Efficacy of a one day training day for reporting Contrast Enhanced Mammography

Background: Rapid uptake of contrast enhanced mammography (CEM) in the UK is driving the need to train mammography readers in this technique. We assessed the efficacy of a one-day training course through comparison of delegates responses with that of an experienced reader.

Methods: Following a series of tutorials, participants were given a series of anonymous CEM studies with relevant clinical details. All CEM studies were acquired as part of a prospective study and had at least three years follow-up. All were initially reported by an experienced reader. Participants were asked to grade images and any lesions to suspicion level. Analysis was performed at lesion level, a true positive was defined as a cancer graded 3-5 on CEM, a false positive a benign lesion or normal breast on 3-year follow-up graded 3-5 on CEM.

Results: 16 patients with 18 lesions (16 malignant, 2 benign) were included. Data from seven delegate readers was analysed. All delegates reported >3000 mammograms per annum in routine clinical practice. Diagnostic accuracy for the delegate readers was, sensitivity: 76.588.2%, specificity 72.2-94.4% and accuracy 80.0-91.4%. The experienced reader had a sensitivity of 93.8%, specificity of 90.0% and accuracy of 91.7%. The results for all readers are consistent with the published literature. There was no significant difference between any of the delegate readers and the experienced reader, p > 0.05.

Conclusion: Training CEM readers is essential as CEM is adopted into clinical practice. Our results are promising, suggesting competence may be achieved with an intensive one-day training course.