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Single Reading with Computer-aided Detection and Double Reading of Screening Mammograms in the United Kingdom National Breast Screening Program¹

¹ From the Department of Radiology, University of Aberdeen, Lilian Sutton Bldg, Foresterhill, Aberdeen, Scotland, AB25 2ZD (F.J.G., M.G.C.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A., P.M.G.); Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand (M.A.M.); Nightingale Center, Withington Hospital, Manchester, England (C.R.M.B.); and Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, London, England (S.W.D.). Received June 29, 2005; revision requested August 25; revision received October 5; accepted October 19; final version accepted February 10, 2006. Supported by Cancer Research UK and the UK NHS Breast Screening Program. Address correspondence to F.J.G. (e-mail: f.j.gilbert{at}abdn.ac.uk).

Purpose: To retrospectively determine if the use of a computer-aided detection (CAD) system can improve the performance of single reading of screening mammograms to match that of double reading in the United Kingdom.

Materials and Methods: Local research ethics committee approval was obtained; informed consent was not required. This study included a sample of 10 267 mammograms obtained in women aged 50 years or older who underwent routine screening at one of two breast screening centers in 1996. Mammograms that were double read in 1996 were randomly allocated to be re-read by eight different radiologists using CAD. The cancer detection and recall rates from double reading and single reading with CAD were compared. Statistical significance and confidence intervals were calculated with the McNemar test to account for the matched nature of the data.

Results: Single reading with CAD led to a cancer detection rate that was significantly (P = .02) higher than that achieved with double reading: 6.5% more cancers were detected by means of single reading with CAD than by means of double reading. However, the recall rate was higher for single reading with CAD than for double reading (8.6% vs 6.5%, respectively; P < .001). This was equivalent to relative increases of 15% and 32% in the cancer detection and recall rates, respectively.

Conclusion: Single reading with CAD leads to an improved cancer detection rate and an increased recall rate.

© RSNA, 2006

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