Effect of the Availability of Prior Full-Field Digital Mammography and Digital Breast Tomosynthesis Images on the Interpretation of Mammograms

Abstract

Purpose:To assess the effect of and interaction between the availability of prior images and digital breast tomosynthesis (DBT) images in decisions to recall women during mammogram interpretation. Materials and Methods:Verbal informed consent was obtained for this HIPAA-compliant institutional review board-approved protocol. Results:Average recall rates in noncancer cases were significantly reduced with the addition of prior FFDM images by 34% (145 of 421) and 32% (106 of 333) without and with DBT images, respectively (P , .001). However, this recall reduction was achieved at the cost of a corresponding 7% (23 of 345) and 4% (14 of 353) reduction in sensitivity (P = .006). In contrast, availability of DBT images resulted in a smaller reduction in recall rates (false-positive interpretations) of 19% (76 of 409) and 26% (71 of 276) without and with prior FFDM images, respectively (P = .001). Availability of DBT images resulted in 4% (15 of 338) and 8% (25 of 322) increases in sensitivity, respectively (P = .007). The effects of the availability of prior FFDM images or DBT images did not significantly change regardless of the sequence in presentation (P = .81 and P = .47 for specificity and sensitivity, respectively). Conclusion:The availability of prior FFDM or DBT images is a largely independent contributing factor in reducing recall recommendations during mammographic interpretation.q RSNA, 2015

Impact of prior mammograms on combined reading of digital mammography and digital breast tomosynthesis

“…The use of prior mammograms in the reading of current mammograms had previously been reported to increase specificity especially in the screening setting (13,15), while also increasing the detection of true-positive findings in the diagnostic setting (1). Current studies by Hakim et al also reported that recall rates were able to be reduced with the addition of prior images by 34% and 32% without and with DBT images (16,17) although their study did not describe the effect of prior mammograms on diagnostic performance in terms of sensitivity and specificity.…”

Change in Image Quality According to the 3D Locations of a CBCT Phantom

“…However, even experienced radiologists sometimes fail to interpret the images correctly. [ 37 , 38 ] To reduce this failure, physical factors that can affect the comparison performance need to be analyzed beforehand. Following the same line of thought, analyzing the effect of the change in object position should precede the comparison of follow up CBCT images.…”

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

“…Although 92% of radiologists were within the recommended ranges for sensitivity, only 63% achieved the recommended levels of specificity . The sensitivity and specificity of mammography are improved if prior studies are available to the interpreting physician . Hayward et al evaluated outcomes of over 46,000 consecutive mammograms and observed a recall rate 16.6% when prior examinations were not compared, but the rate was only 7.8% when 1 prior examination was available for comparison, and it was 6.3% when 2 or more prior examinations were available .…”

“…60,[66][67][68][69][70] The sensitivity and specificity of mammography are improved if prior studies are available to the interpreting physician. 71,72 Hayward et al evaluated outcomes of over 46,000 consecutive mammograms and observed a recall rate 16.6% when prior examinations were not compared, but the rate was only 7.8% when 1 prior examination was available for comparison, and it was 6.3% when 2 or more prior examinations were available. 71 A statistically significant improvement in the cancer detection rate of 2.3 cases per 1000 examinations also was observed for mammograms that were interpreted with multiple prior examinations versus a single prior examination.…”