Screening Mammography with Computer-aided Detection: Prospective Study of 12,860 Patients in a Community Breast Center
Abstract
PURPOSE: To prospectively assess the effect of computer-aided detection (CAD) on the interpretation of screening mammograms in a community breast center.
MATERIALS AND METHODS: Over a 12-month period, 12,860 screening mammograms were interpreted with the assistance of a CAD system. Each mammogram was initially interpreted without the assistance of CAD, followed immediately by a reevaluation of areas marked by the CAD system. Data were recorded to measure the effect of CAD on the recall rate, positive predictive value for biopsy, cancer detection rate, and stage of malignancies at detection.
RESULTS: When comparing the radiologist’s performance without CAD with that when CAD was used, the authors observed the following: (a) an increase in recall rate from 6.5% to 7.7%, (b) no change in the positive predictive value for biopsy at 38%, (c) a 19.5% increase in the number of cancers detected, and (d) an increase in the proportion of early-stage (0 and I) malignancies detected from 73% to 78%.
CONCLUSION: The use of CAD in the interpretation of screening mammograms can increase the detection of early-stage malignancies without undue effect on the recall rate or positive predictive value for biopsy.
References
- 1 vanDijck JA, Verbeek AL, Hendricks JH, Holland R. The current detectability of cancer in a breast screening program. Cancer 1993; 72: 1933-1938.
- 2 Goergen SK, Evans J, Cohen GP, MacMillan JH. Characteristics of breast carcinomas missed by screening radiologists. Radiology 1997; 204: 131-135.
- 3 Bird RE, Wallace TW, Yankaskas BC. Analysis of cancers missed at screening mammography. Radiology 1992; 184: 613-617.
- 4 Harvey JA, Fajardo LL, Innis CA. Previous mammograms in patients with impalpable breast carcinoma: retrospective vs blinded interpretation. AJR Am J Roentgenol 1993; 161: 1167-1172.
- 5 Warren Burhenne LJ, Wood SA, D’Orsi CJ, et al. The potential contribution of computer-aided detection to the sensitivity of screening mammography. Radiology 2000; 215: 554-562.
- 6 Thurfjell EL, Lernevall KA, Taube AAS. Benefit of independent double reading in a population-based mammography screening program. Radiology 1994; 191: 241-244.
- 7 Anttinen I, Pamilo M, Soiva M, Roiha M. Double reading of mammography screening films: one radiologist or two?. Clin Radiol 1993; 48: 414-421.
- 8 Hendee WR, Beam C, Hendrick E. Proposition: all mammograms should be double-read. Med Phys 1999; 26: 115-118.
- 9 Vyborny CJ. Can computers help radiologists read mammograms?. Radiology 1994; 191: 315-317.
- 10 te Brake GM, Karssemeijer N, Hendriks JH. Automated detection of breast carcinomas not detected in a screening program. Radiology 1998; 207: 465-471.
- 11 Chan HC, Doi K, Vyborny CJ, et al. Improvement in radiologists’ detection of clustered microcalcifications on mammograms: the potential of computer-aided diagnosis. Invest Radiol 1990; 25: 1102-1110.
- 12 Nishikawa RM, Doi K, Geiger ML, et al. Computerized detection of clustered microcalcifications: evaluation of performance on mammograms from multiple centers. RadioGraphics 1995; 15: 445-452.
- 13 Kregelmeyer WP, Pruneda JM, Bourland PD, Hillis A, Riggs MW, Nipper ML. Computer-aided mammographic screening for spiculated lesions. Radiology 1994; 191: 331-337.