Department of Radiology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado.
Department of Radiology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado.
J Am Coll Radiol. 2018 Sep;15(9):1293-1299. doi: 10.1016/j.jacr.2018.05.003. Epub 2018 Jun 29.
This retrospective study evaluates the effect of comparison with prior mammograms on recall negation for screening mammography performed with digital breast tomosynthesis (DBT) in a clinical setting and compares it with that performed without DBT.
This is an Institutional Review Board-approved, HIPAA-compliant retrospective review of the electronic medical record for all nonbaseline screening mammograms performed in clinical practice over 13 months. For each mammogram, we recorded if DBT were used, the BI-RADS assigned at initial interpretation, and whether prior mammograms were available at initial interpretation. If prior mammograms arrived later for comparison, the final BI-RADS assigned after comparison was recorded. A mammogram assigned a BI-RADS 0 at initial interpretation and assigned a BI-RADS 1 or BI-RADS 2 after prior mammograms arrived for comparison was labeled as a recall that was negated by the arrival of prior mammograms. The number of recalls negated for mammograms that used DBT was compared with that for mammograms that did not use DBT.
Arrival of prior mammograms for comparison negated the need for recall for mammograms performed with DBT by 67.67% and negated the need for recall for mammograms performed without DBT by 55.80%. After adjusting for age, density, and time between mammograms, the percentage of recalls negated by comparison with prior mammograms was not significantly different for mammograms performed with DBT than it was for those performed without DBT.
Comparison with prior mammograms remains important for the minimization of recall rates during the use of DBT for screening mammography in the clinical setting.
本回顾性研究评估了在临床环境中使用数字乳腺断层合成术（DBT）进行筛查性乳腺 X 光摄影时，与先前的乳腺 X 光片进行比较对否定召回的影响，并将其与不使用 DBT 进行的比较进行比较。
这是一项经过机构审查委员会批准、符合 HIPAA 规定的回顾性电子病历审查，涵盖了 13 个月内在临床实践中进行的所有非基线筛查性乳腺 X 光摄影。对于每一次乳腺 X 光摄影，我们记录了是否使用了 DBT、初始解释时分配的 BI-RADS 以及初始解释时是否有先前的乳腺 X 光片可用。如果先前的乳腺 X 光片后来用于比较，则记录比较后最终分配的 BI-RADS。初始解释时分配 BI-RADS 0 且在先前的乳腺 X 光片到达进行比较后分配 BI-RADS 1 或 BI-RADS 2 的乳腺 X 光片被标记为通过先前的乳腺 X 光片到达而否定召回。使用 DBT 的乳腺 X 光摄影否定召回的数量与未使用 DBT 的乳腺 X 光摄影否定召回的数量进行了比较。
与先前的乳腺 X 光片进行比较到达后，使用 DBT 进行的乳腺 X 光摄影否定召回的必要性为 67.67%，而未使用 DBT 进行的乳腺 X 光摄影否定召回的必要性为 55.80%。在调整年龄、密度和乳腺 X 光摄影之间的时间后，与先前的乳腺 X 光片进行比较否定召回的百分比在使用 DBT 进行筛查性乳腺 X 光摄影时，与未使用 DBT 的乳腺 X 光摄影相比，没有显著差异。
在临床环境中使用 DBT 进行筛查性乳腺 X 光摄影时，与先前的乳腺 X 光片进行比较对于最大限度地减少召回率仍然很重要。
