Salkowski Lonie R, Elezaby Mai, Fowler Amy M, Burnside Elizabeth, Woods Ryan W, Strigel Roberta M
University of Wisconsin Madison, Department of Radiology, Madison, Wisconsin, United States.
University of Wisconsin Madison, Department of Medical Physics, Madison, Wisconsin, United States.
J Med Imaging (Bellingham). 2019 Jul;6(3):031403. doi: 10.1117/1.JMI.6.3.031403. Epub 2018 Dec 22.
Enhancing quality using the inspection program (EQUIP) augments the FDA/MQSA program ensuring image quality review and implementation of corrective processes. We compared technical recalls between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). Prospectively recorded technical recalls of consecutive screening mammograms (10/2013 - 12/2017) were compared for imaging modality [FFDM, DBT + FFDM, DBT + synthesized mammography (SynM)], images requested, and indication(s) (motion, positioning, technical/artifact). Chi-squared tests evaluated statistical significance between proportions. Of 48,324 screening mammograms, 277 (0.57%) patients were recalled for 360 indications with 371 repeated views. DBT exams had significantly less recalls compared to FFDM ( ; ). 98 (27.2%) recalls were for motion, 192 (53.3%) positioning, and 70 (19.4%) technique/artifacts. Theses indications for technical recall were compared for FFDM, DBT + FFDM, and DBT + SynM. There were significant differences in the indications for technical recall prior to and after implementing DBT + SynM ( ; ). Technical recalls declined significantly with the inclusion of DBT (SynM/FFDM) compared to FFDM alone. Recalls for motion demonstrated the greatest decrease. Positioning remains a dominant factor for technical recall regardless of modality, supporting the opportunity for continued technologist education in positioning to decrease technical recalls.
使用检查程序提高质量(EQUIP)强化了FDA/MQSA程序,确保图像质量审查和纠正措施的实施。我们比较了数字乳腺断层合成(DBT)和全视野数字乳腺摄影(FFDM)之间的技术召回情况。对连续筛查乳腺X线摄影(2013年10月 - 2017年12月)前瞻性记录的技术召回情况进行比较,分析成像方式[FFDM、DBT + FFDM、DBT + 合成乳腺摄影(SynM)]、所需图像及召回指征(运动、定位、技术/伪影)。采用卡方检验评估比例之间的统计学显著性。在48,324例筛查乳腺X线摄影中,277例(0.57%)患者因360项指征被召回,共进行了371次重复检查。与FFDM相比,DBT检查的召回率显著更低( ; )。98例(27.2%)召回是由于运动,192例(53.3%)是由于定位,70例(19.4%)是由于技术/伪影。对FFDM、DBT + FFDM和DBT + SynM的这些技术召回指征进行了比较。在实施DBT + SynM前后,技术召回指征存在显著差异( ; )。与单独使用FFDM相比,纳入DBT(SynM/FFDM)后技术召回显著下降。因运动导致的召回下降最为明显。无论采用何种成像方式,定位仍然是技术召回的主要因素,这表明有必要持续对技术人员进行定位方面的培训,以减少技术召回。