Abstract
Purpose
To evaluate radiology residents' performance in screening mammography interpretation and to analyze the factors affecting performance.
Materials and Methods
We enrolled 203 residents from 21 institutions and performed mammography interpretation tests. Between the trainee and non-trainee groups, we compared the interpretation score, recall rate, sensitivity, positive predictive value (PPV) and false-positive rate (FPR). We estimated the training effect using the score differences between trainee and non-trainee groups. We analyzed the factors affecting performance between training-effective and non-effective groups.
Results
Trainees were superior to non-trainees regarding interpretation score (43.1 vs. 37.1), recall rate (11.0 vs. 15.5%), sensitivity (83.6 vs. 72.0%), PPV (53.0 vs. 32.4%) and FPR (13.5 vs. 25.5). The longer the training period, the better were the interpretation score, recall rate, sensitivity, PPV and FPR (rho = 0.486, -0.375, 0.343, 0.504, -0.446, respectively). The training affected an increase by an average of 6 points; however, 31.6% of institutions showed no effect. A difference was noted in the volume of mammography interpretation during a month (594.0 vs. 476.9) and dedication of breast staff (61.5 vs. 0%) between training-effective and non-effective groups.
Figures and Tables
Fig. 1
Radiology residents' training effect of breast imaging according to institutions.
Note.-Dotted line = mean level of training effect, Training effect = score difference between trainee and non-trainee groups in the institution
![jksr-68-333-g001](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-g001.jpg)
Fig. 2
A 56-year-old woman with screening-detected invasive ductal carcinoma in her right breast. Right craniocaudal (CC) view (A) shows an irregular spiculated mass (arrow) in the mid portion that is a small but conspicuous cancer. It was the most common true-positive case. However, not all residents interpreted this mass correctly: 95.9% of trainees and 93.9% of non-trainees were correct. Left CC view (B) shows negative finding.
![jksr-68-333-g002](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-g002.jpg)
Fig. 3
A 46-year-old woman with screening-detected invasive lobular carcinoma in her left breast. Right craniocaudal (CC) view (A) shows negative finding. Left CC view (B) shows an architectural distortion (arrow) with asymmetry in the inner posterior portion. It was the most common false-negative case: 67.8% of trainees and 79.3% of non-trainees missed it.
![jksr-68-333-g003](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-g003.jpg)
Fig. 4
A 56-year-old healthy woman. Right mediolateral oblique (MLO) view (A) shows negative finding. Left MLO view (B) shows an asymmetric-looking normal breast tissue (arrow) in the upper mid portion. Additionally, diffusely scattered calcifications were evident in both breasts. It was the most common false-positive case: 46.3% of trainees and 40.2% of non-trainees recalled the left breast.
![jksr-68-333-g004](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-g004.jpg)
Table 1
Comparison of Performance in Interpretation of Screening Mammography between Trainee and Non-Trainee Groups
![jksr-68-333-i001](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-i001.jpg)
Table 2
Comparison of Performance in Interpretation of Screening Mammography among All Residents, Trainee and Non-Trainee Groups According to Year
![jksr-68-333-i002](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-i002.jpg)
Table 3
Comparison of Radiology Residents' Performance in Interpretation of Screening Mammography According to Training Period
![jksr-68-333-i003](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-i003.jpg)
Table 4
Comparison of Factors Affecting Performance in Interpretation of Screening Mammography between Training-Effective and Non-Effective Groups
![jksr-68-333-i004](/upload/SynapseData/ArticleImage/2016jksr/jksr-68-333-i004.jpg)
Note.-*Statistically significant.
DM = digital mammography, Interval = time interval between breast training and interpretation test, metro = metropolitan area, min = minute, mo = month, Test time = time required to perform interpretation test, Total training = total period of breast training in the institution, Volume of MG = numbers of mammography which a resident reads during one month of training period
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