Department of Radiology, University of Pittsburgh, Radiology Imaging Research, PA 15213-3180, USA.
AJR Am J Roentgenol. 2011 Mar;196(3):737-41. doi: 10.2214/AJR.10.4760.
The purpose of our study was to assess diagnostic performance when retrospectively interpreting full-field digital mammography (FFDM) and breast tomosynthesis examinations under a free-response receiver operating characteristic (FROC) paradigm.
We performed FROC analysis of a previously reported study in which eight experienced radiologists interpreted 125 examinations, including 35 with verified cancers. The FROC paradigm involves detecting, locating, and rating each suspected abnormality. Radiologists reviewed and rated both FFDM alone and a combined display mode of FFDM and digital breast tomosynthesis (DBT) (combined). Observer performance levels were assessed and compared with respect to the fraction of correctly identified abnormalities, the number of reported location-specific findings (both true and false), and their associated ratings. The analysis accounts for the number and locations of findings and the location-based ratings using a summary performance index (Λ), which is the FROC analog of the area between the receiver operating characteristic curve and the diagonal (chance) line.
Under the FROC paradigm, each reader detected more true abnormalities associated with cancer, or a higher true-positive fraction, under the combined mode. In an analysis focused on both the number of findings and associated location-based ratings, each of the radiologists performed better under the combined mode compared with FFDM alone, with increases in Λ ranging from 5% to 34%. On average, under the combined mode radiologists achieved a 16% improvement in Λ compared with the FFDM alone mode (95% CI, 7-26%; p < 0.01).
We showed that DBT-based breast imaging in combination with FFDM could result in better performance under the FROC paradigm.
本研究旨在评估在自由响应接收器操作特性（FROC）范式下回顾性解读全数字化乳腺摄影（FFDM）和乳腺断层合成检查的诊断性能。
我们对先前报道的一项研究进行了 FROC 分析，该研究中 8 名经验丰富的放射科医生共解读了 125 次检查，其中包括 35 次经证实的癌症。FROC 范式涉及检测、定位和评估每个可疑异常。放射科医生单独回顾和评估了 FFDM 以及 FFDM 和数字乳腺断层合成（DBT）的组合显示模式（组合）。评估并比较了观察者的表现水平，包括正确识别异常的比例、报告的位置特异性发现的数量（包括真实和虚假）及其相关评分。该分析考虑了发现的数量和位置以及基于位置的评分，使用了一个综合表现指数（Λ），它是 FROC 与接收者操作特征曲线和对角线（机会）线之间的面积的模拟。
在 FROC 范式下，每位读者在组合模式下检测到更多与癌症相关的真实异常，或更高的真阳性率。在一项重点关注发现数量和相关位置评分的分析中，与单独使用 FFDM 相比，每位放射科医生在组合模式下的表现都更好，Λ的增加幅度在 5%至 34%之间。平均而言，在组合模式下，放射科医生的 Λ 比单独使用 FFDM 模式提高了 16%（95%CI，7%-26%；p<0.01）。
我们表明，基于 DBT 的乳腺成像与 FFDM 相结合，在 FROC 范式下可能会产生更好的性能。
