title: Effect of soft-copy display supported by CAD on mammography screening performance.
abstract: Diagnostic performance and reading speed for conventional mammography film reading is compared to reading digitized mammograms on a dedicated workstation. A series of mammograms judged negative at screening and corresponding priors were collected. Half were diagnosed as cancer at the next screening, or earlier for interval cancers. The others were normal. Original films were read by fifteen experienced screening radiologists. The readers annotated potential abnormalities and estimated their likelihood of malignancy. More than 1 year later, five radiologists reread a subset of 271 cases (88 cancer cases having visible signs in retrospect and 183 normals) on a mammography workstation after film digitization. Markers from a computer-aided detection (CAD) system for microcalcifications were available to the readers. Performance was evaluated by comparison of A(z)-scores based on ROC and multiple-Reader multiple-case (MRMC) analysis, and localized receiver operating characteristic (LROC) analysis for the 271 cases. Reading speed was also determined. No significant difference in diagnostic performance was observed between conventional and soft-copy reading. Average A(z)-scores were 0.83 and 0.84 respectively. Soft-copy reading was only slightly slower than conventional reading. Using a mammography workstation including CAD for detection of microcalcifications, soft-copy reading is possible without loss of quality or efficiency.
authors.affiliation: Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, 430 Radiology, 6500 HB, Nijmegen, The Netherlands. T.Roelofs@rad.umcn.nl
authors.forename: Antonius A J
authors.initials: AA
authors.lastname: Roelofs
authors.forename: Sander
authors.initials: S
authors.lastname: van Woudenberg
authors.forename: Johannes D M
authors.initials: JD
authors.lastname: Otten
authors.forename: Jan H C L
authors.initials: JH
authors.lastname: Hendriks
authors.forename: Anke
authors.initials: A
authors.lastname: Bödicker
authors.forename: Carl J G
authors.initials: CJ
authors.lastname: Evertsz
authors.forename: Nico
authors.initials: N
authors.lastname: Karssemeijer
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands; D015588:Observer Variation; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies