Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Breast Ultrasound Computer-Aided Diagnosis: Analysis of Types of Errors

유방 초음파 컴퓨터 진단: 오류 유형 분석

  • Jeong, Min Kyung (Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kang, Bong Joo (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Eunjeong (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Sung Hun (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 정민경 (가톨릭대학교 의과대학 성빈센트병원 영상의학과) ;
  • 강봉주 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 김은정 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 김성헌 (가톨릭대학교 의과대학 서울성모병원 영상의학과)
  • Received : 2017.11.22
  • Accepted : 2018.05.31
  • Published : 2018.09.01
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Abstract

Purpose: The aim of this study was to evaluate the diagnostic performance of breast ultrasound (US) computer-aided diagnosis (CAD) to distinguish between benign and malignant lesions and analyze features of lesions interpreted with errors retrospectively. Materials and Methods: Three hundred and sixteen women with 375 breast lesions were enrolled. We assessed the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Additionally, we evaluated the causes and patterns of the misinterpretation in the false positive and negative groups. Results: The accuracy, sensitivity, specificity, PPV, and NPV of breast US-CAD were 80.3%, 83.3%, 79.8%, 37.7%, and 97.0%, respectively. There were 8 false negative lesions that were oval in shape and in parallel orientation. There were 66 false positive lesions. The greatest number of errors entailed inappropriate demarcation due to heterogeneous echogenicity, etc. The second exhibited suspicious features with good demarcation and description but were confirmed as benign histologically. The third entailed a benign lesion with suspicious features, such as abscesses. The smallest portion with good demarcations and descriptions indicating benign status exhibited possible malignancy as a final conclusion. Conclusion: Breast US-CAD is expected to be helpful in avoiding unnecessary biopsies due to its high NPV. Therefore, operators need to know the characteristics of lesions prone to misinterpretation.

목적: 이 연구의 목적은 유방 초음파 컴퓨터 진단(computer-aided diagnosis; 이하 CAD)의 양성과 악성을 구별하는 진단능을 알아보고 이 때 발생한 오류 유형을 후향적으로 분석하는데 있다. 대상 및 방법: 316명의 여성에게서 발견된 375개의 병변을 대상으로 정확도, 민감도, 특이도, 양성예측치, 음성예측치를 계산하였다. 위양성 및 위음성 그룹에서 진단 오류의 원인과 유형을 분석하였다. 결과: 유방 초음파 CAD의 정확도, 민감도, 특이도, 양성예측치, 음성예측치는 각각 80.3%, 83.3%, 79.8%, 37.7%, 97.0%였다. 8개의 위음성 병변은 모두 타원형과 피부 평형 방향이었다. 위양성 병변은 66개였고 4가지 유형으로 분류되었다. 가장 많은 수의 첫 번째 유형은 불균인한 에코발생도 등으로 인해 병변의 경계를 틀리게 그려져서 발생하였다. 두 번째 유형은 병변의 경계를 맞게 그리고 악성을 시사하는 적절한 기술을 했지만 병리에서 양성이 나왔다. 세 번째 유형은 농양 등 양성 병변이 악성처럼 보였다. 가장 적은 수의 마지막 네 번째 유형은 병변의 경계를 맞게 그리고 양성을 시사하는 적절한 기술을 했지만 CAD가 최종 진단을 악성으로 내렸다. 결론: 유방 초음파 CAD의 높은 음성예측치는 불필요한 조직검사를 감소시킬 것으로 기대된다. 따라서, 유방 초음파를 시행하는 의사는 CAD의 진단 오류 특징에 대해서 이해할 필요가 있다.

Keywords

Acknowledgement

Supported by : Korea Health Industry Development Institute (KHIDI)

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