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.
Samulski
Maurice
M
Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands. m.samulski@rad.umcn.nl
Hupse
Rianne
R
Boetes
Carla
C
Mus
Roel D M
RD
den Heeten
Gerard J
GJ
Karssemeijer
Nico
N
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