多功能「乳房Ｘ光攝影篩檢教學系統」建構與應用之研究

A Versatile Mammography Screening System for Radiologists with Applications in Teaching

張曼莉(Mann-Li Chang)

指導教授 ： 莊謙本教授 ； 吳清基教授

國立臺灣師範大學/科技學院/工業教育學系/博士(2006年)

摘要

乳癌的發生居台灣女性癌症第二位，乳房Ｘ光攝影是無任何症狀的早期乳癌篩檢最佳診斷方法，目前廣泛提供給放射線專科醫師應用於乳癌篩檢，並進一步協助放射線專科醫師改善對乳房的診斷。惟乳房Ｘ光攝影需經由接受過專業訓練的放射線專科醫師判讀，才可以將乳癌的致死率降低20%-30%。因此，如何有效使用乳房Ｘ光攝影篩檢婦女早期乳癌，變成很重要。但是，在例行性的乳房Ｘ光攝影篩檢缺少受過專業訓練的放射線專科醫師，故需要發展一套多功能乳房Ｘ光攝影篩選教學研究系統，使放射線專科醫師不限時間與地點隨時可自我學習訓練與教學研究的系統。
為此，本研究主要的目的是發展設計六個重要模組(GUI瀏覽模組、DataBase模組、CAD模組、Curriculum Design模組、Data Reporting模組及Internet模組)，並將其融入於不同應用系統(如學習/訓練/教學/研究)內，提供給放射線專科醫師不限時間與地點隨時可自我學習研究與訓練教學的需要，以提昇放射線專科醫師的專業技術，減少診斷的誤差。六個模組中以具有圖形使用者介面(GUI)瀏覽模組(ImageViewer系統)為應用層面最廣、親和力最強的模組。
為了瞭解本教學研究系統的應用成效，本研究特提供77位放射線專科醫師使用本教學研究系統開發的圖形使用者介面(GUI)瀏覽模組(ImageViewer系統)，以調查問卷及統計分析其使用成效，結果發現使用ImageViewer系統較未使用ImageViewer系統的放射線專科醫師，其乳房X光攝影篩檢判讀準確性與一致性略高。

關鍵字

醫學教育 ； 繼續教育 ； 數位學習 ； 乳房Ｘ光攝影

並列摘要

Breast cancer has emerged as a second leading cause in women’s diseases in Taiwan. Mammography is by far is the only effective means to be able to detect breast cancer in early stage. It has been widely used as a screening procedure to provide radiologists with a second opinion and further help radiologists improve their diagnosis. An experienced and well-trained radiologist in mammography can significantly reduce fatality rate in breast cancer by 20-30%. As a result, how to effectively use mammography to detect early breast cancer becomes increasingly important in women’s health screening procedure. Unfortunately, a significant shortage of radiologists specializing in mammography has overburdened trained and experienced radiologists in the routine mammography screening. One effective means of mitigating this dilemma is to have a learning, training, teaching and research system that can allow radiologists to self learn and train to educate themselves at free of locations without compromising their diagnosis.
In order to meet this need, the research conducted in this dissertation is to develop a versatile system which consists of 6 key modules, (1) a Graphic User Interface (GUI) software viewing tool called ImageViewer, (2) data base which includes data available in public domain and real cases, (3) computer aided diagnostic (CAD) system, (4) the curriculum design, (5) data reporting and (6) design and development of a tele-mammography system called Remote Method Invocation (RMI) Communicators. Depending upon different needs, the proposed system can be adapted to applications in learning, training, teaching and research. Graphic User Interface (GUI) model (ImageViewer) is the widest and the strongest among six models.
In order to substantiate the utility of the designed system, an experimental pilot system is particularly designed for evaluation where a sample pool of 77 radiologists is surveyed and statistics analysis is conducted. The results demonstrate that the performance of sample radiologists using the system is improved over without using the system.

並列關鍵字

medical education ； continued education ； e-learning ； mammography