title: Time to diagnosis and performance levels during repeat interpretations of digital breast tomosynthesis: preliminary observations.
abstract: OBJECTIVE
  To compare time to interpretation and diagnostic performance levels during repeat readings of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in a retrospective study.
  
  
  METHODS
  Three experienced radiologists twice interpreted 125 selected examinations, 35 with verified cancers and 90 negative for cancer during a period of 22 months using FFDM alone followed by a combined FFDM + DBT mode. Changes in time to "review and rate" these examinations as well as in diagnostic performance levels where assessed. A fixed-effect analysis accounting for cross-correlation due to the review of the same examinations by the same readers was performed.
  
  
  RESULTS
  The total (combined) time to review and rate an examination increased on average by 33% between the first and second readings of the same examinations (P < .001). Radiologists reduced their time to review FFDM before making the DBT available for viewing. However, they spent more time reviewing the combined FFDM + DBT mode. The recall rates for examinations depicting cancer remained largely unchanged. Among the groups of examinations with concordant and discordant recall recommendations during the two readings only the group examinations that were "newly recalled" during repeat reading, took significantly longer (P < .01).
  
  
  CONCLUSIONS
  DBT-based breast imaging may ultimately result in a substantial increase in performance; however, without efficiency improvements DBT may take longer to interpret. Addition of "false-positive recalls" was most strongly associated with increase in interpretation time while elimination of "false-positive recalls" did not require longer interpretation time.
authors.affiliation: Department of Radiology, Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, PA 15213, USA. zuleyml@upmc.edu
authors.forename: Margarita L
authors.initials: ML
authors.lastname: Zuley
authors.forename: Andriy I
authors.initials: AI
authors.lastname: Bandos
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Abrams
authors.forename: Cathy
authors.initials: C
authors.lastname: Cohen
authors.forename: Christiane M
authors.initials: CM
authors.lastname: Hakim
authors.forename: Jules H
authors.initials: JH
authors.lastname: Sumkin
authors.forename: John
authors.initials: J
authors.lastname: Drescher
authors.forename: Howard E
authors.initials: HE
authors.lastname: Rockette
authors.forename: David
authors.initials: D
authors.lastname: Gur
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010414:Pennsylvania / Q000453:epidemiology; D011361:Professional Competence / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016526:Workload / Q000706:statistics & numerical data*