Computer-aided detection in full-field digital mammography: sensitivity and reproducibility in serial examinations.

PURPOSE To retrospectively evaluate the sensitivity and reproducibility of a computer-aided detection (CAD) system applied to serial digital mammograms obtained in women with breast cancer, with histologic analysis as the reference standard. MATERIALS AND METHODS This study was institutional review board approved, and patient informed consent was waived. A commercially available CAD system was applied to initial and follow-up digital mammograms obtained in 93 women with breast cancer (mean age, 52 years; age range, 32-81 years). The mean interval between mammographic examinations was 23 days (range, 7-58 days). There were 119 visible lesion components (70 masses, 49 microcalcifications). Sensitivity, false-positive mark rate, and reproducibility of the CAD system were evaluated for both sets of mammograms with the t test. RESULTS Sensitivities of the CAD system at initial and follow-up digital mammography were 91% and 89%, respectively, for detection of masses. Sensitivity of the CAD system for detection of microcalcifications was 100% at both initial and follow-up digital mammography. Overall false-positive mark rates were 0.29 per image and 0.27 per image at initial and follow-up digital mammography, respectively. When craniocaudal and mediolateral oblique views were considered separately, sensitivities were 76% and 75%, respectively, for masses and 96% and 92%, respectively, for microcalcifications. The reproducibility of CAD marks was 80% for true-positive masses, 92% for true-positive microcalcifications, 9% for false-positive masses, and 8% for false-positive microcalcifications (P < .001). CONCLUSION The sensitivity of the CAD system was consistently high for detection of breast cancer on initial and short-term follow-up digital mammograms. Reproducibility was significantly higher for true-positive CAD marks than for false-positive CAD marks. SUPPLEMENTAL MATERIAL http://radiology.rsnajnls.org/cgi/content/full/246/1/71/DC1.

[1]  Lihua Li,et al.  Computer-aided diagnosis of masses with full-field digital mammography. , 2002, Academic radiology.

[2]  Jay A Baker,et al.  Computer-aided detection in screening mammography: variability in cues. , 2004, Radiology.

[3]  N A Obuchowski,et al.  On the comparison of correlated proportions for clustered data. , 1998, Statistics in medicine.

[4]  Berkman Sahiner,et al.  Computer-aided detection of breast masses on full field digital mammograms. , 2005, Medical physics.

[5]  Jeffrey W Hoffmeister,et al.  Evaluation of breast cancer with a computer‐aided detection system by mammographic appearance and histopathology , 2005, Cancer.

[6]  Berkman Sahiner,et al.  Sensitivity of noncommercial computer-aided detection system for mammographic breast cancer detection: pilot clinical trial. , 2004, Radiology.

[7]  Jeffrey W Hoffmeister,et al.  Impact of breast density on computer-aided detection for breast cancer. , 2005, AJR. American journal of roentgenology.

[8]  E. Grabbe,et al.  Computer-aided detection in direct digital full-field mammography: initial results , 2002, European Radiology.

[9]  Debra M Ikeda,et al.  Computer-aided detection output on 172 subtle findings on normal mammograms previously obtained in women with breast cancer detected at follow-up screening mammography. , 2004, Radiology.

[10]  L. Tabár,et al.  Potential contribution of computer-aided detection to the sensitivity of screening mammography. , 2000, Radiology.

[11]  J Champness,et al.  Reproducibility of prompts in computer-aided detection (CAD) of breast cancer. , 2003, Clinical radiology.

[12]  Thomas Boehm,et al.  Influence of breast lesion size and histologic findings on tumor detection rate of a computer-aided detection system. , 2003, Radiology.

[13]  T. Freer,et al.  Screening mammography with computer-aided detection: prospective study of 12,860 patients in a community breast center. , 2001, Radiology.

[14]  W A Kaiser,et al.  Reproducibility--an important factor determining the quality of computer-aided detection (CAD) systems. , 2000, European journal of radiology.

[15]  Woo Kyung Moon,et al.  Computer-aided detection in digital mammography: comparison of craniocaudal, mediolateral oblique, and mediolateral views. , 2006, Radiology.

[16]  Bin Zheng,et al.  Mammography with computer-aided detection: reproducibility assessment initial experience. , 2003, Radiology.