Performance Benchmarks for Screening Breast MR Imaging in Community Practice

被引：74

作者：

Lee, Janie M. ^{[1
]}

Ichikawa, Laura ^{[2
]}

Valencia, Elizabeth ^{[1
]}

Miglioretti, Diana L. ^{[2
,3
]}

Wernli, Karen ^{[2
]}

Buist, Diana S. M. ^{[2
]}

Kerlikowske, Karla ^{[4
]}

Henderson, Louise M. ^{[5
]}

Sprague, Brian L. ^{[6
]}

Onega, Tracy ^{[7
,8
]}

Rauscher, Garth H. ^{[9
]}

Lehman, Constance D. ^{[10
]}

机构：

[1] Univ Washington, Dept Radiol, Seattle, WA 98195 USA

[2] Kaiser Permanente Washington Hlth Res Inst, Seattle, WA USA

[3] Univ Calif Davis, Sch Med, Dept Publ Hlth Sci, Davis, CA 95616 USA

[4] Univ Calif San Francisco, Dept Med Epidemiol & Biostat, San Francisco, CA 94143 USA

[5] Univ N Carolina, Dept Radiol, Sch Med, Chapel Hill, NC USA

[6] Univ Vermont, Dept Surg, Burlington, VT 05405 USA

[7] Norris Cotton Canc Ctr, Lebanon, NH USA

[8] Geisel Sch Med Dartmouth, Lebanon, NH USA

[9] Univ Illinois, Inst Hlth Res & Policy, Chicago, IL USA

[10] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiol, Boston, MA USA

来源：

RADIOLOGY | 2017年 / 285卷 / 01期

关键词：

CANCER SURVEILLANCE CONSORTIUM; DIGITAL MAMMOGRAPHY UPDATE; PERSONAL HISTORY; WOMEN; CRITERIA; SOCIETY; RISK; ACR;

D O I：

10.1148/radiol.2017162033

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To compare screening magnetic resonance (MR) imaging performance in the Breast Cancer Surveillance Consortium (BCSC) with Breast Imaging Reporting and Data System (BI-RADS) benchmarks. Materials and Methods: This study was approved by the institutional review board and compliant with HIPAA and included BCSC screening MR examinations collected between 2005 and 2013 from 5343 women (8387 MR examinations) linked to regional Surveillance, Epidemiology, and End Results program registries, state tumor registries, and pathologic information databases that identified breast cancer cases and tumor characteristics. Clinical, demographic, and imaging characteristics were assessed. Performance measures were calculated according to BI-RADS fifth edition and included cancer detection rate (CDR), positive predictive value of biopsy recommendation (PPV 2), sensitivity, and specificity. Results: The median patient age was 52 years; 52% of MR examinations were performed in women with a first-degree family history of breast cancer, 46% in women with a personal history of breast cancer, and 15% in women with both risk factors. Screening MR imaging depicted 146 cancers, and 35 interval cancers were identified (181 total-54 in situ, 125 invasive, and two status unknown). The CDR was 17 per 1000 screening examinations (95% confidence interval [CI]: 15, 20 per 1000 screening examinations; BI-RADS benchmark, 20- 30 per 1000 screening examinations). PPV 2 was 19% (95% CI: 16%, 22%; benchmark, 15%). Sensitivity was 81% (95% CI: 75%, 86%; benchmark, >80%), and specificity was 83% (95% CI: 82%, 84%; benchmark, 85%-90%). The median tumor size of invasive cancers was 10 mm; 88% were node negative. Conclusion: The interpretative performance of screening MR imaging in the BCSC meets most BI- RADS benchmarks and approaches benchmark levels for remaining measures. Clinical practice performance data can inform ongoing benchmark development and help identify areas for quality improvement.

引用

页码：44 / 52

页数：9

共 25 条

[1]

American College of Radiology, 1992, BREAST IM REP DAT SY

[2]

[Anonymous], 1998, BREAST IMAGING REPOR

[3]

[Anonymous], 2013, ACR BIRADS ATLAS BRE

[4]

[Anonymous], 2015, NCCN CLIN PRACTICE G