Brooks K W, Trueblood J H, Kearfott K J
Department of Radiation Oncology, Emory Clinic, Atlanta, GA 30322.
Invest Radiol. 1994 Jan;29(1):42-7. doi: 10.1097/00004424-199401000-00006.
Mammography providers are under increasing pressure to become certified by the American College of Radiology (ACR). Successful accreditation is contingent on passing a phantom image quality test. This study was undertaken to evaluate viewer performance with the phantom image evaluation process and to determine any observer group differences.
A series of standard phantom images were viewed by 30 medical physicists, 30 diagnostic radiologists, and 30 inexperienced observers. From the responses, object detection rates and passing rates according to the ACR criteria were established. These responses were analyzed with standard nonparametric tests to assess the degree of variability, correlation, and agreement among different observer groups.
Median passing scores were similar for the radiologists and untrained readers, but the medical physicists appear to differ from the other two groups. There was not sufficient evidence to indicate that special training among physicists made a significant difference in median passing scores or mass detection rates. However, such training appeared to significantly affect the detection of microcalcification and fibril test patterns among the physicists' subgroups. Agreement among observer groups was high for all groups, but tended to be lower for overall passing rates than for any of the individual test objects. Agreement among physicists was affected by their subspecialty, presumably caused by their levels of specific training for these visual tasks.
The authors conclude that choosing medical physicists to evaluate mammographic phantom films appears to be a good choice among potential observer groups, and that special training for reading these images affects their detection abilities and consistency. However, because passing rates did not appear to be affected by special training and given the current rapid degree of change in this area, more testing of medical physicists is desirable to examine these effects over time, and to study the effect of developing standards for training.
乳腺钼靶检查提供者面临着越来越大的压力，需要获得美国放射学会（ACR）的认证。成功获得认证取决于通过一项体模图像质量测试。本研究旨在评估观察者在体模图像评估过程中的表现，并确定不同观察者群体之间的差异。
30名医学物理学家、30名诊断放射科医生和30名无经验的观察者对一系列标准体模图像进行观察。根据这些反应，确定了根据ACR标准的目标检测率和通过率。使用标准非参数检验对这些反应进行分析，以评估不同观察者群体之间的变异性、相关性和一致性程度。
放射科医生和未经培训的读者的中位数及格分数相似，但医学物理学家似乎与其他两组不同。没有足够的证据表明物理学家之间的特殊培训对中位数及格分数或肿块检测率有显著影响。然而，这种培训似乎对物理学家亚组中的微钙化和纤维测试图案的检测有显著影响。所有组的观察者群体之间的一致性都很高，但总体通过率的一致性往往低于任何单个测试对象。物理学家之间的一致性受到其亚专业的影响，推测是由于他们对这些视觉任务的特定培训水平所致。
作者得出结论，在潜在的观察者群体中选择医学物理学家来评估乳腺钼靶体模胶片似乎是一个不错的选择，并且阅读这些图像的特殊培训影响他们的检测能力和一致性。然而，由于通过率似乎不受特殊培训的影响，并且鉴于该领域目前变化迅速，需要对医学物理学家进行更多测试，以长期研究这些影响，并研究制定培训标准的效果。
