Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Australia; Department of Radiological Sciences, Faculty of Applied Medical Sciences, King Khalid University, Saudi Arabia.
Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Australia.
Radiography (Lond). 2021 Nov;27(4):1027-1032. doi: 10.1016/j.radi.2021.04.002. Epub 2021 Apr 25.
Breast density is associated with an increase in breast cancer risk and limits early detection of the disease. This study assesses the diagnostic performance of mammogram readers in digital mammography (DM) and digital breast tomosynthesis (DBT).
Eleven breast readers with 1-39 years of experience reading mammograms and 0-4 years of experience reading DBT participated in the study. All readers independently interpreted 60 DM cases (40 normal/20 abnormal) and 35 DBT cases (20 normal/15 abnormal). Sensitivity, specificity, ROC AUC, and diagnostic confidence were calculated and compared between DM and DBT.
DBT significantly improved diagnostic confidence in both dense breasts (p = 0.03) and non-dense breasts (p = 0.003) but not in other diagnostic performance metrics. Specificity was higher in DM for readers with >7 years' experience (p = 0.03) in reading mammography, non-radiologists (p = 0.04), readers who had completed a 3-6 months training fellowship in breast imaging (p = 0.04), and those with ≤2 years' experience in reading DBT (p = 0.02), particularly in non-dense breasts.
Diagnostic confidence was higher in DBT when compared to DM. In contrast, other performance metrics appeared to be similar or better with DM and may be influenced by the lack of experience of the reader cohort in reading DBT.
The benefits of DBT may not be entirely accrued until radiologists attain expertise in DBT interpretation. Specificity of DBT varied according to reader characteristics, and these characteristics may be useful for optimising pairing strategies in independent double reading of DBT as practiced in Australia to reduce false positive diagnostic errors.
乳房密度与乳腺癌风险的增加有关，并限制了疾病的早期发现。本研究评估了数字乳腺摄影（DM）和数字乳腺断层合成（DBT）中乳腺摄影读者的诊断性能。
11 名具有 1-39 年阅读乳腺 X 线摄影经验和 0-4 年阅读 DBT 经验的乳腺阅读者参与了这项研究。所有阅读者都独立解读了 60 例 DM 病例（40 例正常/20 例异常）和 35 例 DBT 病例（20 例正常/15 例异常）。在 DM 和 DBT 之间计算并比较了灵敏度、特异性、ROC AUC 和诊断信心。
DBT 显著提高了致密乳房（p=0.03）和非致密乳房（p=0.003）中诊断信心，但其他诊断性能指标没有提高。在阅读乳腺 X 线摄影方面具有>7 年经验的阅读者（p=0.03）、非放射科医师（p=0.04）、完成 3-6 个月乳房成像培训奖学金的阅读者（p=0.04）和具有≤2 年 DBT 阅读经验的阅读者（p=0.02），DM 中的特异性更高，尤其是在非致密乳房中。
与 DM 相比，DBT 的诊断信心更高。相比之下，其他性能指标在 DM 中似乎相似或更好，并且可能受到阅读者在阅读 DBT 方面缺乏经验的影响。
DBT 的益处可能要到放射科医生获得 DBT 解释专业知识后才能完全获得。DBT 的特异性根据阅读者的特征而有所不同，这些特征可能有助于优化澳大利亚实践的 DBT 独立双读配对策略，以减少假阳性诊断错误。
