PURPOSE
To compare screen-film and full-field digital mammography with soft-copy reading in a population-based screening program.
MATERIALS AND METHODS
Full-field digital and screen-film mammography were performed in 3,683 women aged 50-69 years. Two standard views of each breast were acquired with each modality. Images underwent independent double reading with use of a five-point rating scale for probability of cancer. Recall rates and positive predictive values were calculated. Cancer detection rates determined with both modalities were compared by using the McNemar test for paired proportions. Retrospective side-by-side analysis for conspicuity of cancers was performed by an external independent radiologist group with experience in both modalities.
RESULTS
In 3,683 cases, 31 cancers were detected. Screen-film mammography depicted 28 (0.76%) malignancies, and full-field digital mammography depicted 23 (0.62%) malignancies. The difference between cancer detection rates was not significant (P =.23). The recall rate for full-field digital mammography (4.6%; 168 of 3,683 cases) was slightly higher than that for screen-film mammography (3.5%; 128 of 3,683 cases). The positive predictive value based on needle biopsy results was 46% for screen-film mammography and 39% for full-field digital mammography. Side-by-side image comparison for cancer conspicuity led to classification of 19 cancers as equal for probability of malignancy, six cancers as slightly better demonstrated at screen-film mammography, and six cancers as slightly better demonstrated at full-field digital mammography.
CONCLUSION
There was no statistically significant difference in cancer detection rate between screen-film and full-field digital mammography. Cancer conspicuity was equal with both modalities. Full-field digital mammography with soft-copy reading is comparable to screen-film mammography in population-based screening.
[1]
R E Hendrick,et al.
Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting.
,
2001,
AJR. American journal of roentgenology.
[2]
J M Lewin,et al.
Comparison of full-field digital mammography with screen-film mammography for cancer detection: results of 4,945 paired examinations.
,
2001,
Radiology.
[3]
L. Tabár,et al.
Beyond randomized controlled trials
,
2001,
Cancer.
[4]
Craig A. Beam,et al.
Variability in the interpretation of screening mammograms by US radiologists. Findings from a national sample.
,
1996,
Archives of internal medicine.
[5]
J. Elmore,et al.
Variability in radiologists' interpretations of mammograms.
,
1994,
The New England journal of medicine.
[6]
D Resnick,et al.
Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath.
,
2000,
Radiology.