Germino Jessica C, Elmore Joann G, Carlos Ruth C, Lee Christoph I
Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA, 98109-1023.
Department of Medicine, University of Washington School of Medicine, 325 Ninth Avenue, Box 359780, Seattle, WA, 98104-2499; Department of Epidemiology, University of Washington School of Public Health, 325 Ninth Avenue, Box 359780, Seattle, WA, 98104-2499.
Clin Imaging. 2016 Mar-Apr;40(2):339-43. doi: 10.1016/j.clinimag.2015.06.003. Epub 2015 Jun 12.
Advanced imaging technologies play a central role in screening asymptomatic patients. However, the balance between imaging-based screening's potential benefits versus risks is sometimes unclear. Radiologists will have to address ongoing concerns, including high false-positive rates, incidental findings outside the organ of interest, overdiagnosis, and potential risks from radiation exposure. In this article, we provide a brief overview of these recurring controversies and suggest the following as areas that radiologists should focus on in order to tip the balance toward more benefits and less harms for patients undergoing imaging-based screening: interpretive variability, abnormal finding thresholds, and personalized, risk-based screening.
先进的成像技术在无症状患者的筛查中起着核心作用。然而，基于成像的筛查潜在益处与风险之间的平衡有时并不明确。放射科医生将不得不应对持续存在的担忧，包括高假阳性率、感兴趣器官以外的偶然发现、过度诊断以及辐射暴露带来的潜在风险。在本文中，我们简要概述了这些反复出现的争议，并提出以下几点作为放射科医生应关注的领域，以便在基于成像的筛查中使患者获得更多益处且减少伤害：解读变异性、异常发现阈值以及个性化的、基于风险的筛查。
