Lipasti Seppo, Anttila Ahti, Pamilo Martti
Terveystalo Healthcare Helsinki Mammography Screening Center, Helsinki, Finland.
Acta Radiol. 2010 Jun;51(5):491-7. doi: 10.3109/02841851003691961.
Limited information is available concerning differences in the radiological findings of women recalled for diagnostic work-up in digital mammography (DM) versus screen-film mammography (SFM) screening.
To compare the radiological findings, their positive predictive values (PPVs) for cancer and other process indicators of DM screening performed by computed radiography (CR) technology and SFM screening in a population-based program.
The material consisted of women, 50-59 years of age, who were invited for screening: 30 153 women with DM in 2007-2008 and 32 939 women with SFM in 1999-2000. The attendance rate was 77.7% (23 440) in the DM arm and 83.8% (27 593) in the SFM arm. In the DM arm, 1.71% of those screened (401) and in the SFM arm 1.59% (438) were recalled for further work-up. The images resulting in the recall were classified as: 1) tumor-like mass, 2) parenchymal distortion/asymmetry, 3) calcifications, and 4) combination of mass and calcifications. The distributions of the various radiological findings and their PPVs for cancer were compared in both study groups. The recall rates, cancer detection rates, test specificities, and PPVs of the DM and SFM groups were also compared.
Women were recalled for diagnostic work-up most often due to tumor-like mass. It was more common in SFM (1.08% per woman screened) than in DM (0.93%). The second most common finding was parenchymal distortion and asymmetry, more often in DM (0.58%) than in SFM (0.37%). Calcifications were the third most common finding. DM exposed calcifications more often (0.49%) than SFM (0.26%). The PPVs for cancer of the recalls were higher in DM than in SFM in all subgroups of radiological findings. The test specificities were similar (DM 98.9%, SFM 98.8%). Significantly more cancers were detected by DM (cancer detection rate 0.623% per woman screened, n=146) than by SFM (cancer detection rate 0.406% per woman screened, n=112). The PPVs for cancer of all recalls for diagnostic work-up were significantly higher in DM (36%) than in SFM (26%).
In DM women were recalled for diagnostic work-up more often for calcifications, parenchymal distortions, and asymmetries than in SFM. In the case of tumor-like masses, more women were recalled in SFM. DM detected more cancers than SFM, and the PPVs for cancer were higher in DM than in SFM in all subgroups of radiological findings.
关于在数字乳腺摄影（DM）与屏-片乳腺摄影（SFM）筛查中被召回进行诊断性检查的女性的放射学检查结果差异，现有信息有限。
在一项基于人群的项目中，比较计算机X线摄影（CR）技术进行的DM筛查与SFM筛查的放射学检查结果、其对癌症的阳性预测值（PPV）以及其他检查指标。
材料包括50至59岁被邀请进行筛查的女性：2007年至2008年有30153名进行DM筛查的女性，以及1999年至2000年有32939名进行SFM筛查的女性。DM组的出勤率为77.7%（23440人），SFM组为83.8%（27593人）。在DM组中，1.71%（401人）的筛查者被召回进一步检查，在SFM组中这一比例为1.59%（438人）。导致召回的影像被分类为：1）肿瘤样肿块，2）实质变形/不对称，3）钙化，以及4）肿块与钙化的组合。比较了两个研究组中各种放射学检查结果的分布及其对癌症的PPV。还比较了DM组和SFM组的召回率、癌症检出率、检查特异性和PPV。
女性被召回进行诊断性检查最常见的原因是肿瘤样肿块。在SFM中更常见（每筛查一名女性为1.08%），而在DM中为（0.93%）。第二常见的检查结果是实质变形和不对称，在DM中更常见（0.58%），而在SFM中为（0.37%）。钙化是第三常见的检查结果。DM中钙化的检出率更高（0.49%），高于SFM（0.26%）。在所有放射学检查结果亚组中，DM召回病例对癌症的PPV高于SFM。检查特异性相似（DM为98.9%，SFM为98.8%）。DM检测到的癌症显著多于SFM（每筛查一名女性的癌症检出率为0.623%，n = 146），而SFM为（每筛查一名女性的癌症检出率为0.406%，n = 112）。所有诊断性检查召回病例对癌症的PPV在DM中显著高于SFM（36%），而SFM为（26%）。
与SFM相比，DM中女性因钙化、实质变形和不对称被召回进行诊断性检查的情况更常见。在肿瘤样肿块方面，SFM召回的女性更多。DM检测到的癌症比SFM多，并且在所有放射学检查结果亚组中，DM对癌症的PPV高于SFM。
