Using computer-aided detection in mammography as a decision support.
OBJECTIVE
To evaluate an interactive computer-aided detection (CAD) system for reading mammograms to improve decision making.


METHODS
A dedicated mammographic workstation has been developed in which readers can probe image locations for the presence of CAD information. If present, CAD findings are displayed with the computed malignancy rating. A reader study was conducted in which four screening radiologists and five non-radiologists participated to study the effect of this system on detection performance. The participants read 120 cases of which 40 cases had a malignant mass that was missed at the original screening. The readers read each mammogram both with and without CAD in separate sessions. Each reader reported localized findings and assigned a malignancy score per finding. Mean sensitivity was computed in an interval of false-positive fractions less than 10%.


RESULTS
Mean sensitivity was 25.1% in the sessions without CAD and 34.8% in the CAD-assisted sessions. The increase in detection performance was significant (p = 0.012). Average reading time was 84.7 ± 61.5 s/case in the unaided sessions and was not significantly higher when interactive CAD was used (85.9 ± 57.8 s/case).


CONCLUSIONS
Interactive use of CAD in mammography may be more effective than traditional CAD for improving mass detection without affecting reading time.
Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands. m.samulski@rad.umcn.nl
Maurice
M
Samulski
Rianne
R
Hupse
Carla
C
Boetes
Roel D M
RD
Mus
Gerard J
GJ
den Heeten
Nico
N
Karssemeijer
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003201:Computers; D003661:Decision Support Techniques; D055088:Early Detection of Cancer; D005189:False Positive Reactions; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008327:Mammography / Q000379:methods*; D008495:Medical Oncology / Q000379:methods; D015588:Observer Variation; D011871:Radiology / Q000379:methods; D012680:Sensitivity and Specificity; D012984:Software; D013997:Time Factors; D014584:User-Computer Interface