在诊断性乳腺钼靶检查人群中，全视野数字化乳腺钼靶与屏-片乳腺钼靶对乳腺癌诊断的阳性预测值。

The positive predictive value for diagnosis of breast cancer full-field digital mammography versus film-screen mammography in the diagnostic mammographic population.

作者信息

Seo Bo Kyoung, Pisano Etta D, Kuzmiak Cherie M, Koomen Marcia, Pavic Dag, McLelland Robert, Lee Yeonhee, Cole Elodia B, Mattingly Dianne, Lee Juneyoung

机构信息

Department of Diagnostic Radiology, Korea University School of Medicine, Ansan, Korea.

出版信息

Acad Radiol. 2006 Oct;13(10):1229-35. doi: 10.1016/j.acra.2006.07.007.

DOI:10.1016/j.acra.2006.07.007

PMID:16979072

Abstract

RATIONALE AND OBJECTIVES

Diagnostic mammography is performed on women with clinical symptoms that suggest breast cancer or women for whom further mammographic evaluation has been requested because of an abnormal screening mammography. We assessed whether the use of full-field digital mammography would improve the positive predictive value (PPV) for the diagnosis of breast cancer in a diagnostic population compared with film-screen mammography.

MATERIALS AND METHODS

From January 2002 to December 2003, 11,621 patients underwent diagnostic mammography at the University of North Carolina Hospital, Chapel Hill. Among these 11,621 patients, 1400 lesions in 1121 patients underwent biopsy. We included the biopsy-performed lesions, so PPV3 was used for comparison of PPVs between film-screen mammography and full-field digital mammography. Six breast radiologists interpreted the images using the Breast Imaging Reporting and Data System of the American College of Radiology. PPV3s were compared between film-screen and full-field digital mammography in the entire study cohort and in specified subgroups according to different radiologists, breast density, and lesion type on mammography. The chi(2) and Fisher's exact tests were used for comparison of PPV3s between two modalities of mammography with the Bonferroni procedure for subgroup analysis.

RESULTS

In the entire study cohort, PPV3s of full-field digital mammography and film-screen mammography were similar (difference in PPV3,-0.007; 95% confidence interval, -0.081 to 0.068; P = .8602). In predefined subgroups, there was no difference in PPV3 by the radiologist, breast density, or lesion type between two modalities of mammography (P > .005).

CONCLUSION

There is no improvement in PPV for the diagnosis of breast cancer with full-field digital mammography compared with film-screen mammography in a large diagnostic population.

摘要

原理与目的

诊断性乳腺钼靶检查适用于有提示乳腺癌临床症状的女性，或因筛查性乳腺钼靶检查异常而需要进一步进行乳腺钼靶评估的女性。我们评估了与屏-片乳腺钼靶相比，在诊断人群中使用全视野数字乳腺钼靶是否会提高乳腺癌诊断的阳性预测值（PPV）。

材料与方法

2002年1月至2003年12月，11621例患者在北卡罗来纳大学教堂山分校医院接受了诊断性乳腺钼靶检查。在这11621例患者中，1121例患者的1400个病灶接受了活检。我们纳入了接受活检的病灶，因此使用PPV3来比较屏-片乳腺钼靶和全视野数字乳腺钼靶之间的PPV。六位乳腺放射科医生使用美国放射学会的乳腺影像报告和数据系统对图像进行解读。在整个研究队列以及根据不同放射科医生、乳腺密度和乳腺钼靶上的病灶类型划分的特定亚组中，比较屏-片乳腺钼靶和全视野数字乳腺钼靶之间的PPV3。采用卡方检验和Fisher精确检验比较两种乳腺钼靶检查方式之间的PPV3，并采用Bonferroni法进行亚组分析。