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Comparative Study
. 2008 Apr;247(1):38-48.
doi: 10.1148/radiol.2471070418.

Accuracy of soft-copy digital mammography versus that of screen-film mammography according to digital manufacturer: ACRIN DMIST retrospective multireader study

R Edward Hendrick  1 , Elodia B Cole, Etta D Pisano, Suddhasatta Acharyya, Helga Marques, Michael A Cohen, Roberta A Jong, Gordon E Mawdsley, Kalpana M Kanal, Carl J D'Orsi, Murray Rebner, Constantine Gatsonis
Affiliations
Comparative Study

Accuracy of soft-copy digital mammography versus that of screen-film mammography according to digital manufacturer: ACRIN DMIST retrospective multireader study

R Edward Hendrick et al. Radiology. 2008 Apr.

Abstract

Purpose: To retrospectively compare the accuracy for cancer diagnosis of digital mammography with soft-copy interpretation with that of screen-film mammography for each digital equipment manufacturer, by using results of biopsy and follow-up as the reference standard.

Materials and methods: The primary HIPAA-compliant Digital Mammographic Imaging Screening Trial (DMIST) was approved by the institutional review board of each study site, and informed consent was obtained. The approvals and consent included use of data for future HIPAA-compliant retrospective research. The American College of Radiology Imaging Network DMIST collected screening mammography studies performed by using both digital and screen-film mammography in 49 528 women (mean age, 54.6 years; range, 19-92 years). Digital mammography systems from four manufacturers (Fischer, Fuji, GE, and Hologic) were used. For each digital manufacturer, a cancer-enriched reader set of women screened with both digital and screen-film mammography in DMIST was constructed. Each reader set contained all cancer-containing studies known for each digital manufacturer at the time of reader set selection, together with a subset of negative and benign studies. For each reader set, six or 12 experienced radiologists attended two randomly ordered reading sessions 6 weeks apart. Each radiologist identified suspicious findings and rated suspicion of breast cancer in identified lesions by using a seven-point scale. Results were analyzed according to digital manufacturer by using areas under the receiver operating characteristic curve (AUCs), sensitivity, and specificity for soft-copy digital and screen-film mammography. Results for Hologic digital are not presented owing to the fact that few cancer cases were available. The implemented design provided 80% power to detect average AUC differences of 0.09, 0.08, and 0.06 for Fischer, Fuji, and GE, respectively.

Results: No significant difference in AUC, sensitivity, or specificity was found between Fischer, Fuji, and GE soft-copy digital and screen-film mammography. Large reader variations occurred with each modality.

Conclusion: No statistically significant differences were found between soft-copy digital and screen-film mammography for Fischer, Fuji, and GE digital mammography equipment.

