Positive Predictive Value of Mammography: Comparison of Interpretations of Screening and Diagnostic Images by the Same Radiologist and by Different Radiologists
Positive Predictive Value of Mammography: Comparison of Interpretations of Screening and Diagnostic Images by the Same Radiologist and by Different Radiologists
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DOI：
10.2214/ajr.09.2955
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发表时间：
2010-09-01
影响因子：
5
通讯作者：
Alexander, Camille
中科院分区：
文献类型：
--
作者：
Halladay, Jacqueline R.;Yankaskas, Bonnie C.;Alexander, Camille
客观的。本研究的目的是评估在筛查乳房 X 光检查中发现异常结果后，由一名放射科医生（而不是多名放射科医生）进行检查时，建议活检后的阳性预测值 (PPV) 是否有所不同。 材料和方法。利用 1996 年至 2005 年乳房 X 线摄影登记中的数据，我们确定了 6,391 项诊断检查，并建议在筛查检查当天进行活检。根据两种情况计算建议进行活检后的 PPV。在第一种情况下，解读诊断图像的放射科医生也解读了筛查图像。在第二种情况下，放射科医生在另一位放射科医生读取筛查图像后读取诊断图像。我们使用条件逻辑回归分析进行放射科医生内部比较，在建议活检后控制已知与 PPV 相关的协变量。结果。在有阳性结果的筛查检查中，2,335 例 (36.5%) 为情景 1，4,056 例 (63.5%) 为情景 2。当我们控制年龄、乳腺密度、乳腺癌家族史、乳房手术史、自上次乳房 X 光检查以来的时间、筛查乳房 X 光检查结果异常后在检查中任何时间点使用超声以及两次检查之间的间隔天数时，我们发现建议进行活检后两种情况之间的 PPV 没有差异。筛查和诊断研究。结论。筛查乳房 X 光检查显示异常结果后由谁来解释后续图像似乎并不是影响放射科医生之间 PPV 广泛变异性的重要因素。
OBJECTIVE. The purpose of this study was to evaluate whether the positive predictive value (PPV) after a recommendation for biopsy differs when one as opposed to more than one radiologist performs the workup after abnormal findings are discovered at screening mammography.MATERIALS AND METHODS. Using data in a mammography registry for the years 1996-2005, we identified 6,391 diagnostic examinations with a recommendation for biopsy that were performed on a day other than the day of the screening examination. The PPV after a recommendation for biopsy was calculated for two scenarios. In the first scenario, the radiologist interpreting the diagnostic images had interpreted the screening images. In the second scenario, the radiologist read diagnostic images after another radiologist had read the screening images. We used conditional logistic regression analysis to perform within-radiologist comparisons, controlling for covariates known to be associated with PPV after a recommendation for biopsy.RESULTS. Of the screening examinations with positive findings, 2,335 (36.5%) were scenario 1, and 4,056 (63.5%) were scenario 2. We found no difference between the two scenarios with respect to PPV after a recommendation for biopsy when we controlled for age, breast density, family history of breast cancer, history of breast procedures, time since last mammogram, use of ultrasound at any point in the workup after abnormal results of screening mammography, and interval in days between the screening and diagnostic studies.CONCLUSION. Who interprets the follow-up images after screening mammograms show abnormal findings does not appear to be an important factor influencing the wide variability in PPV among radiologists.