Mackenzie Alistair, Warren Lucy M, Wallis Matthew G, Given-Wilson Rosalind M, Cooke Julie, Dance David R, Chakraborty Dev P, Halling-Brown Mark D, Looney Padraig T, Young Kenneth C
National Coordinating Centre for the Physics in Mammography (NCCPM), Level B, St Luke's Wing, Royal Surrey County Hospital, Guildford GU2 7XX, UK.
Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge & NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
Phys Med. 2016 Apr;32(4):568-74. doi: 10.1016/j.ejmp.2016.03.004. Epub 2016 Apr 6.
To investigate the relationship between image quality measurements and the clinical performance of digital mammographic systems.
Mammograms containing subtle malignant non-calcification lesions and simulated malignant calcification clusters were adapted to appear as if acquired by four types of detector. Observers searched for suspicious lesions and gave these a malignancy score. Analysis was undertaken using jackknife alternative free-response receiver operating characteristics weighted figure of merit (FoM). Images of a CDMAM contrast-detail phantom were adapted to appear as if acquired using the same four detectors as the clinical images. The resultant threshold gold thicknesses were compared to the FoMs using a linear regression model and an F-test was used to find if the gradient of the relationship was significantly non-zero.
The detectors with the best image quality measurement also had the highest FoM values. The gradient of the inverse relationship between FoMs and threshold gold thickness for the 0.25mm diameter disk was significantly different from zero for calcification clusters (p=0.027), but not for non-calcification lesions (p=0.11). Systems performing just above the minimum image quality level set in the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis resulted in reduced cancer detection rates compared to systems performing at the achievable level.
The clinical effectiveness of mammography for the task of detecting calcification clusters was found to be linked to image quality assessment using the CDMAM phantom. The European Guidelines should be reviewed as the current minimum image quality standards may be too low.
研究数字乳腺摄影系统的图像质量测量与临床性能之间的关系。
将包含细微恶性非钙化病变和模拟恶性钙化簇的乳腺X线照片进行调整，使其看起来像是由四种类型的探测器采集的。观察者搜索可疑病变并给出恶性程度评分。使用留一法替代自由响应接收器操作特征加权品质因数（FoM）进行分析。将CDMAM对比细节体模的图像进行调整，使其看起来像是使用与临床图像相同的四种探测器采集的。使用线性回归模型将所得的阈值金厚度与FoM进行比较，并使用F检验来确定这种关系的梯度是否显著不为零。
图像质量测量最佳的探测器也具有最高的FoM值。对于钙化簇，直径0.25mm圆盘的FoM与阈值金厚度之间的反比关系梯度显著不同于零（p = 0.027），但对于非钙化病变则不然（p = 0.11）。与达到可实现水平性能的系统相比，仅略高于《欧洲乳腺癌筛查与诊断质量保证指南》中设定的最低图像质量水平的系统导致癌症检测率降低。
发现乳腺摄影在检测钙化簇任务中的临床有效性与使用CDMAM体模进行的图像质量评估有关。由于当前的最低图像质量标准可能过低，因此应重新审视《欧洲指南》。
