Computer-aided detection (CAD) in mammography: does it help the junior or the senior radiologist?
OBJECTIVE
To evaluate the impact of a computer-aided detection (CAD) system on the ability of a junior and senior radiologist to detect breast cancers on mammograms, and to determine the potential of CAD as a teaching tool in mammography.


METHODS
Hundred biopsy-proven cancers and 100 normal mammograms were randomly analyzed by a CAD system. The sensitivity (Se) and specificity (Sp) of the CAD system were calculated. In the second phase, to simulate daily practice, 110 mammograms (97 normal or with benign lesions, and 13 cancers) were examined independently by a junior and a senior radiologist, with and without CAD. Interpretations were standardized according to BI-RADS classification. Sensitivity, Specificity, positive and negative predictive values (PPV, NPV) were calculated for each session.


RESULTS
For the senior radiologist, Se slightly improved from 76.9 to 84.6% after CAD analysis (NS) (one case of clustered microcalcifications case overlooked by the senior radiologist was detected by CAD). Sp, PPV and PNV did not change significantly. For the junior radiologist, Se improved from 61.9 to 84.6% (significant change). Three cancers overlooked by the junior radiologist were detected by CAD. Sp was unchanged.


CONCLUSIONS
CAD mammography proved more useful for the junior than for the senior radiologist, improving sensitivity. The CAD system may represent a useful educational tool for mammography.
Balleyguier
Corinne
C
Radiology Department, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France. balleyguier@igr.fr
Kinkel
Karen
K
Fermanian
Jacques
J
Malan
Sebastien
S
Djen
Germaine
G
Taourel
Patrice
P
Helenon
Olivier
O
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity