Poot Jeffrey D, Chetlen Alison L
Department of Radiology, H066, Penn State Hershey Medical Center, P.O. Box 850, 500 University Drive, Hershey, PA 17033.
Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Acad Radiol. 2016 Nov;23(11):1454-1462. doi: 10.1016/j.acra.2016.07.006. Epub 2016 Sep 13.
To improve mammographic screening training and breast cancer detection, radiology residents participated in a simulation screening mammography module in which they interpreted an enriched set of screening mammograms with known outcomes. This pilot research study evaluates the effectiveness of the simulation module while tracking the progress, efficiency, and accuracy of radiology resident interpretations and also compares their performance against national benchmarks.
A simulation module was created with 266 digital screening mammograms enriched with high-risk breast lesions (seven cases) and breast malignancies (65 cases). Over a period of 27 months, 39 radiology residents participated in the simulation screening mammography module. Resident sensitivity and specificity were compared to Breast Cancer Surveillance Consortium (BCSC data through 2009) national benchmark and American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) acceptable screening mammography audit ranges.
The sensitivity, the percentage of cancers with an abnormal initial interpretation (BI-RADS 0), among residents was 84.5%, similar to the BCSC benchmark sensitivity of 84.9% (sensitivity for tissue diagnosis of cancer within 1 year following the initial examination) and within the acceptable ACR BI-RADS medical audit range of ≥75%. The specificity, the percentage of noncancers that had a negative image interpretation (BI-RADS 1 or 2), among residents was 83.2% compared to 90.3% reported in the BCSC benchmark data, but lower than the suggested ACR BI-RADS range of 88%-95%.
Using simulation modules for interpretation of screening mammograms is a promising method for training radiology residents to detect breast cancer and to help them achieve competence toward national benchmarks.
为了改进乳腺钼靶筛查培训及乳腺癌检测，放射科住院医师参与了一个模拟乳腺钼靶筛查模块，在该模块中他们解读了一组包含已知结果的丰富的筛查钼靶图像。这项初步研究评估了模拟模块的有效性，同时跟踪放射科住院医师解读的进展、效率和准确性，并将他们的表现与全国基准进行比较。
创建了一个模拟模块，其中包含266张数字筛查钼靶图像，这些图像富含高危乳腺病变（7例）和乳腺恶性肿瘤（65例）。在27个月的时间里，39名放射科住院医师参与了模拟乳腺钼靶筛查模块。将住院医师的敏感性和特异性与乳腺癌监测联盟（截至2009年的BCSC数据）的全国基准以及美国放射学会（ACR）乳腺影像报告和数据系统（BI-RADS）可接受的筛查钼靶审核范围进行比较。
住院医师中初始解读异常（BI-RADS 0）的癌症敏感性为84.5%，与BCSC基准敏感性84.9%（初次检查后1年内癌症组织诊断的敏感性）相似，且在ACR BI-RADS医学审核可接受范围≥75%之内。住院医师中非癌症且图像解读为阴性（BI-RADS 1或2）的特异性为83.2%，而BCSC基准数据报告的为90.3%，但低于ACR BI-RADS建议范围的88%-95%。
使用模拟模块解读筛查钼靶图像是一种很有前景的方法，可用于培训放射科住院医师检测乳腺癌，并帮助他们达到全国基准水平。
