Juel Inger-Marie, Skaane Per, Hoff Solveig Roth, Johannessen Gunnar, Hofvind Solveig
Department of Radiology, Forde Central Hospital, Forde, Norway.
Acta Radiol. 2010 Nov;51(9):962-8. doi: 10.3109/02841851.2010.504969.
Studies comparing analog and digital mammography in breast cancer screening have shown conflicting results. Little is known about the use of digital photon-counting detectors.
To retrospectively compare performance indicators in screen-film (SFM) and full-field digital mammography (FFDM) using a photon-counting detector in a population-based screening program.
The Norwegian Social Science Data Services approved the study, which was part of the Norwegian Breast Cancer Screening Program. The program invites women aged 50–69 years to two-view mammography biannually. The study period was January 2005 to June 2006 for SFM and August 2006 to December 2007 for FFDM. Independent double reading was performed using a five-point rating scale for probability of cancer. Recalls due to abnormal mammography were retrospectively reviewed by an expert panel. Performance indicators for the two techniques were compared. Attendance rate was 83.6% (7442/8901) for SFM and 82.0% (6932/8451) for FFDM.
The recall rate due to abnormal mammography, cancer detection rate and positive predictive value did not differ significantly between SFM and FFDM: recall 2.3% (174/7442) versus 2.4% (168/6932), cancer detection 0.39% (29/7442) versus 0.48% (33/6932), positive predictive value 16.7% (29/174) versus 19.6% (33/168), respectively (P>0.05 for all). The recall rate due to technically inadequate mammograms was 0.3% (19/7442) for SFM and 0.01% (1/6932) for FFDM. In the retrospective review, a significantly higher proportion of calcifications and asymmetric density were categorized as normal or definitively benign in FFDM compared with SFM. The average glandular dose was 2.17 mGy for SFM and 1.25 mGy for FFDM.
Performance indicators show that FFDM using photon-counting detector is suitable for breast cancer screening. The lower radiation dose and lower recalls due to technically inadequate mammograms are of importance in mammography screening.
在乳腺癌筛查中比较模拟乳腺摄影和数字乳腺摄影的研究结果相互矛盾。关于数字光子计数探测器的使用知之甚少。
在一项基于人群的筛查项目中，回顾性比较使用光子计数探测器的屏-片乳腺摄影（SFM）和全视野数字乳腺摄影（FFDM）的性能指标。
挪威社会科学数据服务中心批准了该研究，其为挪威乳腺癌筛查项目的一部分。该项目邀请50至69岁的女性每两年进行一次双侧乳腺摄影。SFM的研究期为2005年1月至2006年6月，FFDM的研究期为2006年8月至2007年12月。采用五点癌症概率评分量表进行独立双读。因乳腺摄影异常导致的召回病例由专家小组进行回顾性审查。比较了两种技术的性能指标。SFM的出勤率为83.6%（7442/8901），FFDM的出勤率为82.0%（6932/8451）。
SFM和FFDM因乳腺摄影异常导致的召回率、癌症检出率和阳性预测值无显著差异：召回率分别为2.3%（174/7442）和2.4%（168/6932），癌症检出率分别为0.39%（29/7442）和0.48%（33/6932），阳性预测值分别为16.7%（29/174）和19.6%（33/168）（所有P>0.05）。SFM因乳腺摄影技术欠佳导致的召回率为0.3%（19/7442），FFDM为0.01%（1/6932）。在回顾性审查中，与SFM相比，FFDM中钙化和不对称密度被归类为正常或肯定为良性的比例显著更高。SFM的平均腺体剂量为2.17 mGy，FFDM为1.25 mGy。
性能指标表明，使用光子计数探测器的FFDM适用于乳腺癌筛查。较低的辐射剂量以及因乳腺摄影技术欠佳导致的较低召回率在乳腺摄影筛查中具有重要意义。
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