title: Computer-assisted diagnosis (CAD) in mammography: comparison of diagnostic accuracy of a new algorithm (Cyclopus, Medicad) with two commercial systems.
abstract: OBJECTIVE
  The study compares the diagnostic accuracy (correct identification of cancer) of a new computer-assisted diagnosis (CAD) system (Cyclopus) with two other commercial systems (R2 and CADx).
  
  
  METHODS
  Cyclopus was tested on a set of 120 mammograms on which the two compared commercial systems had been previously tested. The set consisted of mammograms reported as negative, preceding 31 interval cancers reviewed as screening error or minimal sign, and of 89 verified negative controls randomly selected from the same screening database.
  
  
  RESULTS
  Cyclopus sensitivity was 74.1% (R2=54.8%; CADx=41.9%) and was higher for interval cancers reviewed as screening error (90.9%; R2=54.5%; CADx=81.8%) compared with those reviewed as minimal sign (65.0%; R2=55.0%; CADx=20.0%). Specificity was 15.7% (R2=29.2%; CADx=17.9%). Overall accuracy was 30.8% (R2=35.8%; CADx=24.1%). The positive predictive value of a case with CAD marks [regions of interest (ROI)] was 23.4% (23/98; R2=16.0%; CADx=15.1%). Average ROI number per view among negative controls was 1.13 (R2=0.93; CADx=0.99). Cyclopus was more sensitive for masses compared with isolated microcalcifications (208 vs 62 ROI; R2=90 vs 213; CADx=192 vs 130).
  
  
  CONCLUSIONS
  Compared with two other commercial systems, Cyclopus was more sensitive (R2 p=0.14; CADx p=0.02) and less specific (R2 p=0.02; CADx p=0.64).
authors.affiliation: Istituto Scientifico per la Prevenzione Oncologica, Firenze, Italy. stefano.ciatto@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Ciatto
authors.forename: D
authors.initials: D
authors.lastname: Cascio
authors.forename: F
authors.initials: F
authors.lastname: Fauci
authors.forename: R
authors.initials: R
authors.lastname: Magro
authors.forename: G
authors.initials: G
authors.lastname: Raso
authors.forename: R
authors.initials: R
authors.lastname: Ienzi
authors.forename: F
authors.initials: F
authors.lastname: Martinelli
authors.forename: M Vasile
authors.initials: MV
authors.lastname: Simone
mesh_terms: D000465:Algorithms; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity