Dartmouth Medical School, Lebanon, NH 03756, USA.
Acad Radiol. 2010 Oct;17(10):1217-26. doi: 10.1016/j.acra.2010.05.007.
The aim of this study was to examine radiologists' use and perceptions of computer-aided detection (CAD) and double reading for screening mammography interpretation.
A mailed survey of 257 community radiologists participating in the national Breast Cancer Surveillance Consortium was used to assess perceptions and practices related to CAD and double reading. Latent class analysis was used to classify radiologists' overall perceptions of CAD and double reading on the basis of their agreement or disagreement with specific statements about CAD and double reading.
Most radiologists (64%) reported using CAD for more than half the screening mammograms they interpreted, but only <5% reported double reading that much. More radiologists perceived that double reading improved cancer detection rates compared to CAD (74% vs 55% reported), whereas fewer radiologists thought that double reading decreased recall rates compared to CAD (50% vs 65% reported). Radiologists with the most favorable perceptions of CAD were more likely to think that CAD improved cancer detection rates without taking too much time compared to radiologists with the most unfavorable overall perceptions. In latent class analysis, an overall favorable perception of CAD was significantly associated with the use of CAD (81%), a higher percentage of workload in screening mammography (80%), academic affiliation (71%), and fellowship training (58%). Perceptions of double reading that were most favorable were associated with academic affiliation (98%).
Radiologists' perceptions were more favorable toward double reading by a second clinician than by a computer, although fewer used double reading in their own practice. The majority of radiologists perceived both CAD and double reading at least somewhat favorably, although for largely different reasons.
本研究旨在探讨放射科医师在筛查性乳房 X 线摄影判读中对计算机辅助检测(CAD)和双重读片的使用情况和看法。
采用邮寄问卷的方式对参与全国乳腺癌监测联合会的 257 位社区放射科医师进行调查,评估与 CAD 和双重读片相关的看法和实践情况。采用潜在类别分析,根据放射科医师对 CAD 和双重读片的特定陈述的一致或不一致情况,对其整体看法进行分类。
大多数放射科医师(64%)报告称,他们对超过一半的筛查性乳房 X 线摄影判读使用了 CAD,但只有不到 5%的人报告称使用了那么多的双重读片。与报告称 CAD 可提高癌症检出率相比(分别为 74%和 55%),更多的放射科医师认为双重读片可降低召回率,而与报告称 CAD 可降低召回率相比(分别为 50%和 65%),更少的放射科医师认为双重读片可提高癌症检出率。对 CAD 评价最有利的放射科医师更倾向于认为 CAD 可在不花费太多时间的情况下提高癌症检出率,而对 CAD 评价最不利的放射科医师则不然。在潜在类别分析中,对 CAD 的整体有利看法与 CAD 的使用(81%)、筛查性乳房 X 线摄影工作量较高(80%)、学术隶属关系(71%)和奖学金培训(58%)相关。对双重读片评价最有利的看法与学术隶属关系(98%)相关。
尽管在自己的实践中较少使用双重读片,但放射科医师对由第二位临床医生进行的双重读片的看法比对由计算机进行的 CAD 检测更有利。尽管其理由大不相同,但大多数放射科医师对 CAD 和双重读片的看法或多或少是有利的。