Rates and Causes of Disagreement in Interpretation of Full-Field Digital  Mammography and Film-Screen Mammography in a Diagnostic Setting

Venta, Luz A.; Hendrick, R. Edward; Adler, Yehuda; DeLeon, Patricia; Mengoni, Patricia M; Scharl, A.; Comstock, Christopher; Hansen, Lori; Kay, Nina; Coveler, Andrew L.; Cutter, Gary

doi:10.2214/ajr.176.5.1761241

Cited by 65 publications

(38 citation statements)

References 8 publications

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“…A high level of agreement between SFM and FFDM has been reported in a diagnostic evaluation of breast cancer, and significant disagreement affecting treatment approaches between the two imaging techniques was reported in only 4% [19]. Generalization of results from experimental clinical studies on observer variation is problematic, and results from such studies are difficult to compare with prospective interpretations performed in daily practice.…”

Section: Discussionmentioning

confidence: 99%

Observer variability in screen-film mammography versus full-field digital mammography with soft-copy reading

et al. 2008

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Full-field digital mammography (FFDM) with soft-copy reading is more complex than screen-film mammography (SFM) with hard-copy reading. The aim of this study was to compare inter- and intraobserver variability in SFM versus FFDM of paired mammograms from a breast cancer screening program. Six radiologists interpreted mammograms of 232 cases obtained with both techniques, including 46 cancers, 88 benign lesions, and 98 normals. Image interpretation included BI-RADS categories. A case consisted of standard two-view mammograms of one breast. Images were scored in two sessions separated by 5 weeks. Observer variability was substantial for SFM as well as for FFDM, but overall there was no significant difference between the observer variability at SFM and FFDM. Mean kappa values were lower, indicating less agreement, for microcalcifications compared with masses. The lower observer agreement for microcalcifications, and especially the low intraobserver concordance between the two imaging techniques for three readers, was noticeable. The level of observer agreement might be an indicator of radiologist performance and could confound studies designed to separate diagnostic differences between the two imaging techniques. The results of our study confirm the need for proper training for radiologists starting FFDM with soft-copy reading in breast cancer screening.

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Section: Discussionmentioning

confidence: 99%

Observer variability in screen-film mammography versus full-field digital mammography with soft-copy reading

et al. 2008

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“…The proportion of small invasive tumours in the two populations was similar without significant differences. For tumours ≤10 mm this was 30 Table 2). …”

Section: Tumour Characteristicsmentioning

confidence: 97%

Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County Study

et al. 2007

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The purpose of the study was to compare the performance of full-field digital mammography (FFDM) with soft-copy reading to screen film mammography (SFM) used during the first prevalent 2-year round of population-based screening. A total of 18,239 women aged 50-69 years were screened with FFDM as part of the Norwegian Breast Cancer Screening Programme (NBCSP). Process indicators were compared to data from 324,763 women screened with SFM using the common national database of the NBCSP. The cancer detection rates were 0.77% (140/18,239) for FFDM and 0.65% (2,105/324,763) for SFM (p = 0.058). For ductal carcinoma in situ (DCIS) alone, the results were: FFDM 0.21% (38/18,239) compared to SFM 0.11% (343/324,763) (p < 0.001). Recall rates due to positive mammography were for FFDM 4.09% (746/18,239), while for SFM 4.16% (13,520/324,764) (p = 0.645), due to technically insufficient imaging: FFDM 0.22% (40/18,239) versus SFM 0.61% (1,993/324,763) (p < 0.001). The positive predictive value (PPV) in the FFDM group was 16.6% (140/843), while 13.5% (2,105/15,537) for SFM (p = 0.014). No statistically significant differences were recorded concerning histological morphology, tumour size, or lymph node involvement. In conclusion FFDM had a significantly higher detection rate for DCIS than SFM. For invasive cancers no difference was seen. FFDM also had a significantly higher PPV and a significantly lower technical recall rate.

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“…Reason for exclusion Cole et al 15 Assessment of cases with previously known cancer diagnoses Hendrick et al 28 Retrospective study using data from Pisano's 2005 Digital Mammographic Imaging Screening Trial (DMIST) 14 study Venta et al 17 Did not assess clinical data of interest for this systematic review Lewin et al 18 Study conducted with part of the population of the complete study, 30 which was published the following year and has been included in the systematic review Nishikawa et al 19 Retrospective study using data from Pisano et al…”

Section: Authormentioning

confidence: 99%

Comparative evaluation of digital mammography and film mammography: systematic review and meta-analysis

Iared¹,

Shigueoka

Torloni

et al. 2011

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Mammography is the best method for breast-cancer screening and is capable of reducing mortality rates. Studies that have assessed the clinical impact of mammography have been carried out using film mammography. Digital mammography has been proposed as a substitute for film mammography given the benefits inherent to digital technology. The aim of this study was to compare the performance of digital and film mammography. DESIGN: Systematic review and meta-analysis. METHOD: The Medline, Scopus, Embase and Lilacs databases were searched looking for paired studies, cohorts and randomized controlled trials published up to 2009 that compared the performance of digital and film mammography, with regard to cancer detection, recall rates and tumor characteristics. The reference lists of included studies were checked for any relevant citations. RESULTS: A total of 11 studies involving 190,322 digital and 638,348 film mammography images were included. The cancer detection rates were significantly higher for digital mammography than for film mammography (risk relative, RR = 1.17; 95% confidence interval, CI = 1.06-1.29; I² = 19%). The advantage of digital mammography seemed greatest among patients between 50 and 60 years of age. There were no significant differences between the two methods regarding patient recall rates or the characteristics of the tumors detected. CONCLUSION: The cancer detection rates using digital mammography are slightly higher than the rates using film mammography. There are no significant differences in recall rates between film and digital mammography. The characteristics of the tumors are similar in patients undergoing the two methods.

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Rates and Causes of Disagreement in Interpretation of Full-Field Digital Mammography and Film-Screen Mammography in a Diagnostic Setting

Cited by 65 publications

References 8 publications

Observer variability in screen-film mammography versus full-field digital mammography with soft-copy reading

Observer variability in screen-film mammography versus full-field digital mammography with soft-copy reading

Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County Study

Comparative evaluation of digital mammography and film mammography: systematic review and meta-analysis

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