Study finds link between technologist and radiologist performance in mammography

The performance of a radiologist when interpreting screening mammography varies according to which mammographic technologist performs the examination, according to a study in March issue of Academic Radiology.

In the study, researchers led by Louise Henderson, PhD, of the department of radiology at the University of North Carolina, retrospectively analyzed Carolina Mammography Registry data from 372 radiologists and 356 mammographic technologists from 1994 to 2009 who performed 1,003,276 screening mammograms. 

Of the 356 technologists, 343 performed 889,347 screen-film mammography exams, 51 performed 113,929 full-field digital mammography examinations, while 38 performed both.

The researchers looked at recall rates, sensitivity, specificity, positive predictive value, and cancer detection rate of the screening mammograms, finding “significant” variability in the recall rates, sensitivity, specificity, and cancer detection rate depending on the radiologic technologists performing the exam (while controlling for the radiologist interpreting the exam).

This variability was consistent between the imaging modalities. For positive predictive value, however, variability by technologist was found for film mammography but not for digital mammography.

Why this variability? The researchers suggested it could depend on the technologist’s work experience, education and training, or the amount of communication a technologist has with a radiologist.

Henderson and her colleagues said that considering the important role technologists play in a screening examination—positioning the patient and generating images being prime examples—the results of the study seem “reasonable” and that further studies could help explain these variations.