The Tomosynthesis Broken Halo Sign: Diagnostic Utility for the Classification of Newly Diagnosed Breast Tumors
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Published:2023-10-24
Issue:6
Volume:9
Page:1987-1998
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ISSN:2379-139X
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Container-title:Tomography
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language:en
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Short-container-title:Tomography
Author:
Deeg Johannes1ORCID, Swoboda Michael1, Egle Daniel2, Wieser Verena2, Soleiman Afschin3, Ladenhauf Valentin1, Galijasevic Malik1ORCID, Amort Birgit1, Haushammer Silke1, Daniaux Martin1, Gruber Leonhard1
Affiliation:
1. Department of Radiology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria 2. Department of Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria 3. Institute for Pathology, INNPath, University Hospital Tirol Kliniken, Anichstraße 35, 6020 Innsbruck, Austria
Abstract
Background: Compared to conventional 2D mammography, digital breast tomosynthesis (DBT) offers greater breast lesion detection rates. Ring-like hypodense artifacts surrounding dense lesions are a common byproduct of DBT. This study’s purpose was to assess whether minuscule changes spanning this halo—termed the “broken halo sign”—could improve lesion classification. Methods: This retrospective study was approved by the local ethics review board. After screening 288 consecutive patients, DBT studies of 191 female participants referred for routine mammography with a subsequent histologically verified finding of the breast were assessed. Examined variables included patient age, histological diagnosis, architectural distortion, maximum size, maximum halo depth, conspicuous margins, irregular shape and broken halo sign. Results: While a higher halo strength was indicative of malignancy in general (p = 0.031), the broken halo sign was strongly associated with malignancy (p < 0.0001, odds ratio (OR) 6.33), alongside architectural distortion (p = 0.012, OR 3.49) and a diffuse margin (p = 0.006, OR 5.49). This was especially true for denser breasts (ACR C/D), where the broken halo sign was the only factor predicting malignancy (p = 0.03, 5.22 OR). Conclusion: DBT-associated halo artifacts warrant thorough investigation in newly found breast lesions as they are associated with malignant tumors. The “broken halo sign”—the presence of small lines of variable diameter spanning the peritumoral areas of hypodensity—is a strong indicator of malignancy, especially in dense breasts, where architectural distortion may be obfuscated due to the surrounding tissue.
Subject
Radiology, Nuclear Medicine and imaging
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