title: Standalone computer-aided detection compared to radiologists' performance for the detection of mammographic masses.
abstract: OBJECTIVE
  We developed a computer-aided detection (CAD) system aimed at decision support for detection of malignant masses and architectural distortions in mammograms. The effect of this system on radiologists' performance depends strongly on its standalone performance. The purpose of this study was to compare the standalone performance of this CAD system to that of radiologists.
  
  
  METHODS
  In a retrospective study, nine certified screening radiologists and three residents read 200 digital screening mammograms without the use of CAD. Performances of the individual readers and of CAD were computed as the true-positive fraction (TPF) at a false-positive fraction of 0.05 and 0.2. Differences were analysed using an independent one-sample t-test.
  
  
  RESULTS
  At a false-positive fraction of 0.05, the performance of CAD (TPF = 0.487) was similar to that of the certified screening radiologists (TPF = 0.518, P = 0.17). At a false-positive fraction of 0.2, CAD performance (TPF = 0.620) was significantly lower than the radiologist performance (TPF = 0.736, P <0.001). Compared to the residents, CAD performance was similar for all false-positive fractions.
  
  
  CONCLUSIONS
  The sensitivity of CAD at a high specificity was comparable to that of human readers. These results show potential for CAD to be used as an independent reader in breast cancer screening.
authors: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. a.hupse@rad.umcn.nl
authors: Rianne
authors: R
authors: Hupse
authors: Maurice
authors: M
authors: Samulski
authors: Marc
authors: M
authors: Lobbes
authors: Ard
authors: A
authors: den Heeten
authors: Mechli W
authors: MW
authors: Imhof-Tas
authors: David
authors: D
authors: Beijerinck
authors: Ruud
authors: R
authors: Pijnappel
authors: Carla
authors: C
authors: Boetes
authors: Nico
authors: N
authors: Karssemeijer
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D020000:Decision Support Systems, Clinical; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity