Department of Radiology, Duke University Medical Center, Duke South Hospital, Durham, NC 27710, USA.
AJR Am J Roentgenol. 2012 Apr;198(4):962-70. doi: 10.2214/AJR.11.6648.
The purpose of this article is to determine the potential reduction in screening recall rates by strictly following standardized BI-RADS lexicon for lesions seen on screening mammography.
Of 3084 consecutive mammograms performed at our screening facilities, 345 women with 437 lesions were recalled for additional imaging and constituted our study population. Three radiologists retrospectively classified lesions using the standard BI-RADS lexicon and assigned each to one of four groups: group A, the finding met criteria for recall by the BI-RADS lexicon; group B, the finding did not meet strict BI-RADS criteria for recall but was sufficiently indeterminate to warrant recall by the majority of the study panel; group C, the finding was classifiable by the BI-RADS lexicon but was not recalled because it was benign or stable; and group D, the questioned finding was not considered an abnormality by our study panel. Recall rates and the cancer detection rate were determined. The adjusted recall rate was calculated for lesions considered appropriate for recall (group A), and the reduction in the recall rate was determined.
Nineteen malignancies were detected in our recalled population, for a cancer detection rate of 0.65%. All 19 malignancies were lesions considered appropriate for recall (group A). If only group A lesions had been recalled, the recall rate would have decreased from 11.4% to 6.2%, representing a 46% reduction in recalls without affecting the cancer detection rate.
Using the BI-RADS lexicon as a decision-making aid may help adjust thresholds for recalling indeterminate or suspicious lesions and reduce recall rates from screening mammography.
本文旨在通过严格遵循 BI-RADS 词汇表来确定对筛查性乳房 X 光摄影中所见病变进行筛查召回率的潜在降低。
在我们的筛查机构进行的 3084 次连续乳房 X 光摄影中,有 345 名女性的 437 处病变被召回进行额外的影像学检查,构成了我们的研究人群。三位放射科医生使用标准 BI-RADS 词汇表回顾性地对病变进行分类,并将每一处病变分配到以下四个组之一:A 组,该发现符合 BI-RADS 词汇表的召回标准;B 组,该发现不符合 BI-RADS 词汇表严格的召回标准,但具有足够的不确定性,需要大多数研究小组召回;C 组,该发现可通过 BI-RADS 词汇表进行分类,但由于是良性或稳定的,故未被召回;D 组,研究小组认为有疑问的发现不是异常。确定了召回率和癌症检出率。对被认为适合召回的病变(A 组)计算了调整后的召回率,并确定了召回率的降低。
在我们召回的人群中发现了 19 例恶性肿瘤,癌症检出率为 0.65%。所有 19 例恶性肿瘤均为被认为适合召回的病变(A 组)。如果仅召回 A 组病变,召回率将从 11.4%降至 6.2%,召回次数减少 46%,而不会影响癌症检出率。
使用 BI-RADS 词汇表作为决策辅助工具可能有助于调整召回不确定或可疑病变的阈值,并降低筛查性乳房 X 光摄影的召回率。