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Figures

Figure 1:
Figure 1:
Graph shows cumulative accrual of women (numbers along y-axis) according to digital manufacturer during the 107 weeks of DMIST accrual.
Figure 2:
Figure 2:
Flowchart of study selection for this retrospective reader study.
Figure 3a:
Figure 3a:
(a) Graph shows AUC according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all six readers for digital studies (0.73); dashed vertical line = mean AUC across all six readers for film studies (0.76). (b) Graph shows AUC according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all 12 readers for digital studies (0.73); dashed vertical line = mean AUC across all 12 readers for film studies (0.78). (c) Graph shows AUC according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all 12 readers for digital studies (0.78); dashed vertical line = mean AUC across all 12 readers for film studies (0.82).
Figure 3b:
Figure 3b:
(a) Graph shows AUC according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all six readers for digital studies (0.73); dashed vertical line = mean AUC across all six readers for film studies (0.76). (b) Graph shows AUC according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all 12 readers for digital studies (0.73); dashed vertical line = mean AUC across all 12 readers for film studies (0.78). (c) Graph shows AUC according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all 12 readers for digital studies (0.78); dashed vertical line = mean AUC across all 12 readers for film studies (0.82).
Figure 3c:
Figure 3c:
(a) Graph shows AUC according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all six readers for digital studies (0.73); dashed vertical line = mean AUC across all six readers for film studies (0.76). (b) Graph shows AUC according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all 12 readers for digital studies (0.73); dashed vertical line = mean AUC across all 12 readers for film studies (0.78). (c) Graph shows AUC according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean AUC across all 12 readers for digital studies (0.78); dashed vertical line = mean AUC across all 12 readers for film studies (0.82).
Figure 4a:
Figure 4a:
(a) Graph shows sensitivity according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.56); dashed vertical line = mean sensitivity across readers for film studies (0.59). (b) Graph shows sensitivity according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.51); dashed vertical line = mean sensitivity across readers for film studies (0.53). (c) Graph shows sensitivity according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.50); dashed vertical line = mean sensitivity across readers for film studies (0.53).
Figure 4b:
Figure 4b:
(a) Graph shows sensitivity according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.56); dashed vertical line = mean sensitivity across readers for film studies (0.59). (b) Graph shows sensitivity according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.51); dashed vertical line = mean sensitivity across readers for film studies (0.53). (c) Graph shows sensitivity according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.50); dashed vertical line = mean sensitivity across readers for film studies (0.53).
Figure 4c:
Figure 4c:
(a) Graph shows sensitivity according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.56); dashed vertical line = mean sensitivity across readers for film studies (0.59). (b) Graph shows sensitivity according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.51); dashed vertical line = mean sensitivity across readers for film studies (0.53). (c) Graph shows sensitivity according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean sensitivity across readers for digital studies (0.50); dashed vertical line = mean sensitivity across readers for film studies (0.53).
Figure 5a:
Figure 5a:
(a) Graph shows specificity according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for digital studies (0.74); dashed vertical line = mean specificity across readers for film studies (0.78). (b) Graph shows specificity according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for digital studies (0.84); dashed vertical line = mean specificity across readers for film studies (0.86). (c) Graph shows specificity according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for both digital (0.91) and film (0.91) studies.
Figure 5b:
Figure 5b:
(a) Graph shows specificity according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for digital studies (0.74); dashed vertical line = mean specificity across readers for film studies (0.78). (b) Graph shows specificity according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for digital studies (0.84); dashed vertical line = mean specificity across readers for film studies (0.86). (c) Graph shows specificity according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for both digital (0.91) and film (0.91) studies.
Figure 5c:
Figure 5c:
(a) Graph shows specificity according to reader for Fischer digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for digital studies (0.74); dashed vertical line = mean specificity across readers for film studies (0.78). (b) Graph shows specificity according to reader for Fuji digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for digital studies (0.84); dashed vertical line = mean specificity across readers for film studies (0.86). (c) Graph shows specificity according to reader for GE digital versus paired screen-film mammographic studies. Solid vertical line = mean specificity across readers for both digital (0.91) and film (0.91) studies.
Figure 6a:
Figure 6a:
Graphs show sensitivity versus 1 − specificity according to reader for (a) Fischer, (b) Fuji, and (c) GE digital reader sets. □ = sensitivity versus 1 − specificity points for each reader with screen-film mammography; ○ = points for each reader with soft-copy digital mammography. ▪ And • = sensitivity versus 1 − specificity points for film and digital mammography, respectively, averaged over all readers (n = 6 for Fischer; n = 12 for Fuji and GE).
Figure 6b:
Figure 6b:
Graphs show sensitivity versus 1 − specificity according to reader for (a) Fischer, (b) Fuji, and (c) GE digital reader sets. □ = sensitivity versus 1 − specificity points for each reader with screen-film mammography; ○ = points for each reader with soft-copy digital mammography. ▪ And • = sensitivity versus 1 − specificity points for film and digital mammography, respectively, averaged over all readers (n = 6 for Fischer; n = 12 for Fuji and GE).
Figure 6c:
Figure 6c:
Graphs show sensitivity versus 1 − specificity according to reader for (a) Fischer, (b) Fuji, and (c) GE digital reader sets. □ = sensitivity versus 1 − specificity points for each reader with screen-film mammography; ○ = points for each reader with soft-copy digital mammography. ▪ And • = sensitivity versus 1 − specificity points for film and digital mammography, respectively, averaged over all readers (n = 6 for Fischer; n = 12 for Fuji and GE).
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References

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