Assessing the stand-alone sensitivity of computer-aided detection with cancer cases from the Digital Mammographic Imaging Screening Trial.
OBJECTIVE
The purpose of this study was to assess the sensitivities and false-detection rates of two computer-aided detection (CADe) systems when applied to digital or film-screen mammograms in detecting the known breast cancer cases from the Digital Mammographic Imaging Screening Trial (DMIST) breast cancer screening population.


METHODS
Available film-screen and digital mammograms of 161 breast cancer cases from DMIST were analyzed by two CADe systems, iCAD Second-Look and R2 ImageChecker. Three experienced breast-imaging radiologists reviewed the CADe marks generated for each available cancer case, recording the number and locations of CADe marks and whether each CADe mark location corresponded with the known location of the cancer.


RESULTS
For the 161 cancer cases included in this study, the sensitivities of the DMIST reader without CAD were 0.43 (69/161, 95% CI 0.35-0.51) for digital and 0.41 (66/161, 0.33-0.49) for film-screen mammography. The sensitivities of iCAD were 0.74 (119/161, 0.66-0.81) for digital and 0.69 (111/161, 0.61-0.76) for film-screen mammography, both significantly higher than the DMIST study sensitivities (p < 0.0001 for both). The average number of false CADe marks per case of iCAD was 2.57 (SD, 1.92) for digital and 3.06(1.72) for film-screen mammography. The sensitivity of R2 was 0.74 (119/161, 0.66-0.81) for digital, and 0.60 (97/161, 0.52-0.68) for film-screen mammography, both significantly higher than the DMIST study sensitivities (p < 0.0001 for both). The average number of false CADe marks per case of R2 was 2.07 (1.57) for digital and 1.52 (1.45) for film-screen mammography.


CONCLUSIONS
Our results suggest the use of CADe in interpretation of digital and film-screen mammograms could lead to improvements in cancer detection.
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425-3230, USA. coleeb@musc.edu
Elodia B
EB
Cole
Zheng
Z
Zhang
Helga S
HS
Marques
Robert M
RM
Nishikawa
R Edward
RE
Hendrick
Martin J
MJ
Yaffe
Wittaya
W
Padungchaichote
Cherie
C
Kuzmiak
Jatuporn
J
Chayakulkheeree
Emily F
EF
Conant
Laurie L
LL
Fajardo
Janet
J
Baum
Constantine
C
Gatsonis
Etta
E
Pisano
D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008327:Mammography; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D014963:X-Ray Intensifying Screens