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The Tomosynthesis Broken Halo Sign: Diagnostic Utility for the Classification of Newly Diagnosed Breast Tumors

Authors :
Johannes Deeg
Michael Swoboda
Daniel Egle
Verena Wieser
Afschin Soleiman
Valentin Ladenhauf
Malik Galijasevic
Birgit Amort
Silke Haushammer
Martin Daniaux
Leonhard Gruber
Source :
Tomography, Vol 9, Iss 6, Pp 1987-1998 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

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.

Details

Language :
English
ISSN :
2379139X and 23791381
Volume :
9
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Tomography
Publication Type :
Academic Journal
Accession number :
edsdoj.55cae14c638343e6841494e0ba99b027
Document Type :
article
Full Text :
https://doi.org/10.3390/tomography9060155