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Accuracy of Segmentation of a Commercial Computer-aided Detection System for Mammography¹

¹ From the Department of Radiology, Duke University Medical Center, Box 3800, Erwin Rd, Durham, NC 27710. Received May 19, 2004; revision requested June 30; revision received August 26; accepted October 1. Address correspondence to J.A.B. (e-mail: jay.baker@duke.edu).

View larger version (76K): [in a new window]   Figure 1. Bilateral CAD images in a 62-year-old woman demonstrate near-perfect segmentation of breast tissue. The breast outline is accurately highlighted by the CAD system. Left: Craniocaudal CAD image. Right: Medioloateral oblique CAD image.

View larger version (81K): [in a new window]   Figure 2. Bilateral CAD images in a 47-year-old woman with acceptable segmentation of breast parenchyma. Left: Craniocaudal CAD image shows wedge of adipose tissue (thick arrow) that was excluded from the lateral aspect of the right breast. Right craniocaudal view shows location of a possible mass (*), which was marked by the CAD system. Right: Mediolateral oblique CAD image shows wedge of adipose tissue (thin arrows) that was excluded from the superior aspect of both breasts. All breast parenchyma was included in highlighted tissue.

View larger version (29K): [in a new window]   Figure 3. Templates in tenths (deciles) and quarters (quartiles) used to determine percentage of breast parenchyma excluded in cases of unacceptable segmentation.

View larger version (91K): [in a new window]   Figure 4. Bilateral CAD images in a 54-year-old woman demonstrate unacceptable segmentation of breast parenchyma. Left: Craniocaudal CAD image. CAD segmentation excluded 50% of breast parenchyma (arrows). Right: Mediolateral oblique CAD image demonstrates near-perfect segmentation.

View larger version (129K): [in a new window]   Figure 5. Bilateral craniocaudal CAD images in a 44-year-old woman demonstrate unacceptable segmentation of breast parenchyma. Left: CAD segmentation excluded medial half of breast parenchyma (arrowhead) on right view. Right: CAD segmentation excluded 75% of breast parenchyma (arrows) on left view.

View larger version (93K): [in a new window]   Figure 6. Bilateral CAD images in a 71-year-old woman demonstrate unacceptable segmentation of breast parenchyma. Left: Craniocaudal CAD image. The medial 25% of breast parenchyma (arrows) on bilateral views was excluded. Right: Mediolateral oblique CAD image. CAD segmentation excluded almost all breast parenchyma (arrowheads) on the left view, as shown by the interface of highlighted tissue and darker excluded regions.

View larger version (80K): [in a new window]   Figure 7a. Images in a 59-year-old woman with invasive ductal carcinoma of the right breast. (a) Mediolateral oblique mammogram of the right breast shows subtle architectural distortion (arrow) in the superior aspect of the breast. (b) Radiograph of lumpectomy tissue demonstrates distortion that represents carcinoma surrounding barb of localization wire and biopsy marking clip. (c) Right mediolateral oblique CAD image demonstrates unacceptable segmentation (arrowheads) and biopsy-proved cancer missed by the CAD system. (d) Repeated right mediolateral oblique CAD image demonstrates acceptable segmentation. Site of malignancy is correctly identified by the CAD system, as indicated (*).

View larger version (125K): [in a new window]   Figure 7b. Images in a 59-year-old woman with invasive ductal carcinoma of the right breast. (a) Mediolateral oblique mammogram of the right breast shows subtle architectural distortion (arrow) in the superior aspect of the breast. (b) Radiograph of lumpectomy tissue demonstrates distortion that represents carcinoma surrounding barb of localization wire and biopsy marking clip. (c) Right mediolateral oblique CAD image demonstrates unacceptable segmentation (arrowheads) and biopsy-proved cancer missed by the CAD system. (d) Repeated right mediolateral oblique CAD image demonstrates acceptable segmentation. Site of malignancy is correctly identified by the CAD system, as indicated (*).

View larger version (95K): [in a new window]   Figure 7c. Images in a 59-year-old woman with invasive ductal carcinoma of the right breast. (a) Mediolateral oblique mammogram of the right breast shows subtle architectural distortion (arrow) in the superior aspect of the breast. (b) Radiograph of lumpectomy tissue demonstrates distortion that represents carcinoma surrounding barb of localization wire and biopsy marking clip. (c) Right mediolateral oblique CAD image demonstrates unacceptable segmentation (arrowheads) and biopsy-proved cancer missed by the CAD system. (d) Repeated right mediolateral oblique CAD image demonstrates acceptable segmentation. Site of malignancy is correctly identified by the CAD system, as indicated (*).

View larger version (78K): [in a new window]   Figure 7d. Images in a 59-year-old woman with invasive ductal carcinoma of the right breast. (a) Mediolateral oblique mammogram of the right breast shows subtle architectural distortion (arrow) in the superior aspect of the breast. (b) Radiograph of lumpectomy tissue demonstrates distortion that represents carcinoma surrounding barb of localization wire and biopsy marking clip. (c) Right mediolateral oblique CAD image demonstrates unacceptable segmentation (arrowheads) and biopsy-proved cancer missed by the CAD system. (d) Repeated right mediolateral oblique CAD image demonstrates acceptable segmentation. Site of malignancy is correctly identified by the CAD system, as indicated (*).