Purpose
Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH study) is a nation-wide project recruiting women aged less than 40 years or carrying germline mutations of BRCA 1 or 2 (1). The primary outcome of POSH Radiology review is radiological features of breast cancer in women in this population which may be predictive of genetic, pathological factors or outcomes, and which may impact on patient care or screening. The secondary outcome includes mammographic features of the background breast such as mammographic density. The...
Methods and Materials
Study population and image preparationStudy population consisted of subgroup of women in the POSH study whose diagnostic analogue images (mammogram films and ultrasound images printed either on films or thermal paper) were available for both digitisation and film-reading by our radiologist. Diagnostic images of eligible women from 29 hospitals were sent to our hospital and digitized. Analogue mammograms and ultrasound films were digitized by an Array laser 2905 film digitizer (Array Corporation USA, Hampton, NH, USA) with following setting; output format: dicom, resolution: 50 micro...
Results
This pilot analysis included mammograms from 77 patients (154 sides). Final category of web-based and film-based reading agreed completely in 122 out of 154 breasts (79%, weighted kappa value, 0.82). Margin of the mass agreed in 34 out of 48 breasts (71%) . Although calcification type disagreed in 11out of 23 breasts, 7 were of adjacent categories (See table).
Conclusion
Final 5-grade assessment of the web-based reviewing system showed good agreement with those of film-based review, although there were variations in description of mass or calcification. Web-based reading is comparable to film review and is a promising tool for multicentre radiology research.
References
1) Eccles D. et al. Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH): study protocol BMC Cancer 2007,7:1602) Reston,VA ,American College of Radiologists .BI-RADS: mammography. Breast imaging reporting and data syatem: BI-RADS atlas, 4th ed.American College of Radiology, 2003.3) Reston,VA ,American College of Radiologists .BI-RADS: ultrasound. Breast imaging reporting and data system: BI-RADS atlas, 4th ed.American College of Radiology, 2003.
Personal Information
Demonstration version of “ImageBox” is available at http://152.78.9.156/imageboxdemo/(username: demo, password :demo) .AcknowledgementsWe appreciate Prof. Diana Eccles and Ms. Sue Gerty (Southampton) for their help in data and image collection. Funding for the POSH Radiology Review has been provided by Breast Cancer Campaign.