在日本医生之间进行乳房造影的定性视觉乳房组成评估的观察者间和观察者内部变异性:日本的第一个多机构观察者绩效研究
Yoichi Koyama1, Kazuaki Nakashima2, Shunichiro Orihara3
1Department of Breast Surgical Oncology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Breast cancer (Tokyo, Japan)
|April 15, 2024
概括
这项研究发现,虽然对乳房组成的视觉评估显示出观察者内部的良好一致性,但观察者之间的变异性仍然是日本的一个挑战. 这种常见的诊断方法需要进一步的标准化.
科学领域:
- 放射学 放射学是指放射学
- 医疗成像医学成像
- 乳腺健康 乳腺健康
背景情况:
- 乳房摄影对乳房组成的评估至关重要,但主观,导致可重现性问题.
- 这项研究使用新的分类系统来解决日本观察者之间的和观察者内部的变异性.
研究的目的:
- 评估日本乳房摄影乳房组成视觉评估的可靠性.
- 通过使用日本乳腺组成分类系统,研究观察者之间的和观察者内部的变异性.
主要方法:
- 来自5个机构的10名医生在1个月内两次评估了200张乳房图.
- 使用了日本乳腺组成分类系统 (第四版).
- 使用弗莱斯的卡帕 (κ) 评估了观察者间的变化,使用科恩的卡帕 (κ) 评估了观察者内部的变化.
主要成果:
- 在观察者内部变异性 (κ中位数为0.758-0.813) 中发现了实质性的一致性.
- 对观察者间的变异性 (κ 0.553-0.70) 观察到中等到实质性的一致性.
- 医生与自动化软件 (Volpara®) 之间的一致性很小 (κ 0.075-0.104).
结论:
- 新的日本分类证明了乳腺摄影乳腺组成的优异的观察者内可重现性.
- 观察者之间仍然存在显著的变化,这阻碍了其在日本成为黄金标准的建立.
- 自动化软件与专家视觉评估的一致性较差.
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