Operator dependence of physician-performed whole-breast US: Lesion detection and characterization
Operator dependence of physician-performed whole-breast US: Lesion detection and characterization
复制标题
DOI：
10.1148/radiol.2412051710
复制
发表时间：
2006-11-01
期刊：
影响因子：
19.7
通讯作者：
Mendelson, Ellen B.
中科院分区：
文献类型：
--
作者：
Berg, Wendie A.;Blume, Jeffrey D.;Mendelson, Ellen B.
目的：为了前瞻性地研究操作者依赖的病变检测，描述和解释时，有经验的乳腺放射科医生进行全乳房ultrasonography（US）.Materials and Methods：机构审查委员会批准获得了符合HIPAA的研究。10名已知有多处乳腺病变的女性（年龄19-53岁;平均37.4岁; 20个乳房）同意参与研究。11名乳腺放射科医生通过了筛查乳腺US试验的经验和资格要求并同意参与，扫描了所有参与者的双侧乳房，并记录了每个检测到的病变及其大小、位置、特征、可触及性的图像，以及乳腺成像报告和数据系统的最终评估。组内相关系数（ICC）被用来衡量协议病变的大小和位置，并计算卡帕统计协议的功能和最终评估consensus.Results相比：八十八个独特的病变确定了至少两个调查（5至13病变每个参与者）。平均直径为6.7 mm（标准误差为0.4;范围为2-22 mm），8个病灶（9%）可触及。在968个潜在检测中（88个病变，11名研究者），进行了536个（55%）检测。个体研究者检测到43（49%）至58（66%）处病变。较大的病变更一致地被检测到：33个病变中有6个（18%）病变直径为3 mm或更小; 374个病变中有164个（18%）病变直径为3 mm或更小。在3.1-5 mm处，145/275例（52.7%）;在5.1-7 mm处，145/275例（52.7%）;在7.1-9 mm处，119/176例（67.6%）;在9.1-11 mm处，38/44例（86%）; 64/66例（97%）病变大于11 mm（P < .001）。钟面、距乳头距离和单个病变直径的ICC均超过0.7，表明可靠性高。对于实体性病变的形状、边缘和最终评估，kappa值分别为0.62、0.67（基本一致）和0.52（中度一致）。在110个8 mm或更小的一致性囊肿中，15个（14%）被至少一个阅片者认为是实性病变。结论：较大的病变（> 11 mm）被最一致地检测到，少于一半的病变平均直径为5 mm或更小;发现在病变大小、位置和关键特征的描述方面存在实质性一致性，在病变处理方面存在中度一致性。
Purpose: To prospectively examine operator dependence of lesion detection, description, and interpretation when experienced breast radiologists perform whole-breast ultrasonography (US).Materials and Methods: Institutional review board approval was obtained for the HIPAA-compliant study. Ten women (aged 19-53 years; mean, 37.4 years; 20 breasts) with numerous known breast lesions consented to participate. Eleven breast radiologists, who passed experience and qualification requirements for a screening breast US trial and consented to participate, scanned both breasts in all participants and documented images of each detected lesion and its size, location, features, palpability, and Breast Imaging Reporting and Data System final assessment. Intraclass correlation coefficients (ICCs) were used to measure agreement on lesion size and location, and kappa statistics were calculated for agreement on features and final assessments compared with consensus.Results: Eighty-eight unique lesions were identified by at least two investigators (five to 13 lesions per participant). Mean diameter was 6.7 mm (standard error, 0.4; range, 2-22 mm), and eight lesions (9%) were palpable. Of 968 potential detections (88 lesions, 11 investigators), 536 (55%) detections were made. Individual investigators detected between 43 (49%) and 58 (66%) lesions. Larger lesions were more consistently detected: Detection rates were six of 33 lesions (18%) at 3 mm or smaller; 164 of 374 (43.9%) at 3.1-5 mm; 145 of 275 (52.7%) at 5.1-7 mm; 119 of 176 (67.6%) at 7.1-9 mm; 38 of 44 (86%) at 9.1-11 mm; and 64 of 66 (97%) lesions larger than 11 mm (P < .001). ICCs for clockface, distance from nipple, and individual lesion diameter all exceeded 0.7, indicating high reliability. For shape, margins, and final assessments of solid lesions, kappa values were 0.62, 0.67 (substantial agreement), and 0.52 (moderate agreement), respectively. Of 110 detections of consensus cysts 8 mm and smaller, 15 (14%) detections were considered to be of solid lesions by at least one reader.Conclusion: Larger lesions (> 11 mm) are most consistently detected, with fewer than half of lesions 5 mm or smaller in mean diameter identified; substantial agreement was found for description of lesion size, location, and key features, and moderate agreement was found for lesion management.