Department of Radiology, Division of Molecular and Gender Imaging, Medical University of Vienna,Waehringer Guertel 18-20, 1090 Vienna, Austria.
Eur J Radiol. 2013 Mar;82(3):412-6. doi: 10.1016/j.ejrad.2012.03.004. Epub 2012 Apr 11.
The purpose of our study was to demonstrate the feasibility of sending uncompressed digital mammograms in a teleradiologic setting without loss of information by comparing image quality, lesion detection, and BI-RADS assessment.
CDMAM phantoms were sent bidirectionally to two hospitals via the network. For the clinical aspect of the study, 200 patients were selected based on the BI-RAD system: 50% BI-RADS I and II; and 50% BI-RADS IV and V. Two hundred digital mammograms (800 views) were sent to two different institutions via a teleradiology network. Three readers evaluated those 200 mammography studies at institution 1 where the images originated, and in the two other institutions (institutions 2 and 3) where the images were sent. The readers assessed image quality, lesion detection, and BI-RADS classification.
Automatic readout showed that CDMAM image quality was identical before and after transmission. The image quality of the 200 studies (total 600 mammograms) was rated as very good or good in 90-97% before and after transmission. Depending on the institution and the reader, only 2.5-9.5% of all studies were rated as poor. The congruence of the readers with respect to the final BI-RADS assessment ranged from 90% and 91% at institution 1 vs. institution 2, and from 86% to 92% at institution 1 vs. institution 3. The agreement was even higher for conformity of content (BI-RADS I or II and BI-RADS IV or V). Reader agreement in the three different institutions with regard to the detection of masses and calcifications, as well as BI-RADS classification, was very good (κ: 0.775-0.884). Results for interreader agreement were similar.
Uncompressed digital mammograms can be transmitted to different institutions with different workstations, without loss of information. The transmission process does not significantly influence image quality, lesion detection, or BI-RADS rating.
我们的研究目的是通过比较图像质量、病灶检出和 BI-RADS 评估来证明在远程放射学环境中发送无损信息的未经压缩数字乳腺 X 线摄影的可行性。
使用网络将 CDMAM 体模双向发送至两家医院。出于研究的临床方面，根据 BI-RADS 系统选择了 200 名患者：50%为 BI-RADS I 和 II 级；50%为 BI-RADS IV 和 V 级。通过远程放射学网络将 200 份数字乳腺 X 线摄影（800 个视图）发送至两个不同的机构。三位读者对源自图像源机构 1 的 200 项乳腺摄影研究以及图像发送至的另外两个机构（机构 2 和 3）中的这些图像进行了评估。读者评估了图像质量、病灶检出和 BI-RADS 分类。
自动读出显示 CDMAM 图像质量在传输前后完全相同。在传输前后，200 项研究（总计 600 张乳腺 X 线片）的图像质量均有 90%-97%被评为非常好或好。根据机构和读者的不同，所有研究中只有 2.5%-9.5%被评为差。在机构 1 中，读者对于最终 BI-RADS 评估的一致性在机构 1 与机构 2 之间为 90%-91%，在机构 1 与机构 3 之间为 86%-92%。对于内容的一致性（BI-RADS I 或 II 级和 BI-RADS IV 或 V 级），读者的一致性更高。在三个不同机构中，关于肿块和钙化的检出以及 BI-RADS 分类，读者的一致性非常好（κ：0.775-0.884）。对于不同读者之间的一致性，结果相似。
未经压缩的数字乳腺 X 线摄影可以传输至具有不同工作站的不同机构，而不会造成信息丢失。传输过程不会显著影响图像质量、病灶检出或 BI-RADS 分级。
