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Breast Lesion Detection and Classification: Comparison of Screen-Film Mammography and Full-Field Digital Mammography with Soft-copy Reading—Observer Performance Study¹

¹ From the Department of Radiology, Ullevaal University Hospital, Breast Imaging Center, Kirkeveien 166, N-0407 Oslo, Norway (P.S., K.Y.); Institut Gustave Roussy, Villejuif, France (C.B.); Department of Diagnostic Radiology, University Charité, Berlin, Germany (F.D., S.D.); and Institut Imagerive, Geneva, Switzerland (J.C.P.); and private consultant, Milwaukee, Wis (L.T.N.). From the 2003 RSNA Annual Meeting. Received September 19, 2004; revision requested November 5; revision received January 24, 2005; accepted February 23. Address correspondence to P.S. (e-mail: per.skaane{at}ulleval.no).

View larger version (18K): [in a new window]   Figure a. Graphs show fitted ROC curves for full-field digital mammography (FFDM) and screen-film mammography (SFM). (a) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.916; that for screen-film mammography, 0.887 (P = .22). (b) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the five-point rating scale for probability of malignancy: Az value for digital mammography was 0.925; that for screen-film mammography, 0.893 (P = .25). (c) Mean ROC curves for all benign and malignant densities and masses (n = 71) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.860; that for screen-film mammography, 0.835 (P = .646). The six cancers that manifested as masses with associated microcalcifications were excluded from analysis. (d) Mean ROC curves for cases with benign findings that manifested as microcalcifications (n = 43) and cancer cases that manifested as microcalcifications (n = 14) and four readers on the basis of the BI-RADS classification. Az value for digital mammography was 0.841; that for screen-film mammography, 0.787. This difference was not significant. FPF = false-positive fraction, TPF = true-positive fraction.

View larger version (19K): [in a new window]   Figure b. Graphs show fitted ROC curves for full-field digital mammography (FFDM) and screen-film mammography (SFM). (a) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.916; that for screen-film mammography, 0.887 (P = .22). (b) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the five-point rating scale for probability of malignancy: Az value for digital mammography was 0.925; that for screen-film mammography, 0.893 (P = .25). (c) Mean ROC curves for all benign and malignant densities and masses (n = 71) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.860; that for screen-film mammography, 0.835 (P = .646). The six cancers that manifested as masses with associated microcalcifications were excluded from analysis. (d) Mean ROC curves for cases with benign findings that manifested as microcalcifications (n = 43) and cancer cases that manifested as microcalcifications (n = 14) and four readers on the basis of the BI-RADS classification. Az value for digital mammography was 0.841; that for screen-film mammography, 0.787. This difference was not significant. FPF = false-positive fraction, TPF = true-positive fraction.

View larger version (18K): [in a new window]   Figure c. Graphs show fitted ROC curves for full-field digital mammography (FFDM) and screen-film mammography (SFM). (a) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.916; that for screen-film mammography, 0.887 (P = .22). (b) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the five-point rating scale for probability of malignancy: Az value for digital mammography was 0.925; that for screen-film mammography, 0.893 (P = .25). (c) Mean ROC curves for all benign and malignant densities and masses (n = 71) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.860; that for screen-film mammography, 0.835 (P = .646). The six cancers that manifested as masses with associated microcalcifications were excluded from analysis. (d) Mean ROC curves for cases with benign findings that manifested as microcalcifications (n = 43) and cancer cases that manifested as microcalcifications (n = 14) and four readers on the basis of the BI-RADS classification. Az value for digital mammography was 0.841; that for screen-film mammography, 0.787. This difference was not significant. FPF = false-positive fraction, TPF = true-positive fraction.

View larger version (20K): [in a new window]   Figure d. Graphs show fitted ROC curves for full-field digital mammography (FFDM) and screen-film mammography (SFM). (a) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.916; that for screen-film mammography, 0.887 (P = .22). (b) Mean ROC curves for all cases (n = 232) and all six readers on the basis of the five-point rating scale for probability of malignancy: Az value for digital mammography was 0.925; that for screen-film mammography, 0.893 (P = .25). (c) Mean ROC curves for all benign and malignant densities and masses (n = 71) and all six readers on the basis of the BI-RADS classification: Az value for digital mammography was 0.860; that for screen-film mammography, 0.835 (P = .646). The six cancers that manifested as masses with associated microcalcifications were excluded from analysis. (d) Mean ROC curves for cases with benign findings that manifested as microcalcifications (n = 43) and cancer cases that manifested as microcalcifications (n = 14) and four readers on the basis of the BI-RADS classification. Az value for digital mammography was 0.841; that for screen-film mammography, 0.787. This difference was not significant. FPF = false-positive fraction, TPF = true-positive fraction.