student profile: Ms Aarthi Ganesan


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Thesis work

Thesis title: Impact of Breast Screen Reader Assessment Strategy (BREAST) on radiologists� and registrars� performance over the years.

Supervisors: Maram ALAKHRAS, Claudia MELLO-THOMS , Patrick BRENNAN

Thesis abstract:

Background and Purpose
Mammography is the primary screening tool for early detection of breast cancer; however, it may result in approximately 30% of missed cancers [1]. Previous research suggested that the level of radiologists’ experience is one of the most important factors affecting their accuracy in detecting cancers [2]. The determinants of radiologists’ performance include years since certification as screen reader, annual reading volume, hours spent reading mammograms per week and completion of fellowship training [3]. The aim of this study is to evaluate the impact of Breast Screen Reader Assessment Strategy (BREAST) as a training tool by assessing the performance of two separate groups of readers (radiologists and registrars) over the years. In addition, the characteristics of the two groups of readers including age, number of years reading mammograms, completion of fellowship training, number of cases read and number of hours spent reading mammograms per week, will be analysed to identify their impact on radiologists’ and registrars’ breast cancer detection performance using BREAST.

Methods
Breast Screen Reader Assessment Strategy (BREAST), an online testing platform, enables assessment of clinicians’ performance, including radiologists, registrars and breast physicians, in detecting breast cancer using digital mammograms. It allows participants to read test-sets of 60 digital mammograms, report cancerous cases, mark the location of the abnormalities and rate them on a scoring scale of 1-5 (1-“normal”, 2-“benign”, 3-“equivocal”, 4-“suspicious”, and 5-“malignant”). Radiologists and radiology registrars who completed reading of at least three test-sets using the BREAST platform between Jan 2011 and July 2016 will be included in this study to assess the differences in their performance over time. The five performance measures (sensitivity, specificity, location sensitivity, area under the receiver operating characteristics curve (ROC AUC) and jackknife alternative free-response receiver operating characteristic (JAFROC) figure–of-merit) available from BREAST will be compared between pairs of test-sets for radiologists and registrars separately. The radiologists will be grouped based on their characteristics including age, number of hours spent per week reading mammograms, number of cases read per week, number of years screen reading mammograms and their performance difference between test-sets will be compared. Similarly, registrars will be grouped based on their characteristics including age, years of training and completion of fellowship to compare their performance difference between test-sets.

Significance of the study
This study will help us determine the impact of BREAST over time in improving radiologists’ and registrars’ detection of breast cancer using digital mammography. Also, analysing the characteristics of radiologists and registrars will help us identify which group of readers benefit the most by using BREAST as a training tool in improving their detection performance.

References
1. Brennan, P. C., Trieu, P. D., Tapia, K., Ryan, J., Mello-Thoms, C., & Lee, W. (2014, June). BREAST: A Novel Strategy to Improve the Detection of Breast Cancer. In International Workshop on Digital Mammography (pp. 438-443). Springer International Publishing.
2. Gunderman, R., Williamson, K., Fraley, R., & Steele, J. (2001). Expertise: implications for radiological education. Academic radiology, 8(12), 1252-1256.
3. Rawashdeh, M. A., Lee, W. B., Bourne, R. M., Ryan, E. A., Pietrzyk, M. W., Reed, W. M., ... & Brennan, P. C. (2013). Markers of good performance in mammography depend on number of annual readings. Radiology, 269(1), 61-67.

Selected publications

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Journals

  • Brennan, P., Ganesan, A., Eckstein, M., Ekpo, E., Tapia, K., Mello-Thoms, C., Lewis, S., Juni, M. (2019). Benefits of Independent Double Reading in Digital Mammography: A Theoretical Evaluation of All Possible Pairing Methodologies. Academic Radiology, 26(6), 717-723. [More Information]
  • Ganesan, A., Alakhras, M., Brennan, P., Mello-Thoms, C. (2018). A review of factors influencing radiologists� visual search behaviour. Journal of Medical Imaging and Radiation Oncology, 62(6), 747-757. [More Information]

Conferences

  • Ganesan, A., Alakhras, M., Brennan, P., Lee, W., Tapia, K., Mello-Thoms, C. (2018). Characteristics of the group of radiologists that benefits the most using Breast Screen Reader Assessment Strategy (BREAST). SPIE Medical Imaging 2018: Image Perception, Observer Performance, and Technology Assessment, Bellingham: Society of Photo-Optical Instrumentation Engineers (SPIE). [More Information]

2019

  • Brennan, P., Ganesan, A., Eckstein, M., Ekpo, E., Tapia, K., Mello-Thoms, C., Lewis, S., Juni, M. (2019). Benefits of Independent Double Reading in Digital Mammography: A Theoretical Evaluation of All Possible Pairing Methodologies. Academic Radiology, 26(6), 717-723. [More Information]

2018

  • Ganesan, A., Alakhras, M., Brennan, P., Mello-Thoms, C. (2018). A review of factors influencing radiologists� visual search behaviour. Journal of Medical Imaging and Radiation Oncology, 62(6), 747-757. [More Information]
  • Ganesan, A., Alakhras, M., Brennan, P., Lee, W., Tapia, K., Mello-Thoms, C. (2018). Characteristics of the group of radiologists that benefits the most using Breast Screen Reader Assessment Strategy (BREAST). SPIE Medical Imaging 2018: Image Perception, Observer Performance, and Technology Assessment, Bellingham: Society of Photo-Optical Instrumentation Engineers (SPIE). [More Information]

Note: This profile is for a student at the University of Sydney. Views presented here are not necessarily those of the University.