Background Studies suggest that readers experience perceptual adaptation when interpreting batched screening mammograms, which may serve as a mechanism for improved performance. Purpose To analyze clinical digital breast tomosynthesis (DBT) screening data to evaluate changes in reader performance during sequential batch reading. Materials and Methods This observational retrospective study used data from the radiology information system collected for screening DBT examinations performed from January 2018 to December 2019. The reference standard was established based on pathology results, if applicable, or imaging findings at 1-year follow-up. Examinations were aggregated into batches, defined as a sequence of cases for a given reader with differences in interexamination time of 10 minutes or less. Mixed-effect models were used to evaluate performance and timing across batch positions. Statistical adjustments accounted for potential confounders, including patient characteristics (age, breast density), reading factors (day of week, time of day), and between-reader heterogeneity. Results The dataset included 121 652 examinations (median patient age, 61 years [IQR, 53-69 years]), including 1081 cancers interpreted by 15 radiologists. Unadjusted false-positive rates decreased from an averaged 15.5% at the first within-batch examination to 10.5% after three sequentially read examinations (P < .001), without a significant change in sensitivity (82.6% vs 84.2%; P = .15). The interpretation time consistently decreased, achieving a substantial reduction in longer batches (average 2.8 to 2.2 minutes for noncancer examinations; P < .001). Adjustment for sampling bias and confounders (patient age, breast density, day of week, time of day; all P < .005) reduced the effect on false-positive rates (11.5% to 9.4% after three examinations; P < .001) and interpretation time (3.2 to 2.7 minutes for noncancer examinations; P < .001). Conclusion Radiologists showed improved recall rates and interpretation times without change in sensitivity over the course of batch reading of DBT screening examinations. © RSNA, 2024 See also the editorial by Iima and Satake in this issue.

中文翻译：

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乳腺癌筛查数字乳腺断层合成检查序贯阅读期间读者性能的变化。


背景研究表明，读者在解释批量筛查乳腺 X 光检查时会体验到感知适应，这可能是提高性能的一种机制。目的 分析临床数字乳腺断层合成 （DBT） 筛查数据，以评估连续批量读取期间读者性能的变化。材料和方法 这项观察性回顾性研究使用了 2018 年 1 月至 2019 年 12 月进行的筛查 DBT 检查所收集的放射学信息系统的数据。参考标准是根据病理结果（如果适用）或 1 年随访时的影像学检查结果建立的。检查被汇总成批次，定义为给定读者的一系列案例，审问时间差异为 10 分钟或更短。混合效应模型用于评估批处理位置的性能和时间。统计调整考虑了潜在的混杂因素，包括患者特征（年龄、乳腺密度）、阅读因素（星期几、一天中的时间）和读者之间的异质性。结果 该数据集包括 121 652 次检查 （中位患者年龄，61 岁 [IQR，53-69 岁]），包括 15 名放射科医生解释的 1081 例癌症。未经调整的假阳性率从第一次批次内检查的平均 15.5% 下降到三次顺序读取检查后的 10.5% （P < .001），敏感性没有显着变化 （82.6% 对 84.2%;P = .15）。判读时间持续减少，在较长的批次中实现大幅减少（非癌症检查平均 2.8 至 2.2 分钟;P < .001）.采样偏倚和混杂因素的调整 （患者年龄、乳腺密度、星期几、一天中的时间;均 P < 。005） 降低了对假阳性率的影响 （3 次检查后 11.5% 至 9.4%;P < .001） 和解释时间 （非癌症检查为 3.2 至 2.7 分钟;P < .001）.结论 放射科医生在 DBT 筛查检查的批量读取过程中表现出更高的召回率和解释时间，而敏感性没有变化。© RSNA， 2024 另见 Iima 和 Satake 在本期的社论。