Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101 (766), 6500, HB, Nijmegen, the Netherlands.
Dutch Expert Centre for Screening (LRCB), Nijmegen, the Netherlands.
Eur Radiol. 2022 Nov;32(11):7463-7469. doi: 10.1007/s00330-022-08820-5. Epub 2022 Apr 28.
The magnitude of the tradeoff between recall rate (RR) and cancer detection rate (CDR) in breast-cancer screening is not clear, and it is expected to depend on target population and screening program characteristics. Multi-reader multi-case research studies, which may be used to estimate this tradeoff, rely on enriched datasets with artificially high prevalence rates, which may bias the results. Furthermore, readers participating in research studies are subject to "laboratory" effects, which can alter their performance relative to actual practice. The Recall and detection Of breast Cancer in Screening (ROCS) trial uses a novel data acquisition system that minimizes these limitations while obtaining an estimate of the RR-CDR curve during actual practice in the Dutch National Breast Cancer Screening Program. ROCS involves collection of at least 40,000 probability-of-malignancy ratings from at least 20 radiologists during interpretation of approximately 2,000 digital mammography screening cases each. With the use of custom-built software on a tablet, and a webcam, this data was obtained in the usual reading environment with minimal workflow disruption and without electronic access to the review workstation software. Comparison of the results to short- and medium-term follow-up allows for estimation of the RR-CDR and receiver operating characteristics curves, respectively. The anticipated result of the study is that performance-based evidence from practice will be available to determine the optimal operating point for breast-cancer screening. In addition, this data will be useful as a benchmark when evaluating the impact of potential new screening technologies, such as digital breast tomosynthesis or artificial intelligence. KEY POINTS: • The ROCS trial aims to estimate the recall rate-cancer detection rate curve during actual screening practice in the Dutch National Breast Cancer Screening Program. • The study design is aimed at avoiding the influence of the "laboratory effect" in usual observer performance studies. • The use of a tablet and a webcam allows for the acquisition of probability of malignancy ratings without access to the review workstation software.
在乳腺癌筛查中，召回率（RR）和癌症检出率（CDR）之间的权衡幅度尚不清楚，预计这取决于目标人群和筛查计划的特点。多读者多病例研究可能用于估计这种权衡，但这些研究依赖于具有人为高患病率的丰富数据集，这可能会使结果产生偏差。此外，参与研究的读者受到“实验室”效应的影响，这可能会改变他们相对于实际实践的表现。召回和检测乳腺癌筛查中的癌症（ROCS）试验使用了一种新的数据采集系统，该系统在荷兰国家乳腺癌筛查计划中实际实践期间最小化了这些限制，同时获得了 RR-CDR 曲线的估计。ROCS 涉及在对大约 2000 例数字乳房筛查病例进行解释期间，从至少 20 名放射科医生中收集至少 40000 次恶性可能性评分。通过在平板电脑上使用定制软件和网络摄像头，在最小化工作流程中断且无需电子访问审查工作站软件的情况下，在常规阅读环境中获得了这些数据。使用短期和中期随访结果比较，可以分别估计 RR-CDR 和接收者操作特性曲线。该研究的预期结果是，将获得基于性能的实践证据，以确定乳腺癌筛查的最佳操作点。此外，当评估数字乳房断层合成术或人工智能等潜在新筛查技术的影响时，该数据将是有用的基准。关键点：
ROCS 试验旨在估计荷兰国家乳腺癌筛查计划中实际筛查实践中的召回率-癌症检出率曲线。
研究设计旨在避免在常规观察者性能研究中“实验室效应”的影响。
使用平板电脑和网络摄像头可以在不访问审查工作站软件的情况下获取恶性可能性评分。
