Performance parameters for screening and diagnostic mammography: Specialist and general radiologists
Performance parameters for screening and diagnostic mammography: Specialist and general radiologists
复制标题
DOI：
10.1148/radiol.2243011482
复制
发表时间：
2002-09-01
期刊：
影响因子：
19.7
通讯作者：
Dee, KE
中科院分区：
文献类型：
--
作者：
Sickles, EA;Wolverton, DE;Dee, KE
目得：评价放射科医师在乳腺成像专家和普通诊断放射科医师实践中的性能参数，这些医师解释了大量连续的筛查和诊断性乳腺X线检查研究。（即患者年龄;乳腺癌家族史;既往乳房X线照片可供比较;和异常解释、癌症检测和0-1期癌症检测率）来源于对1997年1月至2001年8月期间获得的乳房X线摄影研究的回顾。乳腺成像专家在乳房X线摄影方面接受了更多的初步培训，在乳房X线摄影方面接受了至少6倍的继续教育，他们每年解释的乳房X线摄影研究是普通放射科医生的10倍。通过Student t和χ 2检验评估了专科和普通放射科医师在筛查和诊断检查中的表现差异的显著性。乳腺X线筛查的异常解释率（即回忆率）在专科医生中为4.9%，在全科医生中为7.1%（P <0.001）;诊断性乳腺X线检查的异常解释率（即推荐活检率）分别为15.8%和9.9%（P <0.001）。筛查性乳房X线摄影的癌症检出率为专家每1,000次检查6.0例癌症病例，全科医生每1,000次检查3.4例癌症病例（P = 0.007）;诊断性乳房X线摄影的癌症检出率分别为每1,000次检查59.0例和每1,000次检查36.6例（P <0.001）。在筛查性乳房X线摄影检查中，0-1期癌症检出率为：专科医生每1 000次检查中有5.3例癌症病例，普通科医生每1 000次检查中有3.0例癌症病例（P = 0.012）;诊断性乳腺X线摄影分别为43.9/1000和27.0/1000（P < .001）。结论：与普通放射科医生相比，专业放射科医生检测到更多的癌症和更多的早期癌症，推荐更多的活检，并且召回率较低。(C)RSNA，2002年。
PURPOSE: To evaluate performance parameters for radiologists in a practice of breast imaging specialists and general diagnostic radiologists who interpret a large series of consecutive screening and diagnostic mammographic studies.MATERIALS AND METHODS: Data (ie, patient age; family history of breast cancer; availability of previous mammograms for comparison; and abnormal interpretation, cancer detection, and stage 0-1 cancer detection rates) were derived from review of, mammographic studies obtained from January 1997 through August 2001. The breast imaging specialists have substantially more initial training in mammography and at least six times more continuing education in mammography, and they interpret 10 times more mammographic studies per year than the general radiologists. Differences between specialist and general radiologist performances at both screening and diagnostic examinations were assessed for significance by using Student t and chi(2) tests.RESULTS: The study involved 47,798 screening and 13,286 diagnostic mammographic examinations. Abnormal interpretation rates for scree, ning mammography (ie, recall rate) were 4.9% for specialists and 7.1% for generalists (P < .001); and for diagnostic mammography (ie, recommended biopsy rate), 15.8% and 9.9%, respectively (P < .001). Cancer detection rates at screening mammography were 6.0 cancer cases per 1,000 examinations for specialists and 3.4 per 1,000 for generalists (P = .007); and at diagnostic mammography, 59.0 per 1,000 and 36.6 per 1,000, respectively (P < .001). Stage 0-1 cancer detection rates at screening mammography were 5.3 cancer cases per 1,000 examinations for specialists and 3.0 per 1,000 for generalists (P = .012); and at diagnostic mammography, 43.9 per 1,000 and 27.0 per 1,000, respectively (P < .001).CONCLUSION: Specialist radiologists detect more cancers and more early-stage cancers, recommend more biopsies, and have lower recall rates than general radiologists. (C) RSNA, 2002.