PACS和专用工作站对数字乳腺断层合成摄影图像解释的对比研究

The comparative study of PACS and special workstation in interpretation of digital mammography images

目的比较使用医学影像归档和通信系统(PACS)和专用工作站解释数字乳腺断层合成摄影(DBT)图像的诊断准确性和效率.方法在工作站和PACS上由三位独立的观察者回顾性分析108例为了筛查或诊断目的而获得的DBT图像,并与数字乳腺X线摄影组合进行评估.分析BI-RADS和恶性肿瘤的可能性,并记录使用工作站和PACS时的图像阅片时间.与组织病理学结果和随访数据作为参考标准进行比较,利用受试者工作特征曲线分析敏感性和特异性.结果工作站和PACS乳腺癌检测的ROC曲线下面积分别为0.824、0.790(P=0.689),敏感性分别为82.6%、78.3%(P=0.219).在工作站上进行分析时,特异性高于使用PACS(82.4%vs74.1%,P=0.025).在使用PACS评估DBT图像时,只有1例需要使用工作站进行重新分析.在PACS(1.67min/例)上解释DBT图像的平均时间长于在工作站上的阅片时间(1.30min/例)(P=0.009).结论使用PACS解释DBT图像显示出与专用工作站相当的诊断性能.

Objective To compare the diagnostic accuracy and efficiency of digital breast tomosynthesis(DBT)images using PACS and dedicated workstation.Methods A total of 108 DBT images obtained for screening or diagnostic purposes were retrospectively analyzed by three independent observers on workstations and PACS and evaluated in combination with digital mammography.The BI-RADS and the likelihood of malignancy were analyzed and the interpretation time was recorded when using workstations and PACS.The histopathological findings and follow-up data were compared as reference standards and the receiver operating characteristic curves were used to analyze the sensitivity and specificity.Results The area under ROC curve of workstation and PACS for breast cancer detection were 0.824 and 0.790,respectively(P=0.689),with sensitivity of 82.6%and 78.3%,respectively(P=0.219).Specificity was higher on the workstation than on the PACS(82.4%vs 74.1%,P=0.025).When using PACS to evaluate DBT images,only one case required a workstation for reanalysis.The average time to interpret DBT images on PACS(1.67 minutes/case)was longer than on the dedicated workstation(1.30 minutes/case)(P=0.009).Conclusion The use of PACS to interpret DBT images shows comparable diagnostic performance to dedicated workstation.