Influence of computer-aided detection on performance of screening mammography
Influence of computer-aided detection on performance of screening mammography
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DOI：
10.1056/nejmoa066099
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发表时间：
2007-04-05
影响因子：
158.5
通讯作者：
Elmore, Joann G.
中科院分区：
文献类型：
--
作者：
Fenton, Joshua J.;Taplin, Stephen H.;Elmore, Joann G.
背景计算机辅助检测可识别乳房X光检查中的可疑发现，以协助放射科医生。自 1998 年美国食品和药物管理局批准该技术以来，它已被推广到实践中，但其对解释准确性的影响尚不清楚。 方法我们确定了从 1998 年到 2002 年在三个州的 43 个设施中使用计算机辅助检测与乳房 X 线摄影筛查性能之间的关联。我们拥有 222,135 名女性的完整数据（总共 429,345 次乳房 X 光检查），其中包括 2351 名在筛查后 1 年内被诊断为乳腺癌的女性。我们计算了使用和不使用计算机辅助检测的乳房 X 线摄影筛查的特异性、敏感性和阳性预测值，以及活检和乳腺癌检测率以及总体准确性（以接受者操作特征 (ROC) 曲线下面积来衡量）。 结果 7 个机构 (16%) 在研究期间实施了计算机辅助检测。诊断特异性从实施前的 90.2% 下降至实施后的 87.2%（P
BACKGROUNDComputer-aided detection identifies suspicious findings on mammograms to assist radiologists. Since the Food and Drug Administration approved the technology in 1998, it has been disseminated into practice, but its effect on the accuracy of interpretation is unclear.METHODSWe determined the association between the use of computer-aided detection at mammography facilities and the performance of screening mammography from 1998 through 2002 at 43 facilities in three states. We had complete data for 222,135 women (a total of 429,345 mammograms), including 2351 women who received a diagnosis of breast cancer within 1 year after screening. We calculated the specificity, sensitivity, and positive predictive value of screening mammography with and without computer-aided detection, as well as the rates of biopsy and breast-cancer detection and the overall accuracy, measured as the area under the receiver-operating-characteristic (ROC) curve.RESULTSSeven facilities (16%) implemented computer-aided detection during the study period. Diagnostic specificity decreased from 90.2% before implementation to 87.2% after implementation (P