PMC:2948156 / 15472-18612 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/2948156","sourcedb":"PMC","sourceid":"2948156","source_url":"https://www.ncbi.nlm.nih.gov/pmc/2948156","text":"Identification of cases for further imaging\nTable 2 details individual performance in the identification of cancer cases for further imaging. Mean sensitivity increased from 50% to 81%, an improvement of 63% in the number of cancer cases identified (25.4 vs. 41.4, F(1, 1,161) = 165.95, p \u003c 0.001). Specificity (60–58%; 30.7 vs. 29.1, F(1, 1,161) = 1.11, p = 0.29), PPV (mean = 47–67%; F(1, 1,297) = 0.02, p = 0.89), and NPV (mean = 65–75%; F(1, 933) = 0.61, p = 0.44) did not change significantly with the addition of AWBU.\nTable 2 Reader performance categorized by imaging technique (n = 102, 51 positive cases)\nReader #a True positives True negatives False positives False negatives\nM M+A M M+A M M+A M M+A\n1 28 45 32 21 27 30 15 6\n2 28 45 25 21 33 30 16 6\n3 25 44 30 20 32 31 15 7\n4 26 43 20 28 43 23 13 8\n5 26 43 32 30 28 21 16 8\n6 32 43 20 37 43 14 7 8\n7 26 41 25 27 33 24 18 10\n8 23 40 35 31 17 20 27 11\n9 16 40 43 25 21 26 22 11\n10 27 39 34 36 27 15 14 12\n11 26 37 35 41 24 10 17 14\n12 22 37 37 34 20 17 23 14\nMean # of cases 25.4 41.4 30.7 29.3 29.0 21.8 16.9 9.6\n% of 51 cases 49.8% 81.2% 60.2% 57.5% 56.9% 42.7% 33.1% 18.8%\nMean # of added cases 16.0 −1.4 −7.2 −7.3\nMean % of 51 cases added 31.4% −2.7% −14.1% −14.3%\n% improvement compared with M alone 63% −4% −25% −43%\nM mammography, M+A mammography plus automated whole-breast ultrasound (AWBU)\naReader # presented by best to worst performance based on sensitivity on M+A\nIndividual success varied from 11 to 24 more cancer cases detected by AWBU. As a percentage of the cancers detected with mammography the range in improvement was 42–150%. Not only did all readers find more cancers individually, but all found 16–29% more cancers than the best mammography reader did with mammography alone. For the best performing mammography reader the cancer detections added by AWBU was predictably lower, as more cancers had already been identified with mammography. For the poorest performer on mammography, the addition of AWBU resulted in a 150% improvement, bringing his overall cancer detection rate near the average for the group.\nTable 3 shows the average reader performance by tumor size for the 45 image sets of patients with invasive cancer. The greatest percentage increase was for cancers 1 cm and under. This is due largely to the relatively poor performance at detecting these cancers with mammography, where only 26% of cases were correctly identified. By adding AWBU, the detection of these small cancers was increased to 65%.\nTable 3 Reader performance with 45 invasive cases\n≤1 cm \u003e1 to ≤2 cm \u003e2 cm Total\n# % # % # % # %\n# of cancers 17 100 22 100 6 100 45 100\nMean cancers by mammography 4.4 26 13.5 61 3.0 50 20.9 46\nMean additional cancers by AWBU 6.7 39 6.6 30 2.0 33 15.3 34\nMean total cases detected 11.1 65 20.1 91 5.0 83 36.2 80\n% improvement compared to mammography alone 151% 49% 67% 73%\nFor cases with more than one invasive tumor, the larger of the two was used. For interval cancers after imaging, size is the greatest diameter of the tumor seen retrospectively on the AWBU or mammogram, otherwise the diameter is that reported by pathological 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