Tomossíntese Mamária: o que o radiologista deve saber

Autores

  • Filipa Vilaverde Centro Hospitalar de Entre o Douro e Vouga
  • Ana Rocha Hospital Povisa, Vigo
  • Marta Reis Sousa Centro Hospitalar de Entre o Douro e Vouga
  • Romeu Mesquita Centro Hospitalar de Entre o Douro e Vouga
  • Alcinda Reis Centro Hospitalar de Entre o Douro e Vouga

DOI:

https://doi.org/10.25748/arp.10439

Resumo

O cancro da mama continua a ser a neoplasia maligna mais comum na mulher. A Mamografia é a técnica de imagem estabelecida para o rastreio populacional, reduzindo a mortalidade por cancro da mama em cerca de 30%. No entanto, esta técnica tem limitações conhecidas, inerentes ao facto do volume tridimensional da mama ser apresentado numa imagem bidimensional.

A Tomossíntese Mamária, é uma técnica de imagem emergente, que tem sido progressivamente instalada nas unidades de mama, uma vez que pode resolver algumas das limitações da Mamografia. Na Tomossíntese, o tecido mamário é estudado através da aquisição de múltiplas projeções de raios-X de baixa dose que são posteriormente reconstruídas para criar imagens tridimensionais, e assim, minimizar o impacto da sobreposição de tecido mamário e melhorar a definição das lesões. Os estudos têm demonstrado que o uso da Tomossíntese Mamária melhora a precisão do rastreio e do diagnóstico do cancro da mama. Para considerar o uso combinado de Mamografia e Tomossíntese Mamária na prática clínica, há que ter em conta outros factores para além da taxa de detecção de cancro, tais como a dose de radiação adicional, a taxa de re-convocatória em exames de rastreio, o tempo de realização e leitura de ambos os estudos, entre outros.

Neste artigo revemos os princípios técnicos de Tomossíntese Mamária, suas potenciais utilidades, limitações, e perspectivas futuras.

Biografias Autor

Filipa Vilaverde, Centro Hospitalar de Entre o Douro e Vouga

Serviço de Imagiologia

Ana Rocha, Hospital Povisa, Vigo

Serviço de Radiologia

Marta Reis Sousa, Centro Hospitalar de Entre o Douro e Vouga

Serviço de Imagiologia

Romeu Mesquita, Centro Hospitalar de Entre o Douro e Vouga

Serviço de Imagiologia

Alcinda Reis, Centro Hospitalar de Entre o Douro e Vouga

Serviço de Imagiologia

Referências

Tabár L, Vitak B, Chen TH, Yen AM, Cohen A, Tot T, et al. Swedish two-county trial: Impact of mammographic screening on breast cancer mortality during 3 decades. Radiology. 2011;260:658-63.

Duffy SW, Tabár L, Olsen AH, Vitak B, Allgood PC, Chen TH, et al. Absolute numbers of lives saved and over diagnosis in breast cancer screening, from a randomized trial and from the Breast Screening Programme in England. J Med Screen. 2010;17:25-30.

Pisano ED, Gatsonis C, Hendrick E, Yaffe M, Baum JK, Acharyya S, et al., Digital Mammographic Imaging Screening Trial (DMIST) Investigators Group. Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med. 2005;353:1773-83.

Holland R, Mravunac M, Hendriks JH, Bekker BV. So-called interval cancers of the breast. Pathologic and radiologic analysis of sixty-four cases. Cancer. 1982;49:2527-33.

Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, et al. Breast density as a predictor of mammographic detection: Comparison of interval and screen-detected cancers. J Natl Cancer Inst. 2000;92:1081-7.

Skaane P, Gullien R, Bjørndal H, Eben EB, Ekseth U, Haakenaasen U, et al. Digital breast tomosynthesis (DBT): Initial experience in a clinical setting. Acta Radiol. 2012;53:524-9.

