Young Seon Kim1,2, Jung Min Chang1, Ann Yi3, Sung Ui Shin1, Myung Eun Lee1,4, Won Hwa Kim5, Nariya Cho1, Woo Kyung Moon1. 1. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital , Seoul , Republic of Korea. 2. Department of Radiology, College of Medicine, Yeungnam University , Daegu , Republic of Korea. 3. Department of Radiology, Gangnam Healthcare Center, Seoul National University Hospital , Seoul , Republic of Korea. 4. Advanced Institutes of Convergence Technology, Seoul National University , Seoul , Republic of Korea. 5. Department of Radiology, Kyungpook National University Medical Center , Daegu , Republic of Korea.
Abstract
OBJECTIVE: To compare the diagnostic accuracy and efficiency in the interpretation of digital breast tomosynthesis (DBT) images using a picture archiving and communication system (PACS) and a dedicated workstation. METHODS: 97 DBT images obtained for screening or diagnostic purposes were stored in both a workstation and a PACS and evaluated in combination with digital mammography by three independent radiologists retrospectively. Breast Imaging-Reporting and Data System final assessments and likelihood of malignancy (%) were assigned and the interpretation time when using the workstation and PACS was recorded. Receiver operating characteristic curve analysis, sensitivities and specificities were compared with histopathological examination and follow-up data as a reference standard. RESULTS: Area under the receiver operating characteristic curve values for cancer detection (0.839 vs 0.815, p = 0.6375) and sensitivity (81.8% vs 75.8%, p = 0.2188) showed no statistically significant differences between the workstation and PACS. However, specificity was significantly higher when analysing on the workstation than when using PACS (83.7% vs 76.9%, p = 0.009). When evaluating DBT images using PACS, only one case was deemed necessary to be reanalysed using the workstation. The mean time to interpret DBT images on PACS (1.68 min/case) was significantly longer than that to interpret on the workstation (1.35 min/case) (p < 0.0001). CONCLUSION: Interpretation of DBT images using PACS showed comparable diagnostic performance to a dedicated workstation, even though it required a longer reading time. Advances in knowledge: Interpretation of DBT images using PACS is an alternative to evaluate the images when a dedicated workstation is not available.
OBJECTIVE: To compare the diagnostic accuracy and efficiency in the interpretation of digital breast tomosynthesis (DBT) images using a picture archiving and communication system (PACS) and a dedicated workstation. METHODS: 97 DBT images obtained for screening or diagnostic purposes were stored in both a workstation and a PACS and evaluated in combination with digital mammography by three independent radiologists retrospectively. Breast Imaging-Reporting and Data System final assessments and likelihood of malignancy (%) were assigned and the interpretation time when using the workstation and PACS was recorded. Receiver operating characteristic curve analysis, sensitivities and specificities were compared with histopathological examination and follow-up data as a reference standard. RESULTS: Area under the receiver operating characteristic curve values for cancer detection (0.839 vs 0.815, p = 0.6375) and sensitivity (81.8% vs 75.8%, p = 0.2188) showed no statistically significant differences between the workstation and PACS. However, specificity was significantly higher when analysing on the workstation than when using PACS (83.7% vs 76.9%, p = 0.009). When evaluating DBT images using PACS, only one case was deemed necessary to be reanalysed using the workstation. The mean time to interpret DBT images on PACS (1.68 min/case) was significantly longer than that to interpret on the workstation (1.35 min/case) (p < 0.0001). CONCLUSION: Interpretation of DBT images using PACS showed comparable diagnostic performance to a dedicated workstation, even though it required a longer reading time. Advances in knowledge: Interpretation of DBT images using PACS is an alternative to evaluate the images when a dedicated workstation is not available.
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