Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
Biostatistics Collaboration Unit, Medical Research Center, Yonsei University, College of Medicine, Seoul, South Korea.
Eur Radiol. 2019 Aug;29(8):4468-4476. doi: 10.1007/s00330-018-5934-9. Epub 2019 Jan 7.
To evaluate the effect of training radiology residents on breast ultrasonography (US) according to the Breast Imaging Reporting And Data System (BI-RADS) and the factors that influence the training effect.
This multicenter, prospective study was approved by eight institutional review boards. From September 2013 to July 2014, 248 breast masses in 227 women were included for US image acquisition. Representative B-mode and video images of the breast masses were recorded, among which 54 cases were included in the education set and 66 in the test set. Sixty-one radiology residents scheduled for breast imaging training individually reviewed the test set, immediately before, 1 month after, and 6 months after training. Diagnostic performances and US descriptors of the residents were evaluated and compared against those of expert radiologists.
Agreements between residents and experienced radiologists showed improvement after training, while agreements between post-training and post-6-month training descriptors did not show significant differences (all p > 0.05, respectively). Sensitivity, negative predictive value (NPV), and AUC were significantly improved for residents post-training and post-6-month training (all p < 0.05), while approximating the performances of expert radiologists except for AUC (0.836, 0.840, and 0.908, respectively, p < 0.05). Low levels of pre-training AUC, total number of breast US examinations, and the number of sessions per week that residents were involved in were factors influencing the improvement of AUC.
Training using education material dedicated for breast US imaging effectively improved the diagnostic performances of radiology residents and agreements with experienced radiologists on US BI-RADS features.
• Agreements on lesion descriptors between residents and experienced radiologists showed improvement after training, regardless of test point. • Sensitivity, NPV, and AUC were significantly improved for residents in post-training and post-6-month training (all p < 0.05). • Low levels of pre-training AUC, total number of breast US examinations, and the number of sessions per week that residents were involved in were factors influencing the improvement of AUC.
根据乳腺影像报告和数据系统（BI-RADS）评估培训放射科住院医师进行乳腺超声（US）检查的效果，以及影响培训效果的因素。
本多中心前瞻性研究经 8 家机构审查委员会批准。2013 年 9 月至 2014 年 7 月，纳入 227 名女性的 248 个乳腺肿块进行 US 图像采集。记录具有代表性的乳腺肿块 B 型模式和视频图像，其中 54 例纳入教育集，66 例纳入测试集。61 名计划接受乳腺影像学培训的放射科住院医师分别单独检查测试集，在培训前、培训后 1 个月和 6 个月时进行评估。评估住院医师的诊断表现和 US 描述符，并与经验丰富的放射科医师进行比较。
住院医师与经验丰富的放射科医师之间的一致性在培训后有所提高，而培训后和培训后 6 个月时的描述符之间的一致性没有显著差异（均 p>0.05）。培训后和培训后 6 个月时，住院医师的敏感性、阴性预测值（NPV）和 AUC 均显著提高（均 p<0.05），但除 AUC 外，与经验丰富的放射科医师的表现接近（分别为 0.836、0.840 和 0.908，均 p<0.05）。培训前 AUC、乳腺 US 检查总数和住院医师每周参与的次数较低是影响 AUC 提高的因素。
使用专门用于乳腺 US 成像的教育材料进行培训可有效提高放射科住院医师的诊断表现，并提高其与经验丰富的放射科医师对 US BI-RADS 特征的一致性。
培训后，住院医师与经验丰富的放射科医师对病灶描述符的一致性无论在哪个测试点均有所提高。
培训后和培训后 6 个月时，住院医师的敏感性、NPV 和 AUC 均显著提高（均 p<0.05）。
培训前 AUC、乳腺 US 检查总数和住院医师每周参与的次数较低是影响 AUC 提高的因素。
