利用診斷漏診乳癌數據了解超音波放射師診斷性能

超音波在亞洲是常用乳房診斷工具，超音波對於乳癌診斷率可以達到90%，約10%乳癌被超音波漏診。這項研究回顧了2012年至2015年在單一機構PACS數據庫中通過超音波檢查找到的漏診乳癌。漏診乳癌定義為在超音波檢查後6個月內檢出癌症。一位經驗豐富的放射科醫生重新查核漏診超音波圖像，以確認圖像應該可以回溯診斷乳癌並記錄影像學特徵。最後共收集46例漏診乳癌，和117例年齡相匹配至少1年追蹤的良性超音波病灶進行判讀。9位具有0-23年乳房超音波檢查經驗的超音波放射師判讀46例漏診乳癌和117例良性病變的圖像。ROC曲線下的面積（AUC）評估顯示經驗豐富的資深超音波放射師診斷表現較好。超音波放射師的乳房超音波經驗與敏感性高度相關（r=0.8），放射師在這項測試中的PPV（陽性預測值）也與他們在臨床工作中的PPV高度相關（r=0.7）。我們發現在乳房超音波檢查方面具有2年以上經驗的超音波放射師有能力避免漏診乳癌。

關鍵字

乳癌；超音波檢查；漏診乳癌

並列摘要

Ultrasound is a common breast diagnostic tool in Asia. Ultrasound has a diagnosis rate of 90% for breast cancer, and about 10% of breast cancers are undiagnosed by ultrasound. This study reviewed undiagnosed breast cancers on ultrasound exams in a single institution PACS database from 2012 to 2015. Undiagnosed breast cancers were defined as cancer detected within 6 months after the ultrasound exam. An experienced radiologist rechecked the ultrasound captured images to confirm that undiagnosed cancer can be retrospectively visible and recorded imaging findings. A total of 46 undiagnosed breast cancers and 117 age-matched benign ultrasound lesions with at least 1-year follow-up were collected for reading. Nine sonographers with 0-23 years of experience in breast ultrasound interpreted the mixed images of 46 undiagnosed breast cancers and 117 benign lesions. The area under the ROC curve (AUC) showed the diagnostic performance is higher in senior experienced breast sonographers. Sonographers' breast ultrasound experience was highly related to sensitivities (r=0.8). PPV (positive predictive value) of sonographers in this study was also highly related to their PPV in clinical practice (r=0.7). We found sonographers with more than 2 years of experience in breast ultrasound are capable of avoiding undiagnosed breast cancers.

並列關鍵字

Breast cancer ； Ultrasound ； Undiagnosed breast cancer

國際替代計量

利用診斷漏診乳癌數據了解超音波放射師診斷性能

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