title: Radiologist detection of microcalcifications with and without computer-aided detection: a comparative study.
abstract: OBJECTIVE
  To compare the sensitivity and specificity of microcalcification detection by radiologists alone and assisted by a computer-aided detection (CAD) system.
  
  
  METHODS
  Films of 106 patients were masked, randomized, digitized and analysed by the CAD-system. Five readers interpreted the original mammograms and were blinded to demographics, medical history and earlier films. Forty-two mammograms with malignant microcalcifications, 40 with benign microcalcifications and 24 normal mammograms were included. Results were recorded on a standardized image interpretation form. The mammograms with suspicious areas flagged by the CAD-system were displayed on mini-monitors and immediately re-reviewed. The interpretation was again recorded on a new copy of the standard form and classified according to six groups.
  
  
  RESULTS
  Forty-one out of 42 (98%) malignant microcalcifications and 32 of 40 (80%) benign microcalcifications were flagged by the CAD-system. There was an average of 1.2 markers per image. The sensitivity for malignant microcalcifications detection by mammographers without and with the CAD-system ranged from 81% to 98% and from 88% to 98%, respectively. The mean difference without and with CAD-system was 2.2% (range 0-7%).
  
  
  CONCLUSIONS
  No statistically significant changes in sensitivity were found when experienced mammographers were assisted by the CAD-system, with no significant compromise in specificity.
authors.affiliation: The Breast Imaging and Interventional Center, 2150 Pennsylvania Avenue, Washington DC 20037, USA. radrfb@gwumc.edu
authors.forename: R F
authors.initials: RF
authors.lastname: Brem
authors.forename: J M
authors.initials: JM
authors.lastname: Schoonjans
mesh_terms: D001941:Breast Diseases / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008327:Mammography; D012680:Sensitivity and Specificity