积(AUC)为0.923(95%CI为0.878～0.967，P<0.05)，锥光束乳腺CT诊断的AUC为0.959(95%CI为0.926～0.992，P<0.05)。以BI－RADS 4b为截断点，乳腺X线摄影诊断乳腺癌的灵敏度和特异度分别为70.0%和98.7%，锥光束乳腺CT的灵敏度和特异度分别为83.3%和97.3%。对于141个致密类乳腺，乳腺X线摄影诊断的AUC为0.919(95%CI为0.868～0.969，P<0.05)，锥光束乳腺CT诊断的AUC为0.973(95%CI为0.947～0.999，P<0.05)。以BI－RADS 4b为截断点，乳腺X线摄影诊断致密类乳腺乳腺癌的灵敏度和特异度分别为69.0%和98.6%，锥光束乳腺CT的灵敏度和特异度分别为83.1%和98.6%。 结论： 锥光束乳腺CT对乳腺恶性肿瘤的诊断表现出了较高的灵敏度和特异度，有望为乳腺恶性肿瘤尤其是致密类乳腺的恶性肿瘤诊断提供更多有效信息。.
Keywords: Breast neoplasms; Cone beam breast CT; Mammography; Receiver operating characteristic curve; Sensitivity; Specificity.