Evidence map›Paper›PMID 35907862›Full record

ArticleBreast cancer research : BCR2022

Evaluating the effectiveness of abbreviated breast MRI (abMRI) interpretation training for mammogram readers: a multi-centre study assessing diagnostic performance, using an enriched dataset.

Lyn I Jones, Andrea Marshall, Premkumar Elangovan, Rebecca Geach, Sadie McKeown-Keegan, Sarah Vinnicombe, Sam A Harding, Sian Taylor-Phillips, Mark Halling-Brown, Christopher Foy and 5 more

Abstract readMulticenter Study
In one paragraph

Article in Breast cancer research : BCR, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Lyn I JonesNorth Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK. Lyn@Coppock.uk.com.
Andrea MarshallWarwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.
Premkumar ElangovanScientific Computing, Royal Surrey County Hospital NHS Foundation Trust, Guildford, GU2 7XX, UK.
Rebecca GeachNorth Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK.
Sadie McKeown-KeeganNorth Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK.
Sarah VinnicombeGloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AS, UK.
Sam A HardingNorth Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK.
Sian Taylor-PhillipsWarwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.
Mark Halling-BrownScientific Computing, Royal Surrey County Hospital NHS Foundation Trust, Guildford, GU2 7XX, UK.
Christopher FoyResearch Design Service South West Gloucester Office, National Institute for Health Research (NIHR) Leadon House, Gloucestershire Royal Hospital, Gloucester, GL1 3NN, UK.
Elizabeth O'FlynnSt George's University Hospitals Foundation Trust, London, SW17 0QT, UK.
Hesam GhiasvandInstitute of Health Research, University of Exeter Medical School, Exeter, EX1 2LU, UK.
Claire HulmeInstitute of Health Research, University of Exeter Medical School, Exeter, EX1 2LU, UK.
Janet A DunnWarwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.
FAST MRI Study Group

Funding

Department of Health
6 · The paper itself

Abstract

backgroundAbbreviated breast MRI (abMRI) is being introduced in breast screening trials and clinical practice, particularly for women with dense breasts. Upscaling abMRI provision requires the workforce of mammogram readers to learn to effectively interpret abMRI. The purpose of this study was to examine the diagnostic accuracy of mammogram readers to interpret abMRI after a single day of standardised small-group training and to compare diagnostic performance of mammogram readers experienced in full-protocol breast MRI (fpMRI) interpretation (Group 1) with that of those without fpMRI interpretation experience (Group 2).

methodsMammogram readers were recruited from six NHS Breast Screening Programme sites. Small-group hands-on workstation training was provided, with subsequent prospective, independent, blinded interpretation of an enriched dataset with known outcome. A simplified form of abMRI (first post-contrast subtracted images (FAST MRI), displayed as maximum-intensity projection (MIP) and subtracted slice stack) was used. Per-breast and per-lesion diagnostic accuracy analysis was undertaken, with comparison across groups, and double-reading simulation of a consecutive screening subset.

results37 readers (Group 1: 17, Group 2: 20) completed the reading task of 125 scans (250 breasts) (total = 9250 reads). Overall sensitivity was 86% (95% confidence interval (CI) 84-87%; 1776/2072) and specificity 86% (95%CI 85-86%; 6140/7178). Group 1 showed significantly higher sensitivity (843/952; 89%; 95%CI 86-91%) and higher specificity (2957/3298; 90%; 95%CI 89-91%) than Group 2 (sensitivity = 83%; 95%CI 81-85% (933/1120) p < 0.0001; specificity = 82%; 95%CI 81-83% (3183/3880) p < 0.0001). Inter-reader agreement was higher for Group 1 (kappa = 0.73; 95%CI 0.68-0.79) than for Group 2 (kappa = 0.51; 95%CI 0.45-0.56). Specificity improved for Group 2, from the first 55 cases (81%) to the remaining 70 (83%) (p = 0.02) but not for Group 1 (90-89% p = 0.44), whereas sensitivity remained consistent for both Group 1 (88-89%) and Group 2 (83-84%).

conclusionsSingle-day abMRI interpretation training for mammogram readers achieved an overall diagnostic performance within benchmarks published for fpMRI but was insufficient for diagnostic accuracy of mammogram readers new to breast MRI to match that of experienced fpMRI readers. Novice MRI reader performance improved during the reading task, suggesting that additional training could further narrow this performance gap.

Indexed as

Breast NeoplasmsBreastFemaleHumansMagnetic Resonance ImagingMammographyProspective StudiesSensitivity and SpecificityAbbreviated breast MRIBreast cancerDiagnostic accuracyEducationFAST MRITraining

Identifiers

PMID35907862
PMCPMC9338668

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.