Gur David, Sumkin Jules H, Rockette Howard E, Ganott Marie, Hakim Christiane, Hardesty Lara, Poller William R, Shah Ratan, Wallace Luisa
Department of Radiology, University of Pittsburgh, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
J Natl Cancer Inst. 2004 Feb 4;96(3):185-90. doi: 10.1093/jnci/djh067.
Computer-aided mammography is rapidly gaining clinical acceptance, but few data demonstrate its actual benefit in the clinical environment. We assessed changes in mammography recall and cancer detection rates after the introduction of a computer-aided detection system into a clinical radiology practice in an academic setting.
We used verified practice- and outcome-related databases to compute recall rates and cancer detection rates for 24 Mammography Quality Standards Act-certified academic radiologists in our practice who interpreted 115,571 screening mammograms with (n = 59,139) or without (n = 56,432) the use of a computer-aided detection system. All statistical tests were two-sided.
For the entire group of 24 radiologists, recall rates were similar for mammograms interpreted without and with computer-aided detection (11.39% versus 11.40%; percent difference = 0.09, 95% confidence interval [CI] = -11 to 11; P =.96) as were the breast cancer detection rates for mammograms interpreted without and with computer-aided detection (3.49% versus 3.55% per 1000 screening examinations; percent difference = 1.7, 95% CI = -11 to 19; P =.68). For the seven high-volume radiologists (i.e., those who interpreted more than 8000 screening mammograms each over a 3-year period), the recall rates were similar for mammograms interpreted without and with computer-aided detection (11.62% versus 11.05%; percent difference = -4.9, 95% CI = -21 to 4; P =.16), as were the breast cancer detection rates for mammograms interpreted without and with computer-aided detection (3.61% versus 3.49% per 1000 screening examinations; percent difference = -3.2, 95% CI = -15 to 9; P =.54).
The introduction of computer-aided detection into this practice was not associated with statistically significant changes in recall and breast cancer detection rates, both for the entire group of radiologists and for the subset of radiologists who interpreted high volumes of mammograms.
计算机辅助乳腺钼靶检查正迅速获得临床认可，但很少有数据表明其在临床环境中的实际益处。我们评估了在学术环境中将计算机辅助检测系统引入临床放射科实践后，乳腺钼靶检查召回率和癌症检出率的变化。
我们使用经过验证的与实践和结果相关的数据库，计算了我们科室24名经《乳腺钼靶质量标准法案》认证的学术放射科医生的召回率和癌症检出率，这些医生解读了115,571例筛查乳腺钼靶片，其中使用（n = 59,139）或未使用（n = 56,432）计算机辅助检测系统。所有统计检验均为双侧检验。
对于全部24名放射科医生，未使用和使用计算机辅助检测解读的乳腺钼靶片召回率相似（11.39%对11.40%；百分比差异 = 0.09，95%置信区间[CI] = -11至11；P =.96），未使用和使用计算机辅助检测解读的乳腺钼靶片乳腺癌检出率也相似（每1000例筛查检查中分别为3.49%对3.55%；百分比差异 = 1.7，95%CI = -11至19；P =.68）。对于7名高工作量放射科医生（即那些在3年期间每人解读超过8000例筛查乳腺钼靶片的医生），未使用和使用计算机辅助检测解读的乳腺钼靶片召回率相似（11.62%对11.05%；百分比差异 = -4.9，95%CI = -21至4；P =.16），未使用和使用计算机辅助检测解读的乳腺钼靶片乳腺癌检出率也相似（每1000例筛查检查中分别为3.61%对3.49%；百分比差异 = -3.2，95%CI = -15至9；P =.54）。
将计算机辅助检测引入该实践，对于全部放射科医生群体以及解读大量乳腺钼靶片的放射科医生子集，召回率和乳腺癌检出率均未出现具有统计学意义的变化。
