Trieu Phuong Dung Yun, Borecky Natacha, Li Tong, Brennan Patrick C, Barron Melissa L, Lewis Sarah J
Department of Clinical Imaging, Faculty of Medicine and Health, The University of Sydney, Level 7-D18, Susan Wakil Health Building, Camperdown, NSW 2006, Australia.
BreastScreen New South Wales (North Coast), Lismore, NSW P.O. Box 1098, Australia
Cancers (Basel). 2023 Feb 20;15(4):1339. doi: 10.3390/cancers15041339.
This study aims to investigate the diagnostic efficacy of radiologists when reading screening mammograms in the absence of previous images, and with the presence of prior images from the same and different vendors.
612 radiologists' readings across 9 test sets, consisting of 540 screening mammograms (361-normal and 179-cancer) with 245 cases having prior images obtained from same vendor as current images, 129 from a different vendor and 166 cases having no prior images, were retrospectively analysed. True positive (sensitivity), true negative (specificity) and area under ROC curve (AUC) values of radiologists were calculated for three groups of cases (without prior images (NP), with prior images from same vendor (SP), and with prior images from different vendor (DP)). Logistic regression was used to estimate the odds ratio (OR) of true positive, true negative and true cancer localization among case groups with different levels of breast density and lesion characteristics.
Radiologists obtained 12.8% and 10.3% higher sensitivity in NP and DP than SP (0.803-and-0.785 vs. 0.712; < 0.0001). Specificity in NP and DP cases were 4.8% and 2.0% lower than SP cases (0.749 and 0.771 vs. 0.787). The AUC values for NP and DP were significantly higher than SP cases across different levels of breast density (0.814-and-0.820 vs. 0.782; < 0.0001). The odds ratio (OR) of true positive for NP relative to SP was 1.6 ( < 0.0001) and DP relative to SP was 1.5 ( < 0.0001). Radiologists were more like to detect architectural distortion in DP than SP cases (OR = 3.2; < 0.0001), whilst the OR for abnormal calcifications was 2.85 ( < 0.0001).
Cases without previous mammograms or with prior mammograms obtained from different vendors were more likely to benefit radiologists in cancer detection, whilst prior mammograms undertaken from the same vendor were more useful for radiologists in evaluating normal cases.
本研究旨在调查放射科医生在阅读筛查乳腺钼靶片时，在没有先前影像以及有来自同一供应商和不同供应商的先前影像的情况下的诊断效能。
回顾性分析了9个测试集中612名放射科医生的读片情况，这些测试集包括540张筛查乳腺钼靶片（361例正常，179例癌症），其中245例有与当前影像来自同一供应商的先前影像，129例来自不同供应商，166例没有先前影像。计算了三组病例（无先前影像（NP）、有来自同一供应商的先前影像（SP）、有来自不同供应商的先前影像（DP））的放射科医生的真阳性（敏感性）、真阴性（特异性）和ROC曲线下面积（AUC）值。使用逻辑回归估计不同乳腺密度和病变特征水平的病例组中真阳性、真阴性和真正癌症定位的优势比（OR）。
放射科医生在NP组和DP组中的敏感性分别比SP组高12.8%和10.3%（0.803和0.785对0.712；<0.0001）。NP组和DP组的特异性分别比SP组低4.8%和2.0%（0.749和0.771对0.787）。在不同乳腺密度水平上，NP组和DP组的AUC值显著高于SP组（0.814和0.820对0.782；<0.0001）。NP组相对于SP组的真阳性优势比（OR）为1.6（<0.0001），DP组相对于SP组为1.5（<0.0001）。与SP组相比，放射科医生在DP组中更有可能检测到结构扭曲（OR = 3.2；<0.0001），而异常钙化的OR为2.85（<0.0001）。
没有先前乳腺钼靶片或有来自不同供应商的先前乳腺钼靶片的病例在癌症检测方面更有可能使放射科医生受益，而来自同一供应商的先前乳腺钼靶片在放射科医生评估正常病例时更有用。
