title: The performance of computer-aided detection when analyzing prior mammograms of newly detected breast cancers with special focus on the time interval from initial imaging to detection.
abstract: OBJECTIVE
  The clinical role of CAD systems to detect breast cancer, which have not been on cancer containing mammograms not detected by the radiologist was proven retrospectively.
  
  
  METHODS
  All patients from 1992 to 2005 with a histologically verified malignant breast lesion and a mammogram at our department, were analyzed in retrospect focussing on the time of detection of the malignant lesion. All prior mammograms were analyzed by CAD (CADx, USA). The resulting CAD printout was matched with the cancer containing images yielding to the radiological diagnosis of breast cancer. CAD performance, sensitivity as well as the association of CAD and radiological features were analyzed.
  
  
  RESULTS
  278 mammograms fulfilled the inclusion criteria. 111 cases showed a retrospectively visible lesion (71 masses, 23 single microcalcification clusters, 16 masses with microcalcifications, in one case two microcalcification clusters). 54/87 masses and 34/41 microcalcifications were detected by CAD. Detection rates varied from 9/20 (ACR 1) to 5/7 (ACR 4) (45% vs. 71%). The detection of microcalcifications was not influenced by breast tissue density.
  
  
  CONCLUSIONS
  CAD might be useful in an earlier detection of subtle breast cancer cases, which might remain otherwise undetected.
authors.affiliation: Institute of Diagnostic Radiology, Suedharz-Hospital Nordhausen, Dr.-R.-Koch-Street 38, 99734 Nordhausen, Germany. ansgar.malich@gmx.de
authors.forename: Ansgar
authors.initials: A
authors.lastname: Malich
authors.forename: Sabine
authors.initials: S
authors.lastname: Schmidt
authors.forename: Dorothee R
authors.initials: DR
authors.lastname: Fischer
authors.forename: Mirjam
authors.initials: M
authors.lastname: Facius
authors.forename: Werner A
authors.initials: WA
authors.lastname: Kaiser
mesh_terms: D000465:Algorithms; D001185:Artificial Intelligence; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008327:Mammography / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors