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Sequential Reading Effects in Digital Breast Tomosynthesis

Award Number: R01CA237827
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/14/2020
PERIOD OF PERFORMANCE END DATE: 05/31/2025

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Sequential Reading Effects in Digital Breast Tomosynthesis - Project Summary/Abstract Digital breast tomosynthesis (DBT) has emerged as a viable imaging modality for breast cancer screening. But despite its improvements over standard mammography, the breast imaging community is well aware of its limitations. Roughly 40 million women in the United States have a screening mammogram each year, and the combination of a high-volume exam and less than ideal performance have made screening mammography an active area of research for many years. Prior studies have shown that reading breast screening images in batches improves performance, in terms of lower overall recall rates without significant change in the cancer detection rate. But no mechanism for this improvement has been demonstrated. A recently published clinical trial in the UK with over 1 million screening mammograms read by 360 practicing clinicians finds that screening performance actually improves as a reader progresses through a batch of mammograms. We hypothesize that, rather than vigilance, the operational mechanism affecting performance in batch reading is adaptation, which is consistent with improved performance over the course of a batch. We propose to characterize sequential reading effects in DBT images, to see if there is evidence to support our hypothesis that readers visually adapt to the statistical structure of the images as they read them. A few studies have shown adaptation effects in digital mammograms, but there have been no studies to date evaluating sequential effects in DBT. If adaptation is functioning in batch reading of DBT images, then there are a variety of was to take advantage of it to improve screening performance. We propose a thorough evaluation of sequential effects in DBT images that includes basic visual assessments of adaptation, statistical analysis of retrospective clinical data, and prospective analysis of performance in clinical reader studies. These will be analyzed to determine if image readers are consistent with the adaptation hypothesis, improved performance with depth in a batch, and modeled to see if there are additional factors that influence adaptation. Our project consists of three specific aims that cover these topics. Aim 1 implements a battery of visual assessments that define and characterize visual adaptation to DBT images. Aim 2 proposes mining clinical DBT reading data at the University of Pittsburgh Medical Center to evaluate retrospective performance detecting cancer (true-positive rates) and recalling patients (false-positive rates). This data will be modeled with factors that include adaptive sequential effects. Aim 3 will evaluate screening performance in DBT images in “laboratory” studies using clinical readers and cases that evaluate the effects of different batch length and the ordering of cases within a batch.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$3,705 )
2025	2023	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Cancer Cause and Prevention Research	000	4	9/16/2025	NON-COMPETING CONTINUATION	-$3,705
														Subtotal = -$3,705

Issue Date FY: 2023 ( Subtotal = $450,218 )
2023	2023	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Cancer Cause and Prevention Research	000	4	5/17/2023	NON-COMPETING CONTINUATION	$450,218
														Subtotal = $450,218

Issue Date FY: 2022 ( Subtotal = $449,819 )
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Cancer Cause and Prevention Research	000	3	5/26/2022	NON-COMPETING CONTINUATION	$449,819
														Subtotal = $449,819

Issue Date FY: 2021 ( Subtotal = $340,208 )
2021	2021	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Cancer Cause and Prevention Research	000	2	5/25/2021	NON-COMPETING CONTINUATION	$340,208
														Subtotal = $340,208

Issue Date FY: 2020 ( Subtotal = $365,859 )
2020	2020	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Cancer Cause and Prevention Research	000	1	8/14/2020	NEW	$365,859
														Subtotal = $365,859

Grand Total All Awards = $1,602,399

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Sequential Reading Effects in Digital Breast Tomosynthesis

Award Number: R01CA237827

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/14/2020

PERIOD OF PERFORMANCE END DATE: 05/31/2025

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