Kimme-Smith C, Gold R H, Bassett L W, Gormley L, Morioka C
Iris Cantor Center for Breast Imaging, Department of Radiological Sciences, University of California, Los Angeles, School of Medicine 90024-1721.
AJR Am J Roentgenol. 1989 Nov;153(5):963-7. doi: 10.2214/ajr.153.5.963.
Matched contact and microfocal-spot-magnified images of 31 breasts, each containing a cluster of microcalcifications within a biopsy-proved benign (n = 21) or malignant (n = 10) lesion, were evaluated. Each matched set consisted of one image magnified 1.5 or 2.0 times by a microfocal spot; one contact film-screen mammogram; and one television-digitized, enhanced, and optically magnified contact film-screen mammogram. Three experienced mammographers and three senior diagnostic radiology residents with 2 weeks of training in mammography interpreted the calcifications. The average area under the receiver-operating-characteristic curve for the experienced mammographers was 0.60 for contact radiographs, 0.61 for the television-digitized images, and 0.69 for the microfocal-spot-magnified radiographs. The less experienced senior residents scored below a random choice, 0.44, for the television-digitized images; 0.51 for contact radiographs; and 0.69 for the microfocal-spot-magnified radiographs. We conclude that when evaluating microcalcifications, radiologists without extensive experience in mammography should not substitute television-digitized and enhanced contact mammograms for microfocal-spot-magnified mammograms; rigorous clinical evaluation is needed before this system is accepted for clinical use.
对31例乳房的匹配接触式和微焦点放大图像进行了评估，每例乳房在活检证实为良性（n = 21）或恶性（n = 10）病变内均含有一簇微钙化。每组匹配图像包括一张经微焦点放大1.5倍或2.0倍的图像；一张接触式胶片-屏片乳腺造影片；以及一张经电视数字化、增强和光学放大的接触式胶片-屏片乳腺造影片。三名经验丰富的乳腺造影技师和三名经过两周乳腺造影培训的放射诊断科高级住院医师对钙化进行了解读。经验丰富的乳腺造影技师在接触式X线片上的受试者操作特征曲线下的平均面积为0.60，在电视数字化图像上为0.61，在微焦点放大X线片上为0.69。经验较少的高级住院医师在电视数字化图像上的得分低于随机选择的0.44；接触式X线片上为0.51；微焦点放大X线片上为0.69。我们得出结论，在评估微钙化时，没有丰富乳腺造影经验的放射科医生不应将电视数字化和增强的接触式乳腺造影片替代微焦点放大乳腺造影片；在该系统被临床接受之前，需要进行严格的临床评估。
