Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting

Luz A. Venta, R. E. Hendrick, Y. T. Adler, P. DeLeon, P. M. Mengoni, A. M. Scharl, C. E. Comstock, L. Hansen, N. Kay, A. Coveler, G. Cutter

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

OBJECTIVE. This study was performed to determine the rates and causes of disagreements in interpretation between full-field digital mammography and film-screen mammography in a diagnostic setting. SUBJECTS AND METHODS. Patients undergoing diagnostic mammography were invited to participate in the digital mammography study. Three views, selected by the radiologist interpreting the film-screen mammography, were obtained in both film-screen mammography and digital mammography. Radiologists independently assigned a Breast Imaging Reporting and Data System (BI-RADS) category to the film-screen mammography and the digital mammography images. The BI-RADS categories were grouped into the general categories of agreement, partial agreement, or disagreement. A third and different radiologist reviewed all cases of disagreement, reached a decision as to management, and determined the primary cause of disagreement. RESULTS. Six radiologists reviewed digital mammography and film-screen mammography diagnostic images in a total of 1147 breasts in 692 patients. Agreement between digital mammography and final film-screen mammography assessment was present in 937 breasts (82%), partial agreement in 159 (14%), and disagreement in 51 (4%), for a kappa value of 0.29. The primary causes of disagreement were differences in management approach of the radiologists (52%), information derived from sonography or additional film-screen mammograms (34%), and technical differences between the two mammographic techniques (10%). CONCLUSION. Significant disagreement between film-screen mammography and digital mammography affecting follow-up management was present in only 4% of breasts. The most frequent cause of disagreement in interpretation was a difference in management approach between radiologists (interobserver variability). This source of variability was larger than that due to differences in lesion visibility between film-screen mammography and digital mammography.

Original languageEnglish (US)
Pages (from-to)1241-1248
Number of pages8
JournalAmerican Journal of Roentgenology
Volume176
Issue number5
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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