Diagnostic Value Of Digital Breast Tomosynthesis And First-order Texture Features In Dense Asymmetric Breast Lesions

Objective: To investigate the diagnostic value of digital breast tomosynthesis(DBT)compared with digital mammography(DM)in the diagnosis of asymmetrical dense lesions,and to evaluate the initial diagnostic value of DBT in identifying benign and malignant lesions based on first-order textural features in asymmetrical dense breast.Methods: The diagnostic analysis was performed by two senior breast diagnosticians,and the diagnostic values of DM and DBT were compared using the chi-square test.The area under the curve was calculated and compared with the sensitivity,specificity,positive predictive value and negative predictive value for asymmetric denseness of the breast;to extract and analyse the correlation between the first-order textural features of all lesions and asymmetrically dense benign and malignant lesions;to compare the differences in DBT first-order textural parameters in asymmetrically dense benign and malignant lesions.Results: The diagnostic sensitivity of DBT and DM for asymmetric dense lesions was 100% and 66.7%,the specificity was 78.6% and 68.9%,the diagnostic accuracy was 80.6% and 67.7%,the positive predictive value was 33.3% and 18.2%,and the negative predictive value was 100% and 95%,respectively.The diagnostic efficacy of DBT for asymmetric dense lesions was better than that of DM.The results of DBT assessment of benign and malignant asymmetric dense lesions were in moderate agreement with pathological findings(Kappa: 0.415),while DM was in poor agreement(Kappa: 0.160).Maximum and Range characteristics correlated with asymmetrical dense benign and malignant lesions with statistically significant differences(P<0.05);the AUC values for both predicting asymmetrical dense benign and malignant lesions were 0.893 and 0.905,respectively.Conclusion:(1)DBT can improve the detection and diagnostic accuracy of asymmetric dense lesions in the breast.(2)The consistency,sensitivity,specificity and diagnostic accuracy of DBT in the diagnosis of asymmetric dense lesions and pathological findings are higher than those of DM.(3)The correlation between Maximum and Range features and asymmetric dense benign and malignant lesions can indirectly provide some reference value for the clinical diagnosis and treatment of patients.