Design of an in silico imaging trial with growing breast cancer lesions: comparison between DM and DBT detectability

Miguel A. Lago; Aunnasha Sengupta; Aldo Badano

doi:10.1117/12.2653278

7 April 2023 Design of an in silico imaging trial with growing breast cancer lesions: comparison between DM and DBT detectability

Miguel A. Lago, Aunnasha Sengupta, Aldo Badano

Author Affiliations +

Proceedings Volume 12463, Medical Imaging 2023: Physics of Medical Imaging; 124631A (2023) https://doi.org/10.1117/12.2653278
Event: SPIE Medical Imaging, 2023, San Diego, California, United States

Abstract

We describe a longitudinal in silico imaging trial investigating the advantages of digital breast tomosynthesis (DBT) versus digital mammography (DM) for early detection of breast cancer. To mimic cancer progression, we used a previously developed computational model based on biological and physiological phenomena accounting for rate of metabolic nutrients and cellular waste as well as the stiffness of surrounding anatomical structures affecting lesion morphology. We integrated this model with the VICTRE pipeline to create a cohort of in silico patients each with a unique manifestation of cancer recorded at 5 stages of progression. Digital patients with varying breast densities were considered. A customized version of the VICTRE pipeline was used to simulate DM and DBT imaging of patients with an in silico version of the Siemens Mammomat Inspiration system with image interpretation under a location-known-exactly tasks, relying on 2D/3D algorithmic readers previously described. We analyzed the area under the ROC curve (AUC) for both imaging modalities at the 5 stages of cancer growth to evaluate the performance of DBT and DM along the life of the tumor. Our findings suggest that DBT outperforms DM for all lesion sizes, which is consistent with studies reported in literature. We observed the mean AUCs increases from 0.64 to 0.80 (p < 0.001) forDMand from 0.66 to 0.88 (p < 0.001) for DBT as lesion size increased from 0.37 to 1.8 mm. These results suggest a potential benefit of DBT as compared to DM for the detection of small masses at earlier stages of tumor development. The in silico trial we designed allowed for studying the progression of detectability of masses at different growing stages, something that would be costly and ethically questionable with a human clinical trial.

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Citation Download Citation

Miguel A. Lago, Aunnasha Sengupta, and Aldo Badano "Design of an in silico imaging trial with growing breast cancer lesions: comparison between DM and DBT detectability", Proc. SPIE 12463, Medical Imaging 2023: Physics of Medical Imaging, 124631A (7 April 2023); https://doi.org/10.1117/12.2653278

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