Michell MJ, Iqbal A, Wasan RK, Evans DR, Peacock C, Lawinski CP, et al. A comparison of the accuracy of film-screen mammography, full-field digital mammography, and digital breast tomosynthesis. Clin Radiol. 2012;67:976-81.

Rafferty EA, Park JM, Philpotts LE, Poplack SP, Sumkkin JH, Halpen EF et al. Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial. Radiology. 2013; 266(1):104–113.

Skaane P, Bandos AI, Gullien R, Eben EB, Ekseth U, Izadi M, et al. Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program. Radiology. 2013;267(1):47–56.

P. Martínez M., Etxano J. Tomosíntesis de mama: una nueva herramienta en el diagnóstico del cáncer de mama. Radiologia. 2015; 57(1):3-8.

Acciavatti RJ, Maidment AD. Observation of super-resolution in digital breast tomosynthesis. Med Phys. 2012;39(12):7518–7539.

Svahn T, Andersson I, Chakraborty D, Svensson S, Fornvik D, Mattsson S, et al. The diagnostic accuracy of dual-view digital mammography, single-view breast tomosynthesis and a dual-view combination of breast tomosynthesis and digital mammography in a free-response observer performance study. Radiat Prot Dosimetry. 2010; 139(1–3):113–117.

Tagliafico A, Astengo D, Cavagnetto F, Rosasco R, Rescinito G, Monetti F, et al. One-to-one comparison between digital spot compression view and digital breast tomosynthesis. Eur Radiol. 2012;22:539-44.

Kilburn-Toppin F, Barter SJ. New horizons in breast imaging. Clin Oncol (R Coll Radiol). 2013;25:93-100.

Feng SS, Sechopoulos I. Clinical digital breast tomosynthesis system: Dosimetric characterization. Radiology. 2012;263:35-42.

United States Food and Drug Adminstration. MQSA facility certification extension requirements for digital breast tomosynthesis (DBT) system. http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityCertificationandInspection/ucm243765.htm. Updated May 30, 2013. Accessed March 1, 2014.

Roth RG, Maidment AD, Weinstein SP, Roth SO, Conant EF. Digital Breast Tomosynthesis: Lessons Learned from Early Clinical Implementation. RadioGraphics. 2014; 34(4):E89-102.

Zuley ML, Guo B, Catullo VJ, Chough DM, Kelly AE, Lu AH, et al. Comparison of twodimensional synthesized mammograms versus original digital mammograms alone and in combination with Tomosynthesis images. Radiology. 2014;271(3):664–671

Peppard HR, Nicholson BE, Rochman CM, Merchant JK, Mayo III RC, Harvey JA. Digital Breast Tomosynthesis in the Diagnostic Setting: Indications and Clinical Applications. RadioGraphics. 2015; 35:975–990.

Gur D, Bandos AI, Rockette HE, Zuley ML, Sumkin JH, Chough DM, et al. Localized detection and classification of abnormalities on FFDM and tomosynthesis examinations rated under an FROC paradigm. AJR Am J Roentgenol. 2011;196:737-41.

Waldherr C, Cerny P, Altermatt HJ, Berclaz G, Ciriolo M, Buser K, et al. Value of one-view breast tomosynthesis versus two-view mammography in diagnostic workup of women with clinical signs and symptoms and in women recalled from screening. AJR Am J Roentgenol. 2013;200:226-31.

Butler RS, Ostrover R, Hooley RJ, Geisel JL, Raghu M, Philpotts LE. Tomosynthesis in breast cancer visualization as a function of mammographic density [abstr]. In: Radiological Society of North America Scientific Assembly and Annual Meeting Program. Oak Brook, Ill: Radiological Society of North America. 2013; 156.

Wallis MG, Moa E, Zanca F, Leifland K, Danielsson M. Twoview and single-view tomosynthesis versus full-field digital mammography: High-resolution X-ray imaging observer study. Radiology. 2012;262:788-96.

Poplack SP, Tosteson TD, Kogel CA, Nagy HM. Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography. AJR Am J Roentgenol. 2007;189(3): 616–623.

