Gaspard-Bakhach S, Dilhuydy M H, Bonichon F, Barreau B, Henriques C, Maugey-Laulom B
Service d'Imagerie Médicale et de Sénologie, Institut Bergonié, Centre Régional de Lutte Contre le Cancer, 180, rue Saint-Genès, 33076 Bordeaux Cedex.
J Radiol. 2000 Feb;81(2):133-9.
To compare the diagnosis performances of radiologists on screen film versus digital mammography.
and methods: Two sets of 123 mammograms, screen film mammography and storage phosphor digital mammography, are studied comparatively with ROC analysis.
Phantom study show that conventional method give better scores for usual tension but the detectability of smaller microcalcification is equivalent. To obtain with digital technic the same conventional score you have to increase the radiation dose. Roc Curves, simulated "detection" mode showed that radiologists performed with higher accuracy with conventional system but this difference is weekly statistically significant. ROC Curves, simulated "diagnostic" mode showed the same results wit no statistically significant difference but when the decision to go to the biopsy is the gold standard, ROC Curves were essentially equivalent for both film screen and digital mammography system. The readers consistently considered the digital mammograms to be less suspicious for cancer findings. The agreement study as proposed by the FDA indicate that probability of a positive digital mammograms given a positive screen film is 75% (threshold value 90%) and the probability of a negative digital mammograms given a negative analog film is 85% (threshold value 85%).
Analysis of specific discrepancies indicate that spatial resolution is an essential limiting factor for digital method but high resolution phosphor plate are interesting in imaging treated breast, radioluscent lesion, fatty benign tumor, hamartoma, intramammary lymph node, breast with prosthesis.
比较放射科医生在屏片乳腺摄影和数字乳腺摄影上的诊断性能。
采用ROC分析方法,对两组各123幅乳腺造影片(屏片乳腺摄影和存储磷光体数字乳腺摄影)进行比较研究。
体模研究表明,传统方法在常规张力下得分更高,但对较小微钙化的可检测性相当。要使数字技术获得与传统方法相同的得分,必须增加辐射剂量。ROC曲线,模拟“检测”模式显示,放射科医生使用传统系统时表现出更高的准确性,但这种差异在统计学上仅有微弱意义。ROC曲线,模拟“诊断”模式显示了相同的结果,无统计学显著差异,但当活检决定作为金标准时,屏片和数字乳腺摄影系统的ROC曲线基本等效。读者一直认为数字乳腺造影片对癌症发现的可疑性较低。FDA提出的一致性研究表明,在屏片乳腺摄影阳性的情况下,数字乳腺摄影阳性的概率为75%(阈值为90%),在模拟胶片阴性的情况下,数字乳腺摄影阴性的概率为85%(阈值为85%)。
对特定差异的分析表明,空间分辨率是数字方法的一个重要限制因素,但高分辨率磷光板在成像经治疗的乳腺、放射透光病变、脂肪性良性肿瘤、错构瘤、乳腺内淋巴结、带假体的乳腺方面很有意义。