通过基于促进视觉适应的特征订购筛选乳房X线照片来增强放射科医生的阅读性能

背景乳房X线摄影背景特征可能会刺激人类的视觉适应，从而使放射学家能够更有效地检测异常。但是，尚不清楚密度还是其他图像特征会驱动视觉适应。筛查性能在筛选乳房X线摄影检查检查时是否有所改善，根据乳房X线摄影特征进行批次阅读，以促进视觉适应。材料和方法这项回顾性的多学者多酶研究是通过在2016年9月至2019年5月之间获得的乳房X线照片进行的。筛查检查由13个放射学家以三个不同的顺序解释为四个乳房X线照片，以三个不同的订单进行解释：随机，通过增加自动乳房密度（VBD），并根据自动启用（SSSSSSSS）进行了研究（SSS）（SSL）。 相似的”）。眼睛跟踪器在解释过程中记录了放射科医生的眼动。将接收器工作特性曲线（AUC）下的面积，随机排序读数的灵敏度和特异性与使用差异分析的VBD和SSL订购读数的区域进行了比较。使用Wilcoxon签名的测试比较了阅读时间，固定指标和感知的密度。乳房X线摄影检查（75例患有乳腺癌，75例没有乳腺癌），从150名女性（中位年龄，55岁[IQR，50-63]）中读取。通过增加VBD与随机订购的考试的AUC增加（0.93 [95％CI：0.91，0.96] vs 0.92 [95％CI：0.89，0.95]; p = .009），没有特异性差异的证据（89％[875] vs 86％和975）[86％和975）[875] [875] [8375] s [83] s [835] s [83] s [875] s [875] s [875] sist p.45 n of 975） 81％[975 vs 788 of 975]，p = .78），阅读时间减少（24.3 vs 27.9秒，p <.001），固定计数（47 vs 52，p <.001），以及在恶性区域（3.7 vs 4.6 septims，p <.001，p <.001）。对于SSL排序读数，没有证据表明AUC差异（0.92 [95％CI：0.89，0.95]； P = .70），特异性（84％[820 of 975]，p = .37），敏感性，敏感性（80％[80％[784 of 975]，p = .79），P = .79），MALING COIRTIAN（54），或固定伯爵（54），p = 54，p =。054，p = 0.05。 （4.6秒，p> .99）与随机排序读数相比。与随机排序的读数相比，SSL排序读数的阅读时间明显更高（28.4秒，p = .02）。结论筛查乳房X线摄影检查从低VBD到高VBD的筛查性能改善了筛查性能，同时减少了阅读和固定时间。

Background Mammographic background characteristics may stimulate human visual adaptation, allowing radiologists to detect abnormalities more effectively. However, it is unclear whether density, or another image characteristic, drives visual adaptation. Purpose To investigate whether screening performance improves when screening mammography examinations are ordered for batch reading according to mammographic characteristics that may promote visual adaptation. Materials and Methods This retrospective multireader multicase study was performed with mammograms obtained between September 2016 and May 2019. The screening examinations, each consisting of four mammograms, were interpreted by 13 radiologists in three distinct orders: randomly, by increasing volumetric breast density (VBD), and based on a self-supervised learning (SSL) encoding (examinations automatically grouped as "looking similar"). An eye tracker recorded radiologists' eye movements during interpretation. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of random-ordered readings were compared with those of VBD- and SSL-ordered readings using mixed-model analysis of variance. Reading time, fixation metrics, and perceived density were compared using Wilcoxon signed-rank tests. Results Mammography examinations (75 with breast cancer, 75 without breast cancer) from 150 women (median age, 55 years [IQR, 50-63]) were read. The examinations ordered by increasing VBD versus randomly had an increased AUC (0.93 [95% CI: 0.91, 0.96] vs 0.92 [95% CI: 0.89, 0.95]; P = .009), without evidence of a difference in specificity (89% [871 of 975] vs 86% [837 of 975], P = .04) and sensitivity (both 81% [794 of 975 vs 788 of 975], P = .78), and a reduced reading time (24.3 vs 27.9 seconds, P < .001), fixation count (47 vs 52, P < .001), and fixation time in malignant regions (3.7 vs 4.6 seconds, P < .001). For SSL-ordered readings, there was no evidence of differences in AUC (0.92 [95% CI: 0.89, 0.95]; P = .70), specificity (84% [820 of 975], P = .37), sensitivity (80% [784 of 975], P = .79), fixation count (54, P = .05), or fixation time in malignant regions (4.6 seconds, P > .99) compared with random-ordered readings. Reading times were significantly higher for SSL-ordered readings compared with random-ordered readings (28.4 seconds, P = .02). Conclusion Screening mammography examinations ordered from low to high VBD improved screening performance while reducing reading and fixation times.