Tagliafico A, Astengo D, Cavagnetto F, Rosasco R, Rescinito G, Monetti F, et al. One-to-one comparison between digital spot compression view and digital breast tomosynthesis. Eur Radiol. 2012;22(3):539–544.

Kopans D, Gavenonis S, Halpern E, Moore R. Calcifications in the breast and digital breast tomosynthesis. Breast J. 2011;17:638-44.

Timberg P, Baath M, Andersson I, Mattsson S, Tingberg A, Ruschin M. Visibility of microcalcification clusters and masses in breast tomosynthesis image volumes and digital mammography: A 4 AFC human observer study. Med Phys. 2012;39:2431-7.

Spangler ML, Zuley ML, Sumkin JH, Abrams G, Ganott MA, Hakim C, et al. Detection and classification of calcifications on digital breast tomosynthesis and 2 D digital mammography: A comparison. AJR Am J Roentgenol. 2011;196:320-4.

Hubbard RA, Kerlikowske K, Flowers CI, Yankaskas BC, Zhu W, Miglioretti DL. Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study. Ann Intern Med. 2011;155(8):481–492.

Brewer NT, Salz T, Lillie SE. Systematic review: the long-term effects of false-positive mammograms. Ann Intern Med. 2007;146(7):502–510.

Brodersen J, Siersma VD. Long-term psychosocial consequences of false-positive screening mammography. Ann Fam Med. 2013;11(2):106–115 .

Bernardi D, Ciatto S, Pellegrini M, Anesi V, Burlon S, Cauli E, et al. Application of breast tomosynthesis in screening: Incremental effect on mammography acquisition and reading time. Br J Radiol. 2012;85:1174-1178.

American College of Radiology. ACR practice guideline for the performance of screening and diagnostic mammography. http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Breast-Imaging. Updated 2013. Accessed March 1, 2016.

D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA. Breast Imaging and Reporting Data System: ACR BI-RADS breast imaging atlas. Reston, Va: American College of Radiology, 2013.

Harvey JA, Nicholson BT, Cohen MA. Finding early invasive breast cancers: a practical approach. Radiology. 2008; 248(1):61–76.

Sickles EA, Miglioretti DL, Ballard-Barbash R, et al. Performance benchmarks for diagnostic mammography. Radiology. 2005;235(3):775–790.

Sickles EA, Wolverton DE, Dee KE. Performance parameters for screening and diagnostic mammography: specialist and general radiologists. Radiology. 2002;224(3):861–869.

Barlow WE, Lehman CD, Zheng Y, Ballard-Barbash R, Yankaskas BC, Cutter GR, et al. Performance of diagnostic mammography for women with signs or symptoms of breast cancer. J Natl Cancer Inst. 2002;94(15):1151–1159.

National Cancer Institute. Breast Cancer Surveillance Consortium performance benchmarks.http://breastscreening.cancer.gov/data/benchmarks/diagnostic/2009/tableSensSpec.html. Updated 2009. Accessed March 1, 2016.

Förnvik D, Zackrisson S, Ljungberg O, Svahn T, Timberg P, Tingberg A, et al. Breast tomosynthesis: accuracy of tumor measurement compared with digital mammography and ultrasonography. Acta Radiol. 2010;51(3):240–247.

Nicholson BT, Raymond S, Rochman CM, Peppard HR, Harvey JA. Comparison of tomosynthesis in the diagnostic setting to 2D mammography for the evaluation of focal asymmetry recalled from screening. Presented at the anual meeting of the American Roentgen Ray Society, San Diego, Calif, May 4–9, 2014.

Mun HS, Kim HH, Shin HJ, Cha JH, Ruppel PL, Oh HY, et al. Assessment of extent of breast cancer: comparison between digital breast Tomosynthesis and full-field digital mammography. Clin Radiol. 2013;68(12):1254–1259.

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Publicado

2017-04-28

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