Radiologist agreement for mammographic recall by case difficulty and finding type

Tracy Onega, Megan Smith, Diana L. Miglioretti, Patricia (Patty) Carney, Berta A. Geller, Karla Kerlikowske, Diana S M Buist, Robert D. Rosenberg, Robert A. Smith, Edward A. Sickles, Sebastien Haneuse, Melissa L. Anderson, Bonnie Yankaskas

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: The aim of this study was to assess agreement of mammographic interpretations by community radiologists with consensus interpretations of an expert radiology panel to inform approaches that improve mammographic performance. Methods: From 6 mammographic registries, 119 community-based radiologists were recruited to assess 1 of 4 randomly assigned test sets of 109 screening mammograms with comparison studies for no recall or recall, giving the most significant finding type (mass, calcifications, asymmetric density, or architectural distortion) and location. The mean proportion of agreement with an expert radiology panel was calculated by cancer status, finding type, and difficulty level of identifying the finding at the patient, breast, and lesion level. Concordance in finding type between study radiologists and the expert panel was also examined. For each finding type, the proportion of unnecessary recalls, defined as study radiologist recalls that were not expert panel recalls, was determined. Results: Recall agreement was 100% for masses and for examinations with obvious findings in both cancer and noncancer cases. Among cancer cases, recall agreement was lower for lesions that were subtle (50%) or asymmetric (60%). Subtle noncancer findings and benign calcifications showed 33% agreement for recall. Agreement for finding responsible for recall was low, especially for architectural distortions (43%) and asymmetric densities (40%). Most unnecessary recalls (51%) were asymmetric densities. Conclusions: Agreement in mammographic interpretation was low for asymmetric densities and architectural distortions. Training focused on these interpretations could improve the accuracy of mammography and reduce unnecessary recalls.

Original languageEnglish (US)
Pages (from-to)788-794
Number of pages7
JournalJACR Journal of the American College of Radiology
Volume9
Issue number11
DOIs
StatePublished - 2012

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Radiology
Neoplasms
Mammography
Registries
Breast
Radiologists

Keywords

  • agreement
  • breast cancer
  • Mammography
  • screening

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Radiologist agreement for mammographic recall by case difficulty and finding type. / Onega, Tracy; Smith, Megan; Miglioretti, Diana L.; Carney, Patricia (Patty); Geller, Berta A.; Kerlikowske, Karla; Buist, Diana S M; Rosenberg, Robert D.; Smith, Robert A.; Sickles, Edward A.; Haneuse, Sebastien; Anderson, Melissa L.; Yankaskas, Bonnie.

In: JACR Journal of the American College of Radiology, Vol. 9, No. 11, 2012, p. 788-794.

Research output: Contribution to journalArticle

Onega, T, Smith, M, Miglioretti, DL, Carney, PP, Geller, BA, Kerlikowske, K, Buist, DSM, Rosenberg, RD, Smith, RA, Sickles, EA, Haneuse, S, Anderson, ML & Yankaskas, B 2012, 'Radiologist agreement for mammographic recall by case difficulty and finding type', JACR Journal of the American College of Radiology, vol. 9, no. 11, pp. 788-794. https://doi.org/10.1016/j.jacr.2012.05.020
Onega, Tracy ; Smith, Megan ; Miglioretti, Diana L. ; Carney, Patricia (Patty) ; Geller, Berta A. ; Kerlikowske, Karla ; Buist, Diana S M ; Rosenberg, Robert D. ; Smith, Robert A. ; Sickles, Edward A. ; Haneuse, Sebastien ; Anderson, Melissa L. ; Yankaskas, Bonnie. / Radiologist agreement for mammographic recall by case difficulty and finding type. In: JACR Journal of the American College of Radiology. 2012 ; Vol. 9, No. 11. pp. 788-794.
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AB - Purpose: The aim of this study was to assess agreement of mammographic interpretations by community radiologists with consensus interpretations of an expert radiology panel to inform approaches that improve mammographic performance. Methods: From 6 mammographic registries, 119 community-based radiologists were recruited to assess 1 of 4 randomly assigned test sets of 109 screening mammograms with comparison studies for no recall or recall, giving the most significant finding type (mass, calcifications, asymmetric density, or architectural distortion) and location. The mean proportion of agreement with an expert radiology panel was calculated by cancer status, finding type, and difficulty level of identifying the finding at the patient, breast, and lesion level. Concordance in finding type between study radiologists and the expert panel was also examined. For each finding type, the proportion of unnecessary recalls, defined as study radiologist recalls that were not expert panel recalls, was determined. Results: Recall agreement was 100% for masses and for examinations with obvious findings in both cancer and noncancer cases. Among cancer cases, recall agreement was lower for lesions that were subtle (50%) or asymmetric (60%). Subtle noncancer findings and benign calcifications showed 33% agreement for recall. Agreement for finding responsible for recall was low, especially for architectural distortions (43%) and asymmetric densities (40%). Most unnecessary recalls (51%) were asymmetric densities. Conclusions: Agreement in mammographic interpretation was low for asymmetric densities and architectural distortions. Training focused on these interpretations could improve the accuracy of mammography and reduce unnecessary recalls.

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