Medical Image Perception and Optimization Group (MIOPeG), Medical Radiation Science, Faculty of Health Science, The University of Sydney, PO Box 170, Lidcombe, NSW 2141, Australia.
Medical Image Perception and Optimization Group (MIOPeG), Medical Radiation Science, Faculty of Health Science, The University of Sydney, PO Box 170, Lidcombe, NSW 2141, Australia.
Acad Radiol. 2019 Jan;26(1):62-68. doi: 10.1016/j.acra.2018.03.003. Epub 2018 Mar 23.
Image reporting is a vital component of patient management depending on individual radiologists' performance. Our objective was to explore mammographic diagnostic efficacy in a country where breast cancer screening does not exist.
Two mammographic test sets were used: a typical screening (TS) and high-difficulty (HD) test set. Nonscreening (NS) radiologists (n = 11) read both test sets, while 52 and 49 screening radiologists read the TS and HD test sets, respectively. The screening radiologists were classified into two groups: a less experienced (LE) group with ≤5 years' experience and a more experienced (ME) group with ≥5 years' experience. A Kruskal-Wallis and Tukey-Kramer post hoc test were used to compare reading performance among reader groups, and the Wilcoxon matched pairs tests was used to compare TS and ND test sets for the NS radiologists.
Across the three reader groups, there were significant differences in case sensitivity (χ [2] = 9.4, P = .008), specificity (χ [2] = 10.3, P = .006), location sensitivity (χ [2] = 19.8, P < .001), receiver operating characteristics, area under the curve (χ [2] = 19.7, P < .001) and jack-knife free-response receiver operating characteristics (JAFROCs) (χ [2] = 18.1, P < .001). NS performance for all measured scores was significantly lower than those for the ME readers (P < .006), while only location sensitivity was lower (χ [2] = 17.5, P = .026) for the NS compared to the LE group. No other significant differences were observed.
Large variations in mammographic performance exist between radiologists from screening and nonscreening countries.
影像报告是患者管理的重要组成部分，取决于个别放射科医生的表现。我们的目的是探索在一个没有乳腺癌筛查的国家中，乳腺 X 线摄影的诊断效能。
使用了两个乳腺 X 线摄影测试集：一个是典型筛查（TS）测试集，另一个是高难度（HD）测试集。非筛查（NS）放射科医生（n=11）阅读了这两个测试集，而 52 名和 49 名筛查放射科医生分别阅读了 TS 和 HD 测试集。筛查放射科医生被分为两组：经验较少（LE）组，经验少于 5 年，经验较多（ME）组，经验大于 5 年。使用 Kruskal-Wallis 和 Tukey-Kramer 事后检验比较阅读表现，使用 Wilcoxon 配对检验比较 NS 放射科医生的 TS 和 ND 测试集。
在三个读者群体中，病例敏感度（χ²[2]=9.4，P=0.008）、特异性（χ²[2]=10.3，P=0.006）、定位敏感度（χ²[2]=19.8，P<0.001）、接收器工作特征曲线（ROC）、曲线下面积（AUC）（χ²[2]=19.7，P<0.001）和 Jackknife 无应答者接收器工作特征曲线（JAFROCs）（χ²[2]=18.1，P<0.001）均有显著差异。所有测量评分的 NS 表现明显低于 ME 读者（P<0.006），而 NS 与 LE 组相比，只有定位敏感度较低（χ²[2]=17.5，P=0.026）。未观察到其他显著差异。
来自筛查和非筛查国家的放射科医生之间存在乳腺 X 线摄影表现的较大差异。
