Park Hee Jeong, Kim Sun Mi, La Yun Bo, Jang Mijung, Kim Bohyoung, Jang Ja Yoon, Lee Jong Yoon, Lee Soo Hyun
Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gumi-dong.
Division of Biomedical Engineering, Hankuk University of Foreign Studies, Mohyeon-myeon, Cheoin-gu, Yongin-si.
Medicine (Baltimore). 2019 Jan;98(3):e14146. doi: 10.1097/MD.0000000000014146.
To evaluate the value of the computer-aided diagnosis (CAD) program applied to diagnostic breast ultrasonography (US) based on operator experience.US images of 100 breast masses from 91 women over 2 months (from May to June 2015) were collected and retrospectively analyzed. Three less experienced and 2 experienced breast imaging radiologists analyzed the US features of the breast masses without and with CAD according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and categories. We then compared the diagnostic performance between the experienced and less experienced radiologists and analyzed the interobserver agreement among the radiologists.Of the 100 breast masses, 41 (41%) were malignant and 59 (59%) were benign. Compared with the experienced radiologists, the less experienced radiologists had significantly improved negative predictive value (86.7%-94.7% vs 53.3%-76.2%, respectively) and area under receiver operating characteristics curve (0.823-0.839 vs 0.623-0.759, respectively) with CAD assistance (all P < .05). In contrast, experienced radiologists had significantly improved specificity (52.5% and 54.2% vs 66.1% and 66.1%) and positive predictive value (55.6% and 58.5% vs 64.9% and 64.9%, respectively) with CAD assistance (all P < .05). Interobserver variability of US features and final assessment by categories were significantly improved and moderate agreement was seen in the final assessment after CAD combination regardless of the radiologist's experience.CAD is a useful additional diagnostic tool for breast US in all radiologists, with benefits differing depending on the radiologist's level of experience. In this study, CAD improved the interobserver agreement and showed acceptable agreement in the characterization of breast masses.
评估基于操作者经验的计算机辅助诊断(CAD)程序应用于乳腺超声(US)诊断的价值。收集了91名女性在2个月内(2015年5月至6月)的100个乳腺肿块的US图像并进行回顾性分析。3名经验较少和2名经验丰富的乳腺影像放射科医生根据乳腺影像报告和数据系统(BI-RADS)词典及分类,在有无CAD辅助的情况下分析乳腺肿块的US特征。然后我们比较了经验丰富和经验较少的放射科医生之间的诊断性能,并分析了放射科医生之间的观察者间一致性。100个乳腺肿块中,41个(41%)为恶性,59个(59%)为良性。与经验丰富的放射科医生相比,经验较少的放射科医生在CAD辅助下,阴性预测值(分别为86.7% - 94.7% 对53.3% - 76.2%)和受试者操作特征曲线下面积(分别为0.823 - 0.839对0.623 - 0.759)有显著提高(均P < 0.05)。相比之下,经验丰富的放射科医生在CAD辅助下,特异性(分别为52.5%和54.2%对66.1%和66.1%)和阳性预测值(分别为55.6%和58.5%对64.9%和64.9%)有显著提高(均P < 0.05)。无论放射科医生的经验如何,CAD联合后US特征的观察者间变异性和最终分类评估均有显著改善,最终评估显示出中等程度的一致性。CAD对所有放射科医生而言都是乳腺US诊断中一种有用的辅助诊断工具,其益处因放射科医生的经验水平而异。在本研究中,CAD提高了观察者间一致性,并在乳腺肿块特征描述方面显示出可接受的一致性。