title: CAD in full-field digital mammography-influence of reader experience and application of CAD on interpretation of time.
abstract: OBJECTIVE
  To assess time expenditure using the influence of computer-assisted detection (CAD) system in the interpretation of the dependence of early research and benign and malignant mammograms on readers' experience.
  
  
  METHODS
  CAD (Image Checker V2.3; R2 Technology, Los Altos, CA, USA) was prospectively applied on digital mammograms of 303 patients [early research (n=103), benign (n=102), and malignant group (n=98)]. Mammograms were analyzed by three readers with varying experience in evaluating mammograms (medical student, resident and attending) according to the BI-RADS classification. Time was stopped and recorded. All images were presented randomly with and without the influence of CAD and from the different patient groups. To evaluate the statistical significance, the corresponding P value for time to read the mammograms in addition to different patient groups, application of CAD, readers' experience, and interaction of reader was calculated.
  
  
  RESULTS
  The attending needs, independent of CAD application, the least time, followed by the medical assistant and the student. In all three patient groups, CAD adoption elongates reading time of the student and the resident. The medical specialist needs with and without CAD median the same time. In the early research group, no significant differences were registered (P=.1343). Concerning readers' experience, there is an explicit significant difference (P<.0001). The application of CAD correlates with the corresponding readers' experience and also provides a not significant result. In comparison, the P value for the malignant and benign groups shows significant interactions between the readers' experiences as well as CAD application.
  
  
  CONCLUSIONS
  The future role of CAD application depends on whether sensitivity can be increased and time expenditure caused by false-positive marks can be decreased. In the future, second reading could be substituted by a CAD system if the reader has a wide professional experience.
authors.affiliation: Department of Cardiology and Pneumology/Heart Center, Georg-August-University, Göttingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Sohns
authors.forename: Besim Cetin
authors.initials: BC
authors.lastname: Angic
authors.forename: Samuel
authors.initials: S
authors.lastname: Sossalla
authors.forename: Frank
authors.initials: F
authors.lastname: Konietschke
authors.forename: Silvia
authors.initials: S
authors.lastname: Obenauer
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D011361:Professional Competence / Q000706:statistics & numerical data*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016526:Workload / Q000706:statistics & numerical data*