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Can a limited double reading/second opinion of initially recalled breast ultrasound screening examinations improve radiologists' performances?
Author(s): David Gur; Kimberly Harnist; Terri-Ann Gizienski; Margarita Zuley; Christiane Hakim; Amy Lu; Jules Sumkin; Gordon Abrams; Marie A. Ganott; Amy E Kelly; Cathy S. Tyma; Thomas Chang; Marcella Bӧhm-Vélez; Robin Sobolewski
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Paper Abstract

Interpretations of breast ultrasound screening examinations result in high recall rates and large inter-radiologist variability, frequently leading to “conservative” recommendations. Double reading of all breast ultrasound screening examinations is cost prohibitive, but double reading of only “initially recalled” cases may prove efficacious. We assessed changes in recommendations, if any, by providing a consensus second opinion in a limited subset of examinations initially recommended for recall. We performed a retrospective reader study with 197 ultrasound examinations (97 not recalled and 100 recalled clinically). First, we generated a consensus “second opinion” consisting of the majority vote of three independent readings of each case by experienced ultrasound interpreters. During the reader study that followed, if the reader recommended a “recall” and the “consensus second opinion” did not, a message to that effect was displayed and the reader was asked to re-review the exam and re-assess if, knowing the second opinion, a re-rating of the case was warranted. We compared performance levels pre- and post- the second opinion. The second opinion resulted in “no recall” recommendations of 141 cases in the entire set, including four cancer cases missed by all three readers. On average, radiologists received “warning” messages in 30 cases (range 15-50), or in ~15% of cases. Rating changes (downgrades to no recall) occurred in 36 of these cases. These changes resulted in a possible recall rate reduction of 28% in prompted cases or 14% overall recall reduction, while increasing the false negative rate by only one case missed by 2 readers (~1%).

Paper Details

Date Published: 7 March 2018
PDF: 6 pages
Proc. SPIE 10577, Medical Imaging 2018: Image Perception, Observer Performance, and Technology Assessment, 1057710 (7 March 2018); doi: 10.1117/12.2301249
Show Author Affiliations
David Gur, Univ. of Pittsburgh (United States)
Kimberly Harnist, Magee-Womens Hospital (United States)
Terri-Ann Gizienski, Magee-Womens Hospital (United States)
Margarita Zuley, Magee-Womens Hospital (United States)
Christiane Hakim, Magee-Womens Hospital (United States)
Amy Lu, Magee-Womens Hospital (United States)
Jules Sumkin, Magee-Womens Hospital (United States)
Gordon Abrams, Magee-Womens Hospital (United States)
Marie A. Ganott, Magee-Womens Hospital (United States)
Amy E Kelly, Magee-Womens Hospital (United States)
Cathy S. Tyma, Magee-Womens Hospital (United States)
Thomas Chang, Weinstein Imaging Associates (United States)
Marcella Bӧhm-Vélez, Weinstein Imaging Associates (United States)
Robin Sobolewski, Allegheny General Hospital (United States)


Published in SPIE Proceedings Vol. 10577:
Medical Imaging 2018: Image Perception, Observer Performance, and Technology Assessment
Robert M. Nishikawa; Frank W. Samuelson, Editor(s)

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