Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Interobserver Variability in the Interpretation of Microcalcifications in Digital Magnification Mammographies

디지털확대유방촬영술에서 미세석회화 분석에 대한 판독자간 일치도

  • Jeon, Su-Jin (Department of Radiology, National Health Insurance Corporation Ilsan Hospital) ;
  • Kim, Min-Jung (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Kim, Eun-Kyung (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Son, Eun-Ju (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Youk, Ji-Hyun (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Kwak, Jin-Young (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Choi, Seon-Hyeong (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine)
  • 전수진 (국민건강보험공단 일산병원 영상의학과) ;
  • 김민정 (연세대학교 의과대학 영상의학과) ;
  • 김은경 (연세대학교 의과대학 영상의학과) ;
  • 손은주 (연세대학교 의과대학 영상의학과) ;
  • 육지현 (연세대학교 의과대학 영상의학과) ;
  • 곽진영 (연세대학교 의과대학 영상의학과) ;
  • 최선형 (연세대학교 의과대학 영상의학과)
  • Received : 2009.12.31
  • Accepted : 2010.08.02
  • Published : 2010.10.01
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Abstract

Purpose: To analyze the interobserver variability of radiologists in their description and final assessment categories of microcalcifications in digital magnification mammographies. Materials and Methods: From 2005 to 2006, five radiologists analyzed 66 lesion microcalcifications in 65 patients on digital magnification mammographies using a blind method and including 40 benign and 26 malignant lesions. Each observer evaluated the microcalfication morphology, distribution, and BIRADS$^{(R)}$ category. Using the kappa value, the degree of interobserver agreement was calculated and the rate of malignancy was assessed. Results: The mean kappa value for microcalcification morphology was 0.19, which was considered to be moderate agreement for the microcalcification distribution (k: 0.54). The overall rate of malignancy was 39% for microcalcification morphology and distribution. Among them, amorphous microcalcifications showed the lowest rate of malignancy (17%). The mean kappa value for the final assessment categories of BI-RADS$^{(R)}$ was 0.29 and the mean rate of malignancy was 39%. Conclusion: Although there was slight interobserver variability, according to each of the descriptors, the general interobserver agreement in interpretation of microcalcification on digital magnification mammogram was slight to moderate. To improve interobserver agreement for the interpretation of microcalcifications, proper image quality control, standardization of criteria, and proper training of radiologists are needed.

목적: 디지털확대유방촬영술에서 미세석회화의 분석과 최종 결론에 대한 판독자들 간의 일치도를 평가하고자 하였다. 대상과 방법: 2005년부터 2006년까지 디지털확대유방촬영술을 실시한 65명의 환자에서 66예의 미세석회화를 대상으로 5명의 판독자들로 하여금 맹검법으로 판독하도록 하였으며 40예의 양성과 26예의 악성이 포함되었다. 미세석회화의 모양, 분포 및 BIRADS$^{(R)}$. 범주에 대해 판독한 후 kappa 값을 이용하여 판독자간 일치도과 악성 예측치를 평가하였다. 결과: 미세석회화 모양에 대한 일치도는 평균 Kappa 값이 0.19였으며, 분포에 대한 일치도는 평균 Kappa 값이 0.54로 중등도의 일치도 값을 보였다. 모양과 분포에 대한 총 악성 예측치는 39%를 보였다. 이 중 무정형 미세석회화는 악성 예측치가 17%로 가장 낮은 값을 보였다. BIRADS$^{(R)}$. 범주에 따른 판독자간의 일치도와 악성 예측치는 각각 Kappa 값이 0.29와 39%의 악성 예측치를 보였다. 결론: 디지털확대유방촬영술에서 미세석회화 분석의 일치도는 양상에 따라 약간의 차이를 보였으나 전반적으로 불량하거나 중등도 정도의 값을 보였다. 앞으로 미세석회화 분석의 일치도를 향상하기 위해 적절한 영상의 질 관리, 판독 기준의 표준화와 판독자들의 적절한 훈련이 필요하겠다.

Keywords

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