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Does Interpretation of Digital Mammograms Take Longer?

April 28, 2009
Written by: , Filed in: Breast Imaging
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Does Interpretation of Digital Mammograms Take Longer?

A recent study set out to investigate interpretation times of digital mammograms versus film-screen mammograms, also considering additional variables such as number of views and presence or absence of comparison studies.

The results, published in a recent issue of AJR, found that regardless of confounding variables, interpretation of a digital mammogram is consistently longer than that of film-screen mammography.

The Study
Over the course of 9 months, interpretation times of 4 separate readers were recorded while the readers read actual clinical cases and mammograms.

Methodology
Readers were either assigned to digital or film-screen mammograms at any given session, with no mixing of the modalities at a single interpretation session.

Reports regarding the mammograms were dictated via the same automated report-entering program for both modalities.

Post-residency experience for the 4 readers ranged from 1 to 16 years.

A trained observer recorded the beginning and end times required by each reviewer for each case. Interpretations of the mammograms did not include the input of a resident or fellow.

Variables that were also recorded included number of images per case, whether the study was unilateral or bilateral, the presence or absence of breast implants, and whether the radiologist was involved in hanging the films.

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Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast

Results
Timed interpretations were performed for 17 batches of film-screen mammograms and 26 batches of digital mammograms, with an average of 11 cases per batch.

A total of 457 studies were included in the analysis, 268 of which were digital.

The average interpretation time for all readers was 240 seconds for digital mammograms and 127 seconds for film-screen mammograms.

There was a difference of 129 seconds between average time of the fastest reader versus the slowest reader for digital mammograms, and a difference of 76 seconds for film-screen mammograms.

The differences were statistically significant for all variables, except when it was recorded that the radiologist hung the films. The difference in the number of digital mammograms having ≥4 studies compared to film-screen mammography was statistically significant, causing the authors to suggest a possible reason for the apparent increased time for digital mammography.

Reviewer’s Comments
Regardless of confounding variables, interpretation of a digital mammogram is consistently longer than that of film-screen mammography.

Here is another study that demonstrates increased time in interpreting digital mammograms compared with film-screen mammograms.

The significance of this study is that it showed no difference when accounting for BI-RADs category, the presence or absence of comparison films, or whether the reader personally hung additional films.

Author: Basil Hubbi, MD

Reference:
Haygood TM, Wang J, et al. Timed Efficiency of Interpretation of Digital and Film-Screen Screening Mammograms. AJR; 2009;192 (January): 216-220

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Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast
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