Trieu Phuong Dung Yun, Xiao Qin, Gu Yajia, Lewis Sarah J, Barron Melissa L, Tapia Kriscia, Brennan Patrick C, Li Tong
The University of Sydney, Sydney School of Health Sciences, Faculty of Medicine and Health, BreastScreen Reader Assessment Strategy, Camperdown, New South Wales, Australia.
Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai, China.
J Med Imaging (Bellingham). 2023 Mar;10(2):025502. doi: 10.1117/1.JMI.10.2.025502. Epub 2023 Mar 27.
This study aims to investigate the diagnostic performances of Australian and Shanghai-based Chinese radiologists in reading full-field digital mammogram (FFDM) and digital breast tomosynthesis (DBT) with different levels of breast density.
Eighty-two Australian radiologists interpreted a 60-case FFDM set, and 29 radiologists also reported a 35-case DBT set. Sixty Shanghai radiologists read the same FFDM set, and 32 radiologists read the DBT set. The diagnostic performances of Australian and Shanghai radiologists were assessed using truth data (cancer cases were biopsy proven) and compared overall in specificity, case sensitivity, lesion sensitivity, receiver operating characteristics (ROC) area under the curve, and jack-knife free-response receiver operating characteristics (JAFROC) figure of merit, and they were stratified by case characteristics using the Mann-Whitney U test. The Spearman rank test was used to explore the association between radiologists' performances and their work experience in mammogram interpretation.
There were significantly higher performances of Australian radiologists compared with Shanghai radiologists in low breast density for case sensitivity, lesion sensitivity, ROC, and JAFROC in the FFDM set ( ); in high breast density, Shanghai radiologists' performances in lesion sensitivity and JAFROC were also lower than Australian radiologists ( ). In the DBT test set, Australian radiologists performed better than Shanghai radiologists in cancer detection in both low and high breast density. The work experience of Australian radiologists was positively linked to their diagnostic performances, whereas this association was not statistically significant in Shanghai radiologists.
There were significant variations in reading performances between Australian and Shanghai radiologists in FFDM and DBT across different levels of breast density, lesion types, and lesion sizes. An effective training initiative tailored to suit local readers is essential to enhancing the diagnostic accuracy of Shanghai radiologists.
本研究旨在调查澳大利亚和上海的放射科医生在解读不同乳腺密度水平的全视野数字化乳腺钼靶（FFDM）和数字乳腺断层合成（DBT）图像时的诊断表现。
82名澳大利亚放射科医生解读了一组60例的FFDM病例，29名放射科医生还报告了一组35例的DBT病例。60名上海放射科医生阅读了相同的FFDM病例组，32名放射科医生阅读了DBT病例组。使用真实数据（癌症病例经活检证实）评估澳大利亚和上海放射科医生的诊断表现，并在特异性、病例敏感性、病变敏感性、受试者操作特征（ROC）曲线下面积和留一法自由反应受试者操作特征（JAFROC）品质因数方面进行总体比较，并用曼-惠特尼U检验按病例特征进行分层。使用斯皮尔曼等级检验探索放射科医生的表现与其在乳腺钼靶解读方面的工作经验之间的关联。
在FFDM病例组中，对于低乳腺密度，澳大利亚放射科医生在病例敏感性、病变敏感性、ROC和JAFROC方面的表现显著高于上海放射科医生（ ）；在高乳腺密度下，上海放射科医生在病变敏感性和JAFROC方面的表现也低于澳大利亚放射科医生（ ）。在DBT测试组中，在低乳腺密度和高乳腺密度下，澳大利亚放射科医生在癌症检测方面的表现均优于上海放射科医生。澳大利亚放射科医生的工作经验与他们的诊断表现呈正相关，而在上海放射科医生中这种关联无统计学意义。
澳大利亚和上海的放射科医生在FFDM和DBT的解读表现上，在不同乳腺密度水平、病变类型和病变大小方面存在显著差异。开展适合本地阅片者的有效培训计划对于提高上海放射科医生的诊断准确性至关重要。
