title: Impact of a CAD system in a screen-film mammography screening program: a prospective study.
abstract: OBJECTIVE
  The purpose of our study was to perform a prospective assessment of the impact of a CAD system in a screen-film mammography screening program during a period of 3 years.
  
  
  METHODS
  Our study was carried out on a population of 21,855 asymptomatic women (45-65 years). Mammograms were processed in a CAD system and independently interpreted by one of six radiologists. We analyzed the following parameters: sensitivity of radiologist's interpretation (without and with CAD), detection increase, recall rate and positive predictive value of biopsy, CAD's marks, radiologist's false negatives and comparative analysis of carcinomas detected and non-detected by CAD.
  
  
  RESULTS
  Detection rate was 4.3‰. CAD supposed an increase of 0.1‰ in detection rate and 1% in the total number of cases (p<0.005). The impact on recall rate was not significant (0.4%) and PPV of percutaneous biopsy was unchanged by CAD (20.23%). CAD's marks were 2.7 per case and 0.7 per view. Radiologist's false negatives were 13 lesions which were initially considered as CAD's false positives.
  
  
  CONCLUSIONS
  CAD supposed a significant increase in detection, without modifications in recall rates and PPV of biopsy. However, better results could have been achieved if radiologists had considered actionable those cases marked by CAD but initially misinterpreted.
authors.affiliation: Marqués Valdecilla University Hospital, Radiology, Herrera Oria sn, Santander, Spain. smsanchezg@seram.org
authors.forename: S
authors.initials: S
authors.lastname: Sanchez Gómez
authors.forename: M
authors.initials: M
authors.lastname: Torres Tabanera
authors.forename: A
authors.initials: A
authors.lastname: Vega Bolivar
authors.forename: M
authors.initials: M
authors.lastname: Sainz Miranda
authors.forename: A
authors.initials: A
authors.lastname: Baroja Mazo
authors.forename: M
authors.initials: M
authors.lastname: Ruiz Diaz
authors.forename: P
authors.initials: P
authors.lastname: Martinez Miravete
authors.forename: E
authors.initials: E
authors.lastname: Lag Asturiano
authors.forename: P
authors.initials: P
authors.lastname: Muñoz Cacho
authors.forename: T
authors.initials: T
authors.lastname: Delgado Macias
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology; D014962:X-Ray Film / Q000706:statistics & numerical data*