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Ductal Carcinoma in Situ: Computer-aided Detection in Screening Mammography¹

¹ From the Department of Diagnostic Radiology, William Beaumont Hospital, 3601 W Thirteen Mile Rd, Royal Oak, MI 48073. From the 2004 RSNA Annual Meeting. Received August 15, 2005; revision requested November 2; revision received December 15; accepted January 11, 2006; final version accepted March 17. Address correspondence to M.R. (e-mail: mrebner{at}beaumont.edu).

Purpose: To retrospectively evaluate the sensitivity of computer-aided detection (CAD) in depicting ductal carcinoma in situ (DCIS) on screening mammograms by using biopsy proved lesion location as the reference standard.

Materials and Methods: Institutional review board approval was obtained, with a waiver of patient informed consent for this HIPAA-compliant study. Findings of all image-guided biopsies with a pathologic diagnosis of DCIS during a 1-year period were reviewed. Fifty-eight lesions in 55 women (average age, 61.41 years ± 12.89 [standard deviation]) were available for review. The screening mammogram of the affected breast and, if available, the prior screening mammogram were digitized by the CAD system. An assessment was then made as to whether the CAD system marked the area of DCIS on the current and prior mammograms. Patient age, location and mammographic size of the lesion, type of lesion, and breast density were recorded and were analyzed by using ², Fisher exact, or Cochran-Mantel-Haenzel tests, where applicable.

Results: CAD identified DCIS in 53 (91%) of 58 lesions on craniocaudal (CC) and mediolateral oblique (MLO) views of screening mammograms obtained in the year of the diagnosis. On screening mammograms obtained prior to the year of the diagnosis (34 patients), no radiologically or CAD-detected lesion was present on 11 (32%) of 34 mammograms. CAD identified DCIS in 16 (70%) of 23 lesions on one of the two views. Seven (30%) of 23 lesions had mammographic findings at retrospective review that were not identified with CAD.

Conclusion: CAD had a high sensitivity in the depiction of DCIS.

© RSNA, 2006