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Observational Study
. 2015 Mar;88(1047):20140565.
doi: 10.1259/bjr.20140565. Epub 2014 Dec 23.

Using breast radiographers' reports as a second opinion for radiologists' readings of microcalcifications in digital mammography

R Tanaka  1 , M Takamori, Y Uchiyama, R M Nishikawa, J Shiraishi
Affiliations
Observational Study

Using breast radiographers' reports as a second opinion for radiologists' readings of microcalcifications in digital mammography

R Tanaka et al. Br J Radiol. 2015 Mar.

Abstract

Objective: The aim of this study was to investigate a practical method for incorporating radiographers' reports with radiologists' readings of digital mammograms.

Methods: This simulation study was conducted using data from a free-response receiver operating characteristic observer study obtained with 75 cases (25 malignant, 25 benign and 25 normal cases) of digital mammograms. Each of the rating scores obtained by six breast radiographers was utilized as a second opinion for four radiologists' readings with the radiographers' reports. A logical "OR" operation with various criteria settings was simulated for deciding an appropriate method to select a radiographer's report in all combinations of radiologists and radiographers. The average figure of merit (FOM) of the radiologists' performances was statistically analysed using a jackknife procedure (JAFROC) to verify the clinical utility of using radiographers' reports.

Results: Potential improvement of the average FOM of the radiologists' performances for identifying malignant microcalcifications could be expected when using radiographers' reports as a second opinion. When the threshold value of 2.6 in Breast Imaging-Reporting and Data System (BI-RADS®) assessment was applied to adopt/reject a radiographer's report, FOMs of radiologists' performances were further improved.

Conclusion: When using breast radiographers' reports as a second opinion, radiologists' performances potentially improved when reading digital mammograms. It could be anticipated that radiologists' performances were improved further by setting a threshold value on the BI-RADS assessment provided by the radiographers.

Advances in knowledge: For the effective use of a radiographer's report as a second opinion, radiographers' rating scores and its criteria setting for adoption/rejection would be necessary.

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Figures

Figure 1.
Figure 1.
Relationship between Breast Imaging-Reporting and Data System assessment and a rating scale for the confidence level in our observer study. RR, radiographer's report.
Figure 2.
Figure 2.
Example of selections of responses for simulated radiologists' rating utilizing a radiographer's report (RR). (a) The same lesion marked by both a radiologist and a radiographer was adopted with a higher rating; (b and c) the lesion marked only by a radiographer or a radiologist was adopted when the rating was higher than the pre-determined cut-off threshold value, and a mark with a lower rating (equal or less than the pre-determined cut-off threshold value) was automatically rejected.
Figure 3.
Figure 3.
Relationship between the threshold value for cut-off rating values and average figures of merit (FOMs) of four radiologists with an individual radiographer's (RT) report (RR).
Figure 4.
Figure 4.
Change of the figure of merit (FOM) of radiologists' performances with and without each of six radiographers' reports. BR, breast radiographer; RT, radiographer.
See this image and copyright information in PMC

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