Nishikawa Robert M, Acharyya Suddhasatta, Gatsonis Constantine, Pisano Etta D, Cole Elodia B, Marques Helga S, D'Orsi Carl J, Farria Dione M, Kanal Kalpana M, Mahoney Mary C, Rebner Murray, Staiger Melinda J
Carl J. Vyborny Translation Laboratory for Breast Imaging Research, Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637, USA.
Radiology. 2009 Apr;251(1):41-9. doi: 10.1148/radiol.2511071462.
To compare radiologists' performance in detecting breast cancer when reading full-field digital mammographic (FFDM) images either displayed on monitors or printed on film.
This study received investigational review board approval and was HIPAA compliant, with waiver of informed consent. A reader study was conducted in which 26 radiologists read screening FFDM images displayed on high-resolution monitors (soft-copy digital) and printed on film (hard-copy digital). Three hundred thirty-three cases were selected from the Digital Mammography Image Screening Trial screening study (n = 49,528). Of these, 117 were from patients who received a diagnosis of breast cancer within 15 months of undergoing screening mammography. The digital mammograms were displayed on mammographic workstations and printed on film according to the manufacturer's specifications. Readers read both hard-copy and soft-copy images 6 weeks apart. Each radiologist read a subset of the total images. Twenty-two readers were assigned to evaluate images from one of three FFDM systems, and four readers were assigned to evaluate images from two mammographic systems. Each radiologist assigned a malignancy score on the basis of overall impression by using a seven-point scale, where 1 = definitely not malignant and 7 = definitely malignant.
There were no significant differences in the areas under the receiver operating characteristic curves (AUCs) for the primary comparison. The AUCs for soft-copy and hard-copy were 0.75 and 0.76, respectively (95% confidence interval: -0.04, 0.01; P = .36). Secondary analyses showed no significant differences in AUCs on the basis of manufacturer type, lesion type, or breast density.
Soft-copy reading does not provide an advantage in the interpretation of digital mammograms. However, the display formats were not optimized and display software remains an evolving process, particularly for soft-copy reading.
比较放射科医生在阅读显示于显示器上或打印在胶片上的全视野数字乳腺摄影（FFDM）图像时检测乳腺癌的表现。
本研究获得了研究审查委员会的批准，并符合健康保险流通与责任法案（HIPAA）规定，且豁免了知情同意。进行了一项读者研究，其中26名放射科医生阅读显示在高分辨率显示器上（软拷贝数字图像）和打印在胶片上（硬拷贝数字图像）的筛查FFDM图像。从数字乳腺摄影图像筛查试验筛查研究（n = 49,528）中选取了333例病例。其中，117例来自在接受筛查乳腺摄影后15个月内被诊断为乳腺癌的患者。数字乳腺摄影图像按照制造商的规格显示在乳腺摄影工作站上并打印在胶片上。读者相隔6周阅读硬拷贝和软拷贝图像。每位放射科医生阅读总图像的一个子集。22名读者被分配评估来自三个FFDM系统之一的图像，4名读者被分配评估来自两个乳腺摄影系统的图像。每位放射科医生根据总体印象使用七点量表给出恶性肿瘤评分，其中1 = 肯定不是恶性，7 = 肯定是恶性。
主要比较的受试者操作特征曲线（AUC）下的面积没有显著差异。软拷贝和硬拷贝的AUC分别为0.75和0.76（95%置信区间：-0.04，0.01；P = 0.36）。二次分析显示，基于制造商类型、病变类型或乳腺密度，AUC没有显著差异。
软拷贝阅读在数字乳腺摄影图像解读中没有优势。然而，显示格式未得到优化，显示软件仍在不断发展，特别是对于软拷贝阅读。
