title: Evaluation of computer-aided diagnosis on a large clinical full-field digital mammographic dataset.
abstract: OBJECTIVE
  To convert and optimize our previously developed computerized analysis methods for use with images from full-field digital mammography (FFDM) for breast mass classification to aid in the diagnosis of breast cancer.
  
  
  METHODS
  An institutional review board approved protocol was obtained, with waiver of consent for retrospective use of mammograms and pathology data. Seven hundred thirty-nine FFDM images, which contained 287 biopsy-proven breast mass lesions, of which 148 lesions were malignant and 139 lesions were benign, were retrospectively collected. Lesion margins were delineated by an expert breast radiologist and were used as the truth for lesion-segmentation evaluation. Our computerized image analysis method consisted of several steps: 1) identified lesions were automatically extracted from the parenchymal background using computerized segmentation methods; 2) a set of image characteristics (mathematic descriptors) were automatically extracted from image data of the lesions and surrounding tissues; and 3) selected features were merged into an estimate of the probability of malignancy using a Bayesian artificial neural network classifier. Performance of the analyses was evaluated at various stages of the conversion using receiver-operating characteristic analysis.
  
  
  RESULTS
  An area under the curve value of 0.81 was obtained in the task of distinguishing between malignant and benign mass lesions in a round-robin by case evaluation on the entire FFDM dataset. We failed to show a statistically significant difference (P = .83) compared to results from our previous study in which the computerized classification was performed on digitized screen-film mammograms.
  
  
  CONCLUSIONS
  Our computerized analysis methods developed on digitized screen-film mammography can be converted for use with FFDM. Results show that the computerized analysis methods for the diagnosis of breast mass lesions on FFDM are promising, and can potentially be used to aid clinicians in the diagnostic interpretation of FFDM.
authors.affiliation: Department of Radiology, The University of Chicago, Chicago, IL 60637, USA. huili@uchicago.edu
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.forename: Maryellen L
authors.initials: ML
authors.lastname: Giger
authors.forename: Yading
authors.initials: Y
authors.lastname: Yuan
authors.forename: Weijie
authors.initials: W
authors.lastname: Chen
authors.forename: Karla
authors.initials: K
authors.lastname: Horsch
authors.forename: Li
authors.initials: L
authors.lastname: Lan
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Jamieson
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Sennett
authors.forename: Sanaz A
authors.initials: SA
authors.lastname: Jansen
mesh_terms: D019540:Area Under Curve; D001943:Breast Neoplasms / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods*; D012189:Retrospective Studies