Boonlikit Sarawan
Department of Diagnostic Radiology and Nuclear Medicine, National Cancer Institute, Bangkok, Thailand E-mail :
Asian Pac J Cancer Prev. 2013;14(12):7731-6. doi: 10.7314/apjcp.2013.14.12.7731.
To compare the agreement of screening breast mammography plus ultrasound and reviewed mammography alone in asymptomatic women.
All breast imaging data were obtained for women who presented for routine medical checkup at National Cancer Institute (NCI), Thailand from January 2010 to June 2013. A radiologist performed masked interpretations of selected mammographic images retrieved from the computer imaging database. Previous mammography, ultrasound reports and clinical data were blinded before film re-interpretation. Kappa values were calculated to assess the agreement between BIRADS assessment category and BIRADS classification of density obtained from the mammography with ultrasound in imaging database and reviewed mammography alone.
Regarding BIRADS assessment category, concordance between the two interpretations were good. Observed agreement was 96.1%. There was moderate agreement in which the Kappa value was 0.58% (95%CI; 0.45, 0.87). The agreement of BI-RADS classification of density was substantial, with a Kappa value of 0.60 (95%CI; 0.54, 0.66). Different results were obtained when a subgroup of patients aged ≥60 years were analyzed. In women in this group, observed agreement was 97.6%. There was also substantial agreement in which the Kappa value was 0.74% (95%CI; 0.49, 0.98).
The present study revealed that concordance between mammography plus ultrasound and reviewed mammography alone in asymptomatic women is good. However, there is just moderate agreement which can be enhanced if age- targeted breast imaging is performed. Substantial agreement can be achieved in women aged ≥60. Adjunctive breast ultrasound is less important in women in this group.
比较无症状女性中乳腺钼靶联合超声筛查与单纯回顾性钼靶检查的一致性。
获取2010年1月至2013年6月在泰国国家癌症研究所（NCI）进行常规体检的女性的所有乳腺影像数据。一名放射科医生对从计算机影像数据库中检索出的选定钼靶影像进行盲法解读。在重新解读影像之前，将之前的钼靶、超声报告及临床数据进行盲法处理。计算Kappa值，以评估影像数据库中钼靶联合超声检查与单纯回顾性钼靶检查所获得的BIRADS评估类别及BIRADS密度分类之间的一致性。
关于BIRADS评估类别，两种解读之间的一致性良好。观察到的一致性为96.1%。存在中度一致性，Kappa值为0.58%（95%CI；0.45，0.87）。BI-RADS密度分类的一致性较高，Kappa值为0.60（95%CI；0.54，0.66）。对年龄≥60岁的患者亚组进行分析时得到了不同的结果。在该组女性中，观察到的一致性为97.6%。也存在较高一致性，Kappa值为0.74%（95%CI；0.49，0.98）。
本研究表明，无症状女性中乳腺钼靶联合超声检查与单纯回顾性钼靶检查之间的一致性良好。然而，仅存在中度一致性，如果进行针对年龄的乳腺影像检查，一致性可以提高。在年龄≥60岁的女性中可实现较高一致性。辅助性乳腺超声在该组女性中不太重要。
