Isabelle Théberge1, Marie-Hélène Guertin2, Nathalie Vandal2, Jean-Marc Daigle2, Michel-Pierre Dufresne3, Nancy Wadden4, Rene Shumak5, Caroline Samson6, André Langlois2, Isabelle Larocque2, Linda Perron7, Éric Pelletier2, Jacques Brisson8. 1. Institut national de santé publique du Québec, Quebec City, Québec, Canada; Département de médecine sociale et préventive, Faculté de Médecine, Université Laval, Quebec City, Québec, Canada. Electronic address: isabelle.theberge@inspq.qc.ca. 2. Institut national de santé publique du Québec, Quebec City, Québec, Canada. 3. Département de Radiologie, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada. 4. Faculty of Medicine, Memorial University, St John's, Newfoundland, Canada. 5. Department of Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada. 6. Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Département de radiologie, radio-oncologie et médecine nucléaire, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada. 7. Institut national de santé publique du Québec, Quebec City, Québec, Canada; Département de médecine sociale et préventive, Faculté de Médecine, Université Laval, Quebec City, Québec, Canada; Département de santé publique et médecine préventive, CHU de Québec-Université Laval, Hôpital Saint-François d'Assise, Quebec City, Québec, Canada. 8. Institut national de santé publique du Québec, Quebec City, Québec, Canada; Département de médecine sociale et préventive, Faculté de Médecine, Université Laval, Quebec City, Québec, Canada; Axe Oncologie, Centre de Recherche du CHU de Québec, Quebec City, Québec, Canada.
Abstract
PURPOSE: The study sought to examine the association between clinical image quality of mammograms and screening sensitivity. METHODS: Four radiologists evaluated the clinical image quality of 374 invasive screen-detected cancers and 356 invasive interval breast cancers for which quality evaluation of screening mammograms could be assessed from cancers diagnosed among participants in the Quebec Breast Cancer Screening Program in 2007. Quality evaluation was based on the Canadian Association of Radiologists accreditation criteria, which are similar to those of the American College of Radiology. The association between clinical quality and screening sensitivity was assessed by logistic regression. Adjusted sensitivity and adjusted sensitivity ratios were obtained through marginal standardization. No institutional review board approval was required. RESULTS: A proportion of 28% (206 of 730) of screening mammograms had lower overall quality for the majority of assessments. Positioning was the quality attribute that was the most frequently deficient. The 2-year screening sensitivity reached 68%. Sensitivity of screening was not statistically associated with the overall quality (ratio of 2-year sensitivity = 1.03; 95% confidence interval: 0.93-1.15) or with any quality attributes (positioning, exposure, compression, sharpness, artifacts, contrast). Results were similar for the 1-year sensitivity. CONCLUSIONS: Although not all mammograms in the Quebec screening program met the optimum quality required by the Canadian Association of Radiologists or American College of Radiology accreditation, the screening mammograms produced in this population-based organized screening program reached a high enough level of quality so that the remaining variation in quality is too little to impair screening sensitivity.
PURPOSE: The study sought to examine the association between clinical image quality of mammograms and screening sensitivity. METHODS: Four radiologists evaluated the clinical image quality of 374 invasive screen-detected cancers and 356 invasive interval breast cancers for which quality evaluation of screening mammograms could be assessed from cancers diagnosed among participants in the Quebec Breast Cancer Screening Program in 2007. Quality evaluation was based on the Canadian Association of Radiologists accreditation criteria, which are similar to those of the American College of Radiology. The association between clinical quality and screening sensitivity was assessed by logistic regression. Adjusted sensitivity and adjusted sensitivity ratios were obtained through marginal standardization. No institutional review board approval was required. RESULTS: A proportion of 28% (206 of 730) of screening mammograms had lower overall quality for the majority of assessments. Positioning was the quality attribute that was the most frequently deficient. The 2-year screening sensitivity reached 68%. Sensitivity of screening was not statistically associated with the overall quality (ratio of 2-year sensitivity = 1.03; 95% confidence interval: 0.93-1.15) or with any quality attributes (positioning, exposure, compression, sharpness, artifacts, contrast). Results were similar for the 1-year sensitivity. CONCLUSIONS: Although not all mammograms in the Quebec screening program met the optimum quality required by the Canadian Association of Radiologists or American College of Radiology accreditation, the screening mammograms produced in this population-based organized screening program reached a high enough level of quality so that the remaining variation in quality is too little to impair screening sensitivity.
Authors: M Goossens; I De Brabander; J De Grève; C Van Ongeval; P Martens; E Van Limbergen; E Kellen Journal: BMC Cancer Date: 2019-10-28 Impact factor: 4.430