Martaindale Sarah, Moseley Tanya, Santiago Lumarie, Huang Monica, Sullivan Callie, Bassett Roland L, Whitman Gary
The University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA.
The University of Texas MD Anderson Cancer Center, Department of Breast Surgical Oncology, Houston, TX, USA.
J Breast Imaging. 2023 Jun 19;5(4):416-424. doi: 10.1093/jbi/wbad039. eCollection 2023 Jul-Aug.
To identify causes of technical repeats, determine whether differences exist between mobile and fixed mammography units, and evaluate the rate of improvement on repeat imaging.
IRB approval was obtained for retrospective review of Enhancing Quality Using the Inspection Program (EQUIP) logs of screening mammography technical repeats performed from March 2017 to December 2018 at a hospital breast imaging center and from April 2017 to December 2018 on mobile mammography units. Frequency tables and Fisher's exact tests were used for statistical analysis.
Technical deficiencies were reported in 483 cases and reviewed by two or three auditors. Auditors identified no technical deficiencies in 31 cases, which were excluded. The remaining 452 cases were assigned a technical recall category: motion, positioning/excluded tissue, skin folds, artifacts, undercompression, or contrast (under/overexposure). Motion was the most common technical recall category (253/452, 56.0%). Positioning/excluded tissue was the second most common reason (150/452, 33.2%). Statistically significant differences in technical deficiencies were identified between mammograms performed on mobile versus fixed mammography units for motion (94/143, 65.7% vs 159/309, 51.5%, respectively, = 0.0058), skin folds (16/143, 11.2% vs 15/309, 4.8%, respectively, = 0.02), and positioning/excluded tissue (30/143, 21% vs 120/309, 38.8%, respectively, = 0.00016). Most recalls improved with repeat imaging (auditor 1: 451/483, 93% and auditor 2: 387/483, 80%).
Motion and positioning/excluded tissue are the most common reasons for screening mammography technical recalls. The reasons for technical recall differ between patients imaged on mobile and fixed mammography units, likely because of differences in each location's patient population.
确定技术重复的原因,判断移动和固定乳腺摄影设备之间是否存在差异,并评估重复成像的改善率。
本研究获得机构审查委员会(IRB)批准,对2017年3月至2018年12月在某医院乳腺影像中心进行的筛查乳腺摄影技术重复检查的“利用检查程序提高质量”(EQUIP)日志,以及2017年4月至2018年12月在移动乳腺摄影设备上进行的检查日志进行回顾性分析。使用频率表和Fisher精确检验进行统计分析。
报告了483例技术缺陷病例,并由两至三名审核员进行审查。审核员在31例中未发现技术缺陷,这些病例被排除。其余452例被归入技术召回类别:运动、定位/排除组织、皮肤褶皱、伪影、压迫不足或对比度(曝光不足/过度曝光)。运动是最常见的技术召回类别(253/452,56.0%)。定位/排除组织是第二常见原因(150/452,33.2%)。在移动和固定乳腺摄影设备上进行的乳腺摄影检查中,技术缺陷在运动方面(分别为94/143,65.7%和159/309,51.5%,P = 0.0058)、皮肤褶皱方面(分别为16/143,11.2%和15/309,4.8%,P = 0.02)以及定位/排除组织方面(分别为30/143,21%和120/309,38.8%,P = 0.00016)存在统计学显著差异。大多数召回通过重复成像得到改善(审核员1:451/483,93%;审核员2:387/483,80%)。
运动和定位/排除组织是筛查乳腺摄影技术召回的最常见原因。在移动和固定乳腺摄影设备上成像的患者,技术召回的原因不同,这可能是由于每个地点患者群体的差异所致。