Purpose: We investigated the clinical utility of a radiological technologist's (RT)'s reports (RRs) as a second opinion by the free-response receiver operating characteristic (FROC) observer study that compared the performance of medical doctors' (MDs') reading of digital mammogram with and without consulting the RR.
Method: One hundred women (39 malignant, 61 benign or normal) who underwent diagnostic mammography were selected from among 1674 routine clinical images classified by the degree of difficulty and categories for inclusion in the FROC study. The first FROC study performed by three RTs (RT 1-3) was conducted to collect the data for RR utilized in the second FROC study. The second FROC study was performed by five MDs, and the statistical significance of MDs' performances with and without reference to the RR was investigated by figure of merit (FOM).
Result: The FOM values of three RTs obtained in the first FROC study were 0.529, 0.576, and 0.539, respectively. In the second FROC study, RT 2 had the highest FOM, RT 1 the lowest false positives/case, and RT 3 the highest sensitivity. The average FOM values in the second FROC study for the five MDs with/without reference to the RR were as follows: RT 2's RR was 0.534/0.588 (p=0.003), RT 1's RR was 0.500/0.545 (p=0.099), and RT 3's RR was 0.569/0.592 (p=0.324).
Conclusion: We concluded that the MDs' performance of reading mammogram was statistically improved by consulting the RR when the RT's reading skill was high.
Keywords: free-response receiver operating characteristic (FROC) observer study; mammogram; radiological technologist’s report.