Teleradiology and screening mammography: a telemammography system evaluation and comparison to clinical results

Abstract

Radiologists' performance reviewing and rating breast cancer screening mammography exams using a telemammography system was evaluated and compared with the actual clinical interpretations of the same interpretations. Mammography technologists from three remote imaging sites transmitted 245 exams to a central site (radiologists), which they (the technologists) believed needed additional procedures (termed "recall"). Current exam image data and non-image data (i.e., technologist's text message, technologist's graphic marks, patient's prior report, and Computer Aided Detection (CAD) results) were transmitted to the central site and displayed on three highresolution, portrait monitors. Seven radiologists interpreted ("recall" or "no recall") the exams using the telemammography workstation in three separate multi-mode studies. The mean telemammography recall rates ranged from 72.3% to 82.5% while the actual clinical recall rates ranged from 38.4% to 42.3% across the three studies. Mean Kappa of agreement ranged from 0.102 to 0.213 and mean percent agreement ranged from 48.7% to 57.4% across the three studies. Eighty-seven percent of the disagreement interpretations occurred when the telemammography interpretation resulted in a recommendation to recall and the clinical interpretation resulted in a recommendation not to recall. The poor agreement between the telemammography and clinical interpretations may indicate a critical dependence on images from prior screening exams rather than any text based information. The technologists were sensitive, if not specific, to the mammography features and changes that may lead to recall. Using the telemammography system the radiologists were able to reduce the recommended recalls by the technologist by approximately 25 percent.

Korrelation zwischen histologischem Befund und einem Computer-assistierten Detektionssystem (CAD) für die Mammografie

“…Diese Läsionen sind meist unspezifischer als Mikrokalkcluster und von Architekturstörungen teilweise schwer zu differenzieren [4,21]. In der Literatur werden diese Befunde als problematischer für die Detektion durch die untersuchten Systeme beschrieben als reine Mikrokalk-Cluster [12,15,22]. Die niedrigsten Detektionsraten mit 52,9 % wurden von Malich et al hier für Tumoren > 40 mm gefunden, was auf die hier meist unscharf begrenzten und relativ unspezifischen Läsionen zurückgeführt wird [20].…”