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

L. 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

*Corresponding author for this work

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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    Venta, L. A., Hendrick, R. E., Adler, Y. T., DeLeon, P., Mengoni, P. M., Scharl, A. M., Comstock, C. E., Hansen, L., Kay, N., Coveler, A., & Cutter, G. (2001). Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting. American Journal of Roentgenology, 176(5), 1241-1248. https://doi.org/10.2214/ajr.176.5.1761241