Does it impact performance metrics when DBT exams are interpreted right away?

There is “no statistically significant difference” in radiologist performance metrics when screening digital breast tomosynthesis (DBT) examinations immediately compared to screening them later when the patient has left the facility, according to a new study published by Academic Radiology.

Many facilities do not interpret screening mammography immediately because prior research has shown it results in a higher rate of false positives. However, the authors noted, there are clear-cut benefits to providing immediate interpretations.

“It has been shown that stress related to being called back for additional imaging is reduced in patients given immediate results who receive immediate additional imaging compared to patients who are scheduled to return at a later date,” wrote lead author Nicole S. Winkler, MD, of the University of Utah’s Huntsman Cancer Institute in Salt Lake City, and colleagues. “The vast majority of patients prefer immediate results of their screening mammogram. The main incentives to provide immediate results are to reduce duration of patient anxiety and to improve patient service.” 

So do facilities have a legitimate reason not to interpret DBT exams right away? Winkler and colleagues retrospectively studied data from more than 5,500 DBT exams, including more than 1,000 interpreted on a delay and more than 4,000 interpreted immediately. Exams interpreted on a delay were performed in 2013-2014, and those interpreted immediately were performed in 2015.

Overall, the group with delayed interpretations had a recall rate (RR) of 6.5 percent, a positive predictive value of recall (PPV1) of 10.1 percent, a positive predictive value of biopsy recommendation (PPV2) of 42.1 percent, a positive predictive value of biopsy performed (PPV3) of 40 percent and a cancer detection rate (CDR) of 6.6 percent.

Meanwhile, the group with immediate interpretations had a RR of 5.3 percent, a PPV1 of 13.6 percent, a PPV2 of 39.2 percent, a PPV3 of 39.7 percent and a CDR of 7.2 percent.

“Our study has shown no statistically significant difference in RR, CDR, false positives or PPV for recall, biopsy recommendation, and biopsy for immediate or delayed interpretation,” the authors wrote.

Winkler et al. added that reducing patient anxiety is a significant benefit of interpreting these