Reversal of the hanging protocol of Contrast Enhanced Mammography leads to similar diagnostic performance yet decreased reading times.
Eur J Radiol
; 117: 62-68, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31307654
ABSTRACT
OBJECTIVES:
Contrast-enhanced mammography (CEM) was found superior to Full-Field Digital Mammography (FFDM) for breast cancer detection. Current hanging protocols show low-energy (LE, similar to FFDM) images first, followed by recombined (RC) images. However, evidence regarding which hanging protocol leads to the most efficient reading process and highest diagnostic performance is lacking. This study investigates the effects of hanging-protocol ordering on the reading process and diagnostic performance of breast radiologists using eye-tracking methodology. Furthermore, it investigates differences in reading processes and diagnostic performance between LE, RC and FFDM images. MATERIALS ANDMETHODS:
Twenty-seven breast radiologists were randomized into three reading groups LE-RC (commonly used hangings), RC-LE (reversed hangings) and FFDM. Thirty cases (nine malignant) were used. Fixation count, net dwell time and time-to-first fixation on malignancies as visual search measures were registered by the eye-tracker. Reading time per image was measured. Participants clicked on suspicious lesions to determine sensitivity and specificity. Area-under-the-ROC-curve (AUC) values were calculated.RESULTS:
RC-LE scored identical on visual search measures, t(16)= -1.45, p = .17 or higher-p values, decreased reading time with 31%, t(16)= -2.20, p = .04, while scoring similar diagnostic performance compared to LE-RC, t(13.2) = -1.39, p - .20 or higher p-values. The reading process was more efficient on RC compared to LE. Diagnostic performance of CEM was superior to FFDM; F (2,26) = 16.1, p < .001. Average reading time did not differ between the three groups, F (2,25) = 3.15, p = .06.CONCLUSION:
The reversed CEM hanging protocol (RC-LE) scored similar on diagnostic performance compared to LE-RC, while reading time was a third faster. Abnormalities were interpreted quicker on RC images. A RC-LE hanging protocol is therefore recommended for clinical practice and training. Diagnostic performance of CEM was (again) superior to FFDM.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mama
/
Mamografia
/
Radiologistas
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2019
Tipo de documento:
Article