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Computer Applications |
1 From the Dept of Radiology, Univ of British Columbia, Vancouver, Canada (L.J.W.B.); R2 Technology, 325 Distel Circle, Los Altos, CA 94022 (S.A.W., K.F.O., R.A.C.); Dept of Radiology, Univ of Massachusetts Medical Center, North Worcester (C.J.D.); Breast Imaging Center, Thomas Jefferson Univ Hosp, Philadelphia, Pa (S.A.F.); Dept of Radiology, Massachusetts General Hosp, Boston (D.B.K.); UCSF Medical Center, San Francisco, Calif (E.A.S.); Dept of Mammography, Central Hosp, Falun, Sweden (L.T.); and Dept of Radiology, Univ of Chicago, Ill (C.J.V.). From the 1998 RSNA scientific assembly. Received Jul 19, 1999; revision requested Aug 26; revision received Sep 21; accepted Oct 21. Address correspondence to R.A.C. (e-mail: rcastell@r2tech.com).
PURPOSE: To determine the false-negative rate in screening mammography, the capability of computer-aided detection (CAD) to identify these missed lesions, and whether or not CAD increases the radiologists' recall rate.
MATERIALS AND METHODS: All available screening mammograms that led to the detection of biopsy-proved cancer (n = 1,083) and the most recent corresponding prior mammograms (n = 427) were collected from 13 facilities. Panels of radiologists evaluated the retrospectively visible prior mammograms by means of blinded review. All mammograms were analyzed by a CAD system that marks features associated with cancer. The recall rates of 14 radiologists were prospectively measured before and after installation of the CAD system.
RESULTS: At retrospective review, 67% (286 of 427) of screening mammography–detected breast cancers were visible on the prior mammograms. At independent, blinded review by panels of radiologists, 27% (115 of 427) were interpreted as warranting recall on the basis of a statistical evaluation index; and the CAD system correctly marked 77% (89 of 115) of these cases. The original attending radiologists' sensitivity was 79% (427 of [427 + 115]). There was no statistically significant increase in the radiologists' recall rate when comparing the values before (8.3%) with those after (7.6%) installation of the CAD system.
CONCLUSION: The original attending radiologists had a false-negative rate of 21% (115 of [427 + 115]). CAD prompting could have potentially helped reduce this false-negative rate by 77% (89 of 115) without an increase in the recall rate.
Index terms: Breast neoplasms, 00.32 • Breast neoplasms, diagnosis, 00.32 • Cancer screening, 00.11, 00.1299 • Computers, diagnostic aid
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W. A. Berg, C. J. D'Orsi, V. P. Jackson, L. W. Bassett, C. A. Beam, R. S. Lewis, and P. E. Crewson Does Training in the Breast Imaging Reporting and Data System (BI-RADS) Improve Biopsy Recommendations or Feature Analysis Agreement with Experienced Breast Imagers at Mammography? Radiology, September 1, 2002; 224(3): 871 - 880. [Abstract] [Full Text] [PDF]
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N. Petrick, B. Sahiner, H.-P. Chan, M. A. Helvie, S. Paquerault, and L. M. Hadjiiski Breast Cancer Detection: Evaluation of a Mass-Detection Algorithm for Computer-aided Diagnosis—Experience in 263 Patients Radiology, July 1, 2002; 224(1): 217 - 224. [Abstract] [Full Text]
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J. T. Ferrucci Colon Cancer Screening with Virtual Colonoscopy: Promise, Polyps, Politics Am. J. Roentgenol., November 1, 2001; 177(5): 975 - 988. [Full Text] [PDF]
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T. W. Freer and M. J. Ulissey Screening Mammography with Computer-aided Detection: Prospective Study of 12,860 Patients in a Community Breast Center Radiology, September 1, 2001; 220(3): 781 - 786. [Abstract] [Full Text] [PDF]
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D. R. Enzmann, P. M. Anglada, C. Haviley, and L. A. Venta Providing Professional Mammography Services: Financial Analysis Radiology, May 1, 2001; 219(2): 467 - 473. [Abstract] [Full Text]
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L. Berlin Dot Size, Lead Time, Fallibility, and Impact on Survival: Continuing Controversies in Mammography Am. J. Roentgenol., May 1, 2001; 176(5): 1123 - 1130. [Full Text] [PDF]
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R. L. Birdwell, D. M. Ikeda, K. F. O’Shaughnessy, and E. A. Sickles Mammographic Characteristics of 115 Missed Cancers Later Detected with Screening Mammography and the Potential Utility of Computer-aided Detection Radiology, April 1, 2001; 219(1): 192 - 202. [Abstract] [Full Text]
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