Article

Population-based mammography screening: comparison of screen-film and full-field digital mammography with soft-copy reading--Oslo I study.

Department of Radiology, Breast Imaging Center, Ullevaal University Hospital, Kirkeveien 166, N-0407 Oslo, Norway.
Radiology (impact factor: 5.73). 01/2004; 229(3):877-84. DOI:10.1148/radiol.2293021171
Source: PubMed

ABSTRACT To compare screen-film and full-field digital mammography with soft-copy reading in a population-based screening program.
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.
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.
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.

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Keywords

31 cancers
 
cancer conspicuity
 
cancer detection rate
 
cancer detection rates
 
external independent radiologist group
 
five-point rating scale
 
Full-field digital
 
full-field digital mammography
 
independent double reading
 
needle biopsy results
 
population-based screening
 
population-based screening program
 
positive predictive value
 
positive predictive values
 
Retrospective side-by-side analysis
 
screen-film
 
screen-film mammography
 
Side-by-side image comparison
 
soft-copy reading
 
statistically significant difference
 

Per Skaane