title: Comparison of standard reading and computer aided detection (CAD) on a national proficiency test of screening mammography.
abstract: OBJECTIVE
  To evaluate the role of computer aided detection (CAD) in improving the interpretation of screening mammograms
  
  
  METHODS
  Ten radiologists underwent a proficiency test of screening mammography first by conventional reading and then with the help of CAD. Radiologists were blinded to test results for the whole study duration. Results of conventional and CAD reading were compared in terms of sensitivity and recall rate. Double reading was simulated combining conventional readings of four expert radiologists and compared with CAD reading.
  
  
  RESULTS
  Considering all ten readings, cancer was identified in 146 or 153 of 170 cases (85.8 vs. 90.0%; chi(2)=0.99, df=1, P=0.31) and recalls were 106 or 152 of 1330 cases (7.9 vs. 11.4%; chi(2)=8.69, df=1, P=0.003) at conventional or CAD reading, respectively. CAD reading was essentially the same (sensitivity 97.0 vs. 96.0%; chi(2)=7.1, df=1, P=0.93; recall rate 10.7 vs. 10.6%; chi(2)=1.5, df=1, P=0.96) as compared with simulated conventional double reading.
  
  
  CONCLUSIONS
  CAD reading seems to improve the sensitivity of conventional reading while reducing specificity, both effects being of limited size. CAD reading had almost the same performance of simulated conventional double reading, suggesting a possible use of CAD which needs to be confirmed by further studies inclusive of cost-effective analysis.
authors.affiliation: Centro per lo Studio e la Prevenzione Oncologica, Viale A Volta 171, I-50131 Florence, Italy. s.ciatto@cspo.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Ciatto
authors.forename: Marco Rosselli
authors.initials: MR
authors.lastname: Del Turco
authors.forename: Gabriella
authors.initials: G
authors.lastname: Risso
authors.forename: Sandra
authors.initials: S
authors.lastname: Catarzi
authors.forename: Rita
authors.initials: R
authors.lastname: Bonardi
authors.forename: Valeria
authors.initials: V
authors.lastname: Viterbo
authors.forename: Pierangela
authors.initials: P
authors.lastname: Gnutti
authors.forename: Barbara
authors.initials: B
authors.lastname: Guglielmoni
authors.forename: Lelio
authors.initials: L
authors.lastname: Pinelli
authors.forename: Anna
authors.initials: A
authors.lastname: Pandiscia
authors.forename: Francesco
authors.initials: F
authors.lastname: Navarra
authors.forename: Adele
authors.initials: A
authors.lastname: Lauria
authors.forename: Rosa
authors.initials: R
authors.lastname: Palmiero
authors.forename: Pietro Luigi
authors.initials: PL
authors.lastname: Indovina
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003362:Cost-Benefit Analysis; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards*; D012680:Sensitivity and Specificity