Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting
Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting
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DOI：
10.2214/ajr.176.5.1761241
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发表时间：
2001-05-01
影响因子：
5
通讯作者：
Cutter, G
中科院分区：
文献类型：
--
作者：
Venta, LA;Hendrick, RE;Cutter, G
客观的。进行本研究的目的是确定诊断环境中全视野数字乳房 X 光检查和胶片屏幕乳房 X 光检查之间解释不一致的比率和原因。 主题和方法。接受诊断性乳房X光检查的患者被邀请参加数字乳房X光检查研究。在胶片屏幕乳房X线照相和数字乳房X线照相中获得由解释胶片屏幕乳房X线照相的放射科医生选择的三个视图。放射科医生独立地将乳房成像报告和数据系统（BI-RADS）类别分配给胶片屏幕乳房X线照相和数字乳房X线照相图像。 BI-RADS 类别分为同意、部分同意或不同意的一般类别。第三位不同的放射科医生审查了所有分歧的案例，做出了管理决定，并确定了主要的：分歧的原因。结果。六位放射科医生审查了 692 名患者总共 1147 个乳房的数字乳房 X 光检查和胶片屏幕乳房 X 光检查诊断图像。数字乳房 X 光检查和最终胶片屏幕乳房 X 光检查评估之间的一致性在 937 个乳房 (82%) 中存在，在 159 个乳房 (14%) 中部分一致，在 51 个乳房 (4%) 中不一致，kappa 值为 0.29。分歧的主要原因是放射科医生的管理方法差异（52%）、超声检查或额外的胶片乳房X光检查产生的炎症（34%）以及两种乳房X光检查技术之间的技术差异（10%）。结论。仅 4% 的乳房存在影响后续管理的胶片乳房 X 光检查和数字乳房 X 光检查之间的显着差异。解释不一致的最常见原因是放射科医生之间管理方法的差异（观察者间的变异性）。这种变异性的来源比由于病变可见性差异造成的变异性更大；介于胶片屏幕乳房X线摄影和数字乳房X线摄影之间。
OBJECTIVE. This study was performed to determine the rates and causes of disageements in interpretation between full-field digital mammography and film-screen mammography in a diagnostic setting.SUBJECTS AND METHODS. Patients undergoing diagnostic mammography were invited to participate in the digital mammography study. Three views, selected by the radiologist interpreting the film-screen-mammography, were obtained in both film-screen mammography and digital mammography Radiologists independently assigned a Breast Imaging Reporting and Data System (BI-RADS) category to the film-screen mammography and the digital mammography images. The BI-RADS categories were grouped into the general categories of agreement, partial agreement or disagreement. A third and different radiologist reviewed all cases of disagreement, reached a decision as to management, and determined the primary: cause of disagreement.RESULTS. Six radiologists reviewed digital mammography and film-screen mammography diagnostic images in a total of 1147 breasts in 692 patients. Agreement between digital mammography and final film-screen mammography assessment was present in 937 breasts (82%), partial agreement in 159 (14%), and disagreement in 51 (4%), for a kappa value of 0.29. The primary causes of disagreement were differences in management approach of the radiologists (52%), inflammation derived from sonogaphy or additional film-screen mammograms (34%), and technical differences between the two mammographic techniques (10%).CONCLUSION. Significant disagreement between film-screen mammography and digital mammography affecting follow-up management was present in only 4% of breasts. The most frequent cause of disagreement in interpretation was a difference in management approach between radiologists (interobserver variability). This source of variability was larger than that due to differences in lesion visibility; between film-screen mammography and digital mammography.