title: Reproducibility of prompts in computer-aided detection (CAD) of breast cancer.
abstract: OBJECTIVE
  We evaluated the reproducibility of prompts using the R2 ImageChecker M2000 computer-aided detection (CAD) system.
  
  
  METHODS
  Forty selected two-view mammograms of women with breast cancer were digitized and analysed using the ImageChecker on 10 separate occasions. The mammograms were chosen to provide both straightforward and subtle signs of malignancy. Data analysed included mammographic abnormality, pathology, and whether the cancer was prompted or given an emphasized prompt.
  
  
  RESULTS
  Correct prompts were generated in 86 out of 100 occasions for screen-detected cancers. Reproducibility was less in the other categories of more subtle cancers: 21% for cancers previously missed by CAD, a group that contained more grade 1 and small (<10 mm) tumours. Prompts for calcifications were more reproducible than those for masses (76% versus 53%) and these cancers were more likely to have an emphasized prompt.
  
  
  CONCLUSIONS
  Probably the most important cause of variability of prompts is shifts in film position between sequential digitizations. Consequently subtle lesions that are only just above the threshold for display may not be prompted on repeat scanning. However, users of CAD should be aware that even emphasized prompts are not consistently reproducible.
authors.affiliation: South West London Breast Screening Service, London, UK.
authors.forename: C G
authors.initials: CG
authors.lastname: Taylor
authors.forename: J
authors.initials: J
authors.lastname: Champness
authors.forename: M
authors.initials: M
authors.lastname: Reddy
authors.forename: P
authors.initials: P
authors.lastname: Taylor
authors.forename: H W W
authors.initials: HW
authors.lastname: Potts
authors.forename: R
authors.initials: R
authors.lastname: Given-Wilson
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008327:Mammography; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity