title: Computer-aided detection of amorphous calcifications.
abstract: OBJECTIVE
  Computer-aided detection (CAD) systems have been used successfully to detect malignant calcifications on mammography, with sensitivities ranging from 86% to 99%. Amorphous calcifications are a subset of small indistinct calcifications of intermediate concern that have a 20% likelihood of being malignant and that are frequently overlooked on mammography. The purpose of our study was to determine the sensitivity of one commercially available CAD system for detecting amorphous calcifications.
  
  
  METHODS
  A commercially available CAD system evaluated mammograms of 82 patients with 85 mammographically detected and histologically sampled groups of amorphous calcifications (21 malignant, 14 high risk, and 50 benign). The sensitivity of the system for detecting the calcifications on at least one image of the two-view mammographic examination (case sensitivity) and on each individual mammographic image (image sensitivity) was determined. Findings were correlated with results from large core needle biopsy or surgical excision in each case.
  
  
  RESULTS
  The CAD system detected amorphous calcifications in 43 of 85 cases (case sensitivity, 51%) and in 59 of 146 mammographic images (image sensitivity, 40%). The case sensitivities by histologic outcome were 57% for malignant calcifications, 29% for high-risk calcifications, and 54% for benign calcifications. An average of 2.0 false-positive marks were displayed per case.
  
  
  CONCLUSIONS
  The CAD sensitivity for malignant amorphous calcifications is markedly lower than previously reported for all malignant calcifications. Breast imaging radiologists who use CAD systems should continue to search diligently for these difficult-to-detect lesions.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, DUMC, 2nd Fl., Red Zone, South Hospital, Durham, NC 27710, USA.
authors.forename: Mary Scott
authors.initials: MS
authors.lastname: Soo
authors.forename: Eric L
authors.initials: EL
authors.lastname: Rosen
authors.forename: Jessie Q
authors.initials: JQ
authors.lastname: Xia
authors.forename: Sujata
authors.initials: S
authors.lastname: Ghate
authors.forename: Jay A
authors.initials: JA
authors.lastname: Baker
mesh_terms: D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity