Computer-aided detection in full-field digital mammography: sensitivity and reproducibility in serial examinations.
OBJECTIVE
To retrospectively evaluate the sensitivity and reproducibility of a computer-aided detection (CAD) system applied to serial digital mammograms obtained in women with breast cancer, with histologic analysis as the reference standard.


METHODS
This study was institutional review board approved, and patient informed consent was waived. A commercially available CAD system was applied to initial and follow-up digital mammograms obtained in 93 women with breast cancer (mean age, 52 years; age range, 32-81 years). The mean interval between mammographic examinations was 23 days (range, 7-58 days). There were 119 visible lesion components (70 masses, 49 microcalcifications). Sensitivity, false-positive mark rate, and reproducibility of the CAD system were evaluated for both sets of mammograms with the t test.


RESULTS
Sensitivities of the CAD system at initial and follow-up digital mammography were 91% and 89%, respectively, for detection of masses. Sensitivity of the CAD system for detection of microcalcifications was 100% at both initial and follow-up digital mammography. Overall false-positive mark rates were 0.29 per image and 0.27 per image at initial and follow-up digital mammography, respectively. When craniocaudal and mediolateral oblique views were considered separately, sensitivities were 76% and 75%, respectively, for masses and 96% and 92%, respectively, for microcalcifications. The reproducibility of CAD marks was 80% for true-positive masses, 92% for true-positive microcalcifications, 9% for false-positive masses, and 8% for false-positive microcalcifications (P < .001).


CONCLUSIONS
The sensitivity of the CAD system was consistently high for detection of breast cancer on initial and short-term follow-up digital mammograms. Reproducibility was significantly higher for true-positive CAD marks than for false-positive CAD marks.


BACKGROUND
http://radiology.rsnajnls.org/cgi/content/full/246/1/71/DC1.
Kim
Seung Ja
SJ
Department of Radiology, Konkuk University Hospital, Seoul, Korea.
Moon
Woo Kyung
WK
Cho
Nariya
N
Cha
Joo Hee
JH
Kim
Sun Mi
SM
Im
Jung-Gi
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012680:Sensitivity and Specificity