24 March 2016 Changes in frequency of recall recommendations of examinations depicting cancer with the availability of either priors or digital breast tomosynthesis
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Performance changes in a binary environment when using additional information is affected only when changes in recommendations are made due to the additional information in question. In a recent study, we have shown that, contrary to general expectation, introducing prior examinations improved recall rates, but not sensitivity. In this study, we assessed cancer detection differences when prior examinations and/or digital breast tomosynthesis (DBT) were made available to the radiologist. We identified a subset of 21 cancer cases with differences in the number of radiologists who recalled these cases after reviewing either a prior examination or DBT. For the cases with differences in recommendations after viewing either priors or DBT, separately, we evaluated the total number of readers that changed their recommendations, regardless of the specific radiologist in question. Confidence intervals for the number of readers and a test for the hypothesis of no difference was performed using the non-parameteric bootstrap approach addressing both case and reader-related sources of variability by resampling cases and readers. With the addition of priors, there were 14 cancer cases (out of 15) where the number of “recalling radiologists” decreased. With the addition of DBT, the number of “recalling radiologists” decreased in only five cases (out of 15) while increasing in the remaining 9 cases. Unlike most new approaches to breast imaging DBT seems to improve both recall rates and cancer detection rates. Changes in recommendations were noted by all radiologists for all cancers by type, size, and breast density.
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Christiane M. Hakim, Christiane M. Hakim, Andriy I. Bandos, Andriy I. Bandos, Marie A. Ganott, Marie A. Ganott, Victor J. Catullo, Victor J. Catullo, Denise M. Chough, Denise M. Chough, Amy E. Kelly, Amy E. Kelly, Dilip D. Shinde, Dilip D. Shinde, Jules H. Sumkin, Jules H. Sumkin, Luisa P. Wallace, Luisa P. Wallace, Robert M. Nishikawa, Robert M. Nishikawa, David Gur, David Gur, "Changes in frequency of recall recommendations of examinations depicting cancer with the availability of either priors or digital breast tomosynthesis", Proc. SPIE 9787, Medical Imaging 2016: Image Perception, Observer Performance, and Technology Assessment, 97871A (24 March 2016); doi: 10.1117/12.2213075; https://doi.org/10.1117/12.2213075

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