title: Computer-aided detection (CAD) in mammography: does it help the junior or the senior radiologist?
abstract: 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.
authors.affiliation: Radiology Department, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France. balleyguier@igr.fr
authors.forename: Corinne
authors.initials: C
authors.lastname: Balleyguier
authors.forename: Karen
authors.initials: K
authors.lastname: Kinkel
authors.forename: Jacques
authors.initials: J
authors.lastname: Fermanian
authors.forename: Sebastien
authors.initials: S
authors.lastname: Malan
authors.forename: Germaine
authors.initials: G
authors.lastname: Djen
authors.forename: Patrice
authors.initials: P
authors.lastname: Taourel
authors.forename: Olivier
authors.initials: O
authors.lastname: Helenon
mesh_terms: 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