Diagnostic accuracy of digital versus film mammography: Exploratory analysis of selected population subgroups in DMIST
Diagnostic accuracy of digital versus film mammography: Exploratory analysis of selected population subgroups in DMIST
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DOI：
10.1148/radiol.2461070200
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发表时间：
2008-02-01
期刊：
影响因子：
19.7
通讯作者：
Gatsonis, Constantine A.
中科院分区：
文献类型：
--
作者：
Pisano, Etta D.;Hendrick, R. Edward;Gatsonis, Constantine A.
目的：回顾性比较数字与胶片乳腺摄影的准确性，在人口亚组的数字乳腺摄影成像筛查试验（DMIST）定义的年龄组合，绝经状态和乳腺密度，通过使用活检结果或后续信息作为参考标准。材料和方法：DMIST包括妇女谁接受了数字和胶片筛查乳腺摄影。DMIST和该回顾性分析获得了所有参与研究中心的机构审查委员会批准和所有参与女性的知情同意书，符合HIPAA。在每个评估的亚组（年龄：< 50 vs 50-64 vs >65岁，乳腺X线摄影时的致密乳腺与非致密乳腺，以及两个较年轻年龄组（共10个新的亚组）的绝经前或围绝经期与绝经后状态）内比较每种模式的受试者工作特征曲线下面积（AUC），同时控制多重比较（P <0.002表示有显著差异）。所有DMIST癌症进行了评估方面的乳腺X线摄影检测方法（数字与电影与两者都没有）;乳腺X线摄影病变类型（质量，钙化，或其他）数字机器类型，乳腺X线摄影和病理学的大小和诊断，存在以前的mammagrapluc研究在解释的时间，月，因为以前的mammagrapluc研究，并压缩乳房thicken.Results：33个中心招募了49 528名妇女。乳腺癌的状态被确定为42 760名妇女，该组包括在这项研究中。在乳腺X线摄影中，年龄小于50岁的乳腺致密的绝经前或绝经期妇女是唯一一个数字乳腺X线摄影显著优于胶片的亚组（AUC，0.79 vs 0.54; P = 0.0015）。因此，亚组中基于乳腺成像报告和数据系统的灵敏度为数字乳腺X线摄影0：59，胶片乳腺X线摄影0：27。AUC在任何其他亚组中均无显著差异。对于年龄在65岁或以上的乳腺脂肪女性，AUC显示胶片优于数字乳腺X射线摄影的趋势不显著（AUC，0.88 vs 0.70; P =.0025）。对于50岁以下乳腺致密的绝经前和围绝经期妇女，数字乳腺X线摄影的表现明显优于胶片，但对于65岁或65岁以上的乳房脂肪过多的女性，胶片的表现并不明显。(C)RSNA，2008年。
Purpose: To retrospectively compare the accuracy of digital versus film mammography in population subgroups of the Digital Mammographic Imaging Screening Trial (DMIST) defined by combinations of age; menopausal status, and breast density, by using either biopsy results or follow-up information as the reference standard.Materials ans Methods: DMIST included women who underwent both digital and film screening mammography. Institutional review board approval at all participating sites and informed consent from all participating women in compliance with HIPAA was obtained for DMIST and this retrospective analysis. Areas under the receiver operating characteristic curve (AUCs) for each modality were compared within each subgroup evalu- ated (age: < 50 vs 50-64 vs > 65 years, dense vs nondense breasts at mammography, and pre- or perimenopausal vs postmenopausal status for the two younger age cohorts (10 new subgroups in toto]) while controlling for multiple comparisons (P < .002 indicated a significant difference). All DMIST cancers were evaluated with respect to mammographic detection method (digital vs film vs both vs neither); mammographic lesion type (mass, calcifications, or other) digital machine type, mammographic and pathologic size and diagnosis, existence of prior mammograpluc study at time of interpretation, months since prior mammographic study, and compressed breast thickness.Results: Thirty-three centers enrolled 49 528 women. Breast cancer status was determined for 42 760 women, the group included in this study. Pre- or perimenopausal women younger than 50 years who had dense breasts at film mammography comprised the only subgroup for which digital mammography was significantly better than film (AUCs, 0.79 vs 0.54; P = .0015). Breast Imaging Reporting and Data System based sensitivity in thus subgroup was 0:59 for digital and 0:27 for film mammography. AUCs were not significantly different in any of the other subgroups. For women aged 65 years or older with fatty breasts, the AUC showed a nonsignificant tendency toward film being better than digital mammography (AUCs, 0.88 vs 0.70; P =.0025).Conclusion: Digital mammography performed significantly better than film for pre- and perimenopausal women younger than 50 years with dense breasts, but film tended nonsignificantly to perform better for women aged 65 years or older with fatty breasts. (C) RSNA, 2008.