Changes in breast cancer detection and mammography recall rates after the introduction of a computer-aided detection system
Changes in breast cancer detection and mammography recall rates after the introduction of a computer-aided detection system
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DOI：
10.1093/jnci/djh067
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发表时间：
2004-02-04
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影响因子：
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通讯作者：
Wallace, L
中科院分区：
文献类型：
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作者：
Gur, D;Sumkin, JH;Wallace, L
背景资料：计算机辅助乳腺X射线摄影正在迅速获得临床认可，但很少有数据表明其在临床环境中的实际益处。我们评估了计算机辅助检测系统引入学术环境中的临床放射学实践后，乳房X线摄影回忆率和癌症检出率的变化。研究方法：我们使用经过验证的实践和结果相关数据库来计算召回率和癌症检测率，24名乳腺X线摄影质量标准法案认证的学术放射科医生在我们的实践中解释了115571例筛查乳腺X线摄影（n = 59139）或不使用（n = 56432）计算机辅助检测系统。所有统计检验均为双侧检验。结果如下：对于整个24名放射科医生的小组，回忆率是相似的乳房X光片解释没有和有计算机辅助检测（11.39% vs 11.40%;百分比差异= 0.09，95%置信区间[Cl] = -11至11; P = 0.96）以及不使用和使用计算机辅助检测的乳腺X线照片的乳腺癌检出率（每1000次筛查检查中，3.49% vs 3.55%;差异百分比= 1.7，95% CI = -11至19; P = 0.68）。对于七个高容量放射科医生（即，那些在3年内解释了8000多个筛查乳房X线照片的人），没有和有计算机辅助检测的乳房X线照片的回忆率相似（11.62% vs 11.05%;百分比差异=-4.9，95%CI = -21至4; P = 0.16），以及在没有和有计算机辅助检测的情况下解释的乳房X线照片的乳腺癌检出率（每1000次筛查检查中，3.61% vs 3.49%;百分比差异=-3.2，95%C1 = -15至9; P = 0.54）。结论：在这一实践中引入计算机辅助检测与召回率和乳腺癌检出率的统计学显著变化无关，无论是对于整个放射科医生组还是对于解释大量乳房X线照片的放射科医生子集。
Background: Computer-aided mammography is rapidly gaining clinical acceptance, but few data demonstrate its actual benefit in the clinical environment. We assessed changes in mammography recall and cancer detection rates after the introduction of a computer-aided detection system into a clinical radiology practice in an academic setting. Methods: We used verified practice- and outcome-related databases to compute recall rates and cancer detection rates for 24 Mammography Quality Standards Act-certified academic radiologists in our practice who interpreted 115 571 screening mammograms with (n = 59 139) or without (n = 56 432) the use of a computer-aided detection system. All statistical tests were two-sided. Results: For the entire group of 24 radiologists, recall rates were similar for mammograms interpreted without and with computer-aided detection (11.39% versus 11.40%; percent difference = 0.09, 95% confidence interval [Cl] = -11 to 11; P =.96) as were the breast cancer detection rates for mammograms interpreted without and with computer-aided detection (3.49% versus 3.55% per 1000 screening examinations; percent difference = 1.7, 95% CI = -11 to 19; P =.68). For the seven high-volume radiologists (i.e., those who interpreted more than 8000 screening mammograms each over a 3-year period), the recall rates were similar for mammograms interpreted without and with computer-aided detection (11.62% versus 11.05%; percent difference = -4.9, 95% CI = -21 to 4; P =.16), as were the breast cancer detection rates for mammograms interpreted without and with computer-aided detection (3.61% versus 3.49% per 1000 screening examinations; percent difference = -3.2,95% C1 = -15 to 9; P =.54). Conclusion: The introduction of computer-aided detection into this practice was not associated with statistically significant changes in recall and breast cancer detection rates, both for the entire group of radiologists and for the subset of radiologists who interpreted high volumes of mammograms.