Impact of computer-aided detection in a regional screening mammography program
Impact of computer-aided detection in a regional screening mammography program
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DOI：
10.2214/ajr.04.1300
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发表时间：
2005-10-01
影响因子：
5
通讯作者：
Reynolds, JC
中科院分区：
文献类型：
--
作者：
Cupples, TE;Cunningham, JE;Reynolds, JC
客观的。本研究旨在前瞻性评估计算机辅助检测 (CAD) 对区域乳房 X 光检查项目筛查结果的影响。材料和方法。 1998年1月1日至2000年12月31日期间，连续放映了27,274场。放射科医生在 CAD 之前 (n = 7,872) 和 CAD (n = 19,402) 的表现由年度审计确定。审查所有阳性活检结果；组织病理学进行了审查并确认。将 CAD 的结果（回忆、活检和癌症检出率）（1999 年、2000 年）与历史对照数据（1998 年）进行比较。结果。 CAD 的召回率（8.1%，从 7.7% 提高到 8.3%）、活检率（6.7%，从 1.4% 提高到 1.5%）和癌症检出率（16.1%，从每 1,000 人 3.7 例提高到每 1,000 人 4.3 例）都有所提高。 1.0 厘米或更小的浸润性癌症的检出率增加了 164%（从每 1,000 次筛查 0.508 增至 1.34；p = 0.069）。原位癌症的检出率下降了 6.7%（从每 1,000 人 1.27 下降到 1. 19；p = 0.849）。在浸润性癌症的多变量分析中，早期（1 期）与 CAD 检测密切相关（比值比 = 4.13，p = 0.025）。 CAD 组筛查癌症时的平均年龄比 CAD 前期组年轻 5.3 岁 (P = 0.060)。 结论。检出率的提高、诊断时的年轻化以及浸润性癌症检出的显着早期阶段与 CAD 的积极筛查影响一致。审计结果是积极的，但由于样本量的限制，通常不具有统计显着性。我们的研究结果支持这样的假设：CAD 筛查可显着改善 CAD 算法旨在检测的特定癌症形态的检测。
OBJECTIVE. This study was conducted to prospectively assess the effect of computer-aided detection (CAD) on screening outcomes in a regional mammography program.MATERIALS AND METHODS. Between January 1, 1998, and December 31, 2000, 27,274 consecutive screenings were performed. Radiologists' performance before CAD (n = 7,872) and with CAD (n = 19,402) was determined by annual audits. All positive biopsy results were reviewed; histopathology was reviewed and confirmed. Outcomes (recall, biopsy, and cancer detection rates) with CAD (1999, 2000) were compared with historical control data(1998).RESULTS. With CAD, increases were seen in recall rate (8.1%, from 7.7% to 8.3%), biopsy rate (6.7%, from 1.4% to 1.5%), and cancer detection rate (16.1%, from 3.7 per 1,000 to 4.3 per 1,000). Detection rate of invasive cancers of 1.0 cm or less increased 164% (from 0.508 to 1.34 per 1,000 screens; p = 0.069). Detection rate of in situ cancers declined 6.7% (from 1.27 to 1. 19 per 1,000; p = 0.849). In multivariable analysis of invasive cancers, early stage (stage 1) was strongly associated with detection by CAD (odds ratio = 4.13, p = 0.025). Mean age at screening detection of cancer was 5.3 years younger in the CAD group than in the pre-CAD group (P = 0.060).CONCLUSION. Increased detection rate, younger age at diagnosis, and significantly earlier stage of invasive cancer detection are consistent with a positive screening impact of CAD. Audit results were positive but generally not statistically significant due to sample size limitations. Our findings support the hypothesis that screening with CAD significantly improves detection of the specific cancer morphologies that CAD algorithms were designed to detect.