乳腺实质密度对计算机辅助检测诊断乳腺癌的影响  

Impact of breast density on computer-aided detection （ CAD ） of breast cancer

作　　者：杨开颜[1] 刘小娟[1] 翟仁友[1] 

机构地区：[1]首都医科大学附属北京朝阳医院放射科,100020

出　　处：《中华肿瘤杂志》2012年第5期360-363,共4页Chinese Journal of Oncology

基　　金：“十一五”国家科技支撑计划（2007BAI05B05）

摘　　要：目的评价乳腺实质密度对计算机辅助检测（CAD）诊断乳腺癌的影响。方法收集2008年2月至2009年12月问确诊的271例乳腺恶性病变患者及随机抽取的238例正常对照者，依据美国放射学会制定的乳腺影像学报告及数据系统（BI-RADS）标准进行乳腺实质分型，乳腺x线片表现为1型或2型的定义为非致密型乳腺，表现为3型或4型的定义为致密型乳腺。乳腺x线摄影采用全视野数字化乳腺成像x线造影成像系统，常规采用头尾位和内外斜位投照。图像采集完毕后，数据传输到SenoAdvantage回放工作站，由CAD系统对病变组和对照组分别进行标记。对CAD在非致密型乳腺与致密型乳腺问的敏感性和假阳性率进行比较。结果271例乳腺恶性病变患者中，CAD总的敏感性为84．1％（228／271），致密型乳腺与非致密型乳腺之间敏感性比较，差异有统计学意义（P=0．015）。CAD对肿块的敏感性为76．5％（186／243），对钙化的敏感性为79．1％（125／158），二者之间差异无统计学意义（P=0．547）。CAD对肿块的敏感性在致密型乳腺与非致密型乳腺之间差异有统计学意义（P=0．001），对钙化的敏感性在二者之间差异无统计学意义（P=0．216）。正常对照组中，致密型乳腺与非致密型乳腺间假阳性肿块标记差异无统计学意义（P=0．207），假阳性钙化标记差异有统计学意义（P=0．001）；假阳性标记差异有统计学意义（P=0．043）。结论乳腺实质密度影响CAD对乳腺癌探查的敏感性，在非致密型乳腺与致密型乳腺间CAD的敏感性有显著差异；CAD的假阳性率在致密型乳腺中低于非致密型乳腺。对致密型乳腺中无钙化的早期肿块，CAD的探测有明显局限性。Objective To evaluate the impact of breast density on computer-aided detection （CAD） for breast cancer and the CAD false-positive rate of normal controls. Methods Two hundred and seventy-one histologically proven breast malignant lesions （ from Feb. 2008 to Dec. 2009 ） and 238 randomly selected normal cases were classified by mammographic density according to the American College of Radiology breast imaging reporting and data system （BI-RADS）. Mammograms of BI-RADS I or BI-RADS 2 density were categorized as non-dense breasts, and those of BI-RADS 3 or BI-RADS 4 density were categorized as dense breasts. Full-field digital mammography （ GEMS Senographe） were performed in all patients and controls with craniocaudal （CC） and mediolateral oblique （MLO） views. Then the image data were transferred to review workstation （SenoAdvantage） , and the lesions were marked by Second Look Digital CAD system （version 7.2, iCAD ）. The differences of sensitivity and false-positive rate between dense and non-dense breasts were compared. Results Overall, the sensitivity of CAD in detection of cancers was 84.1% （228/271） , there was a statistically significant difference in CAD of cancers in dense versus non-dense breasts （P = 0. 015 ）. The sensitivity of CAD in detection of mass cancers was 76.5% （186/243）, in detection of calcification cancers was 79.1% （125/158）, there was no statistically significant difference in CAD performance for the detection of mass cancers versus calcification cancers （ P = 0.547 ）. There was a significant difference in the CAD performance for the detection of mass cancer cases in non-dense versus dense breasts （P = 0. 001 ） , but no significant difference in the CAD for the detection of calcification cancers in non-dense versus dense breasts （P = 0. 216）. In the controls, the distribution of mass false-positive marks did not differ significantly between non-dense and dense breast tissue eases （ P = 0. 207） ,but the distribution of calcificatio

关 键 词：乳房X线摄影术 数值分析 计算机辅助 乳腺肿瘤 

分 类 号：R737.9[医药卫生—肿瘤]