Differences in lesion interpretation between radiologists in two countries: Lessons from a digital breast...

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Diagnostic Accuracy

Background:

• Limited data exists on Chinese radiologists' diagnostic performance with digital breast tomosynthesis (DBT).
• Understanding error patterns and missed cancers in DBT interpretation by Chinese radiologists is crucial.
• This study benchmarks Chinese radiologists' DBT performance against Australian counterparts.

Purpose of the Study:

• To investigate diagnostic error patterns among Chinese radiologists interpreting DBT images.
• To identify specific lesion types that pose challenges for Chinese radiologists.
• To compare diagnostic performance between Chinese and Australian radiologists using DBT.

Main Methods:

• Twelve Chinese radiologists interpreted a DBT test set, identifying true positives, false positives (FP), true negatives, and false negatives (FN).
• Fourteen Australian radiologists also read the same DBT test set.
• Statistical analyses including Z-scores and Pearson correlations compared lesion interpretation and normal appearance identification between the two groups.

Main Results:

• Architectural distortions and stellate masses were significantly more difficult for Chinese radiologists to diagnose correctly (p < .001, p = .02).
• Chinese readers miscategorized more false positives as discrete masses (p < .001) and fewer as architectural distortions (p < .001) compared to Australian radiologists.
• No significant correlation was found in false negatives (r = 0.37, p = .18), but moderate correlation existed for false positives in normal cases (r = 0.52, p = .02) between groups.

Conclusions:

• Architectural distortions and stellate masses present interpretation challenges for Chinese radiologists using DBT.
• Findings suggest a need for developing tailored training and education programs for specific reader groups based on observed interpretation patterns.
• Improving diagnostic accuracy in DBT interpretation requires addressing identified areas of difficulty for radiologists.