背景：制定针对乳腺X线摄影筛查性能的基准值，对于提高质量至关重要。目的：制定数字乳腺断层摄影（DBT）筛查性能基准值，并评估美国社区实践中性能趋势的变化。材料和方法：本回溯性研究收集了来自五个乳腺癌监测联盟（BCSC）登记处的DBT筛查检查（从2011年至2018年）。性能衡量指标包括异常解释率（AIR）、癌症检出率（CDR）、敏感度、特异度和假阴性率（FNR），根据美国放射学院第五版乳腺影像报告和数据系统计算，并与当前BCSC DM筛查检查、以前发布的BCSC和国家乳腺X线摄影数据库基准以及专家意见可接受性能范围进行比较，基准值通过对放射科医生（n=84或n=73，具体取决于指标）的性能指标分布进行制定，并以百分位数的形式呈现。结果：本研究共纳入了896,101名妇女的2,301,766个筛查检查（458,175个DBT检查[中位数年龄为58岁；年龄范围为18-111岁]和1,843,591个DM检查[中位数年龄为58岁；年龄范围为18-109岁]）。DBT筛查性能指标如下：AIR为8.3%（95% CI：7.5，9.3），每1,000个屏幕的CDR为5.8（95% CI：5.4，6.1），敏感度为87.4%（95% CI：85.2，89.4）），特异度为92.2%（95% CI：91.3，93.0），每1,000个屏幕的FNR为0.8（95% CI：0.7，1.0）。与同一时期的BCSC DM筛查检查和以前发布的BCSC和国家乳腺X线摄影数据库性能基准相比，DBT的所有性能指标（除了敏感度和FNR外）都更高，这两个指标与同时和以前的DM性能指标相似。以下比例的放射科医生通过了DBT的性能范围：CDR为97.6%，敏感度为91.8%，AIR为75.0%，特异度为74.0%。结论：在美国社区实践中，大多数放射科医生满足了DBT筛查性能指标的可接受范围。© RSNA，2023 本文提供了附加资料。请参阅本期的Lee和Moy编辑评论。

Background It is important to establish screening mammography performance benchmarks for quality improvement efforts. Purpose To establish performance benchmarks for digital breast tomosynthesis (DBT) screening and evaluate performance trends over time in U.S. community practice. Materials and Methods In this retrospective study, DBT screening examinations were collected from five Breast Cancer Surveillance Consortium (BCSC) registries between 2011 and 2018. Performance measures included abnormal interpretation rate (AIR), cancer detection rate (CDR), sensitivity, specificity, and false-negative rate (FNR) and were calculated based on the American College of Radiology Breast Imaging Reporting and Data System, fifth edition, and compared with concurrent BCSC DM screening examinations, previously published BCSC and National Mammography Database benchmarks, and expert opinion acceptable performance ranges. Benchmarks were derived from the distribution of performance measures across radiologists (n = 84 or n = 73 depending on metric) and were presented as percentiles. Results A total of 896 101 women undergoing 2 301 766 screening examinations (458 175 DBT examinations [median age, 58 years; age range, 18-111 years] and 1 843 591 DM examinations [median age, 58 years; age range, 18-109 years]) were included in this study. DBT screening performance measures were as follows: AIR, 8.3% (95% CI: 7.5, 9.3); CDR per 1000 screens, 5.8 (95% CI: 5.4, 6.1); sensitivity, 87.4% (95% CI: 85.2, 89.4); specificity, 92.2% (95% CI: 91.3, 93.0); and FNR per 1000 screens, 0.8 (95% CI: 0.7, 1.0). When compared with BCSC DM screening examinations from the same time period and previously published BCSC and National Mammography Database performance benchmarks, all performance measures were higher for DBT except sensitivity and FNR, which were similar to concurrent and prior DM performance measures. The following proportions of radiologists achieved acceptable performance ranges with DBT: 97.6% for CDR, 91.8% for sensitivity, 75.0% for AIR, and 74.0% for specificity. Conclusion In U.S. community practice, large proportions of radiologists met acceptable performance ranges for screening performance metrics with DBT. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Lee and Moy in this issue.