Localized Detection and Classification of Abnormalities on FFDM and Tomosynthesis Examinations Rated Under an FROC Paradigm
Localized Detection and Classification of Abnormalities on FFDM and Tomosynthesis Examinations Rated Under an FROC Paradigm
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DOI：
10.2214/ajr.10.4760
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发表时间：
2011-03-01
影响因子：
5
通讯作者：
Hakim, Christiane M.
中科院分区：
文献类型：
--
作者：
Gur, David;Bandos, Andriy I.;Hakim, Christiane M.
目标。本研究的目的是评估在自由反应受体操作特征（FROC）范式下回顾性解释全视野数字乳房x线摄影（FFDM）和乳房断层合成检查时的诊断性能。材料和方法。我们对先前报道的一项研究进行了FROC分析，在该研究中，8名经验丰富的放射科医生解释了125次检查，其中35次确诊为癌症。FROC范例包括检测、定位和评估每个可疑的异常。放射科医生对单独FFDM和FFDM与数字乳腺断层合成（DBT）联合显示模式（联合）进行了评估。对观察者的表现水平进行评估，并根据正确识别异常的比例、报告的特定位置发现（包括真和假）的数量及其相关评级进行比较。该分析使用总结性能指数（Lambda）来计算发现的数量和位置以及基于位置的评级，该指数是接收器工作特性曲线和对角线（机会线）之间区域的FROC模拟。在FROC模式下，每个阅读器检测到更多与癌症相关的真实异常，或者在组合模式下更高的真阳性分数。在一项针对发现数量和相关的基于位置的评分的分析中，与单独使用FFDM相比，每个放射科医生在联合模式下的表现都更好，Lambda增加了5%到34%。平均而言，在联合模式下，放射科医生的Lambda比单纯FFDM模式改善了16% （95% CI, 7-26%; p < 0.01）。我们发现基于dbt的乳房成像结合FFDM可以在FROC范式下获得更好的表现。
OBJECTIVE. The purpose of our study was to assess diagnostic performance when retrospectively interpreting full-field digital mammography (FFDM) and breast tomosynthesis examinations under a free-response receiver operating characteristic (FROC) paradigm.MATERIALS AND METHODS. We performed FROC analysis of a previously reported study in which eight experienced radiologists interpreted 125 examinations, including 35 with verified cancers. The FROC paradigm involves detecting, locating, and rating each suspected abnormality. Radiologists reviewed and rated both FFDM alone and a combined display mode of FFDM and digital breast tomosynthesis (DBT) (combined). Observer performance levels were assessed and compared with respect to the fraction of correctly identified abnormalities, the number of reported location-specific findings (both true and false), and their associated ratings. The analysis accounts for the number and locations of findings and the location-based ratings using a summary performance index (Lambda), which is the FROC analog of the area between the receiver operating characteristic curve and the diagonal (chance) line.RESULTS. Under the FROC paradigm, each reader detected more true abnormalities associated with cancer, or a higher true-positive fraction, under the combined mode. In an analysis focused on both the number of findings and associated location-based ratings, each of the radiologists performed better under the combined mode compared with FFDM alone, with increases in Lambda ranging from 5% to 34%. On average, under the combined mode radiologists achieved a 16% improvement in Lambda compared with the FFDM alone mode (95% CI, 7-26%; p < 0.01).CONCLUSION. We showed that DBT-based breast imaging in combination with FFDM could result in better performance under the FROC paradigm.