Computer-aided Detection of Masses at Mammography: Interactive Decision Support versus Prompts

Hupse, Rianne; Samulski, Maurice; Lobbes, Marc; Mann, Ritse M.; Mus, Roel; Heeten, Gerard J. den; Beijerinck, David; Pijnappel, Ruud M.; Boetes, C.; Karssemeijer, Nico

doi:10.1148/radiol.12120218

Cited by 53 publications

(56 citation statements)

References 27 publications

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“…The authors presume that the hiding of cues will be effective in minimizing reading disruptions and biases that are normally brought on by the numerous prompts that are readily displayed. 153 Initial testing of interactive CAD has demonstrated a statistically significant improvement in detection sensitivity concurrent with a reduction in the FP rate when compared with prompt-based CAD (receiver-operating characteristic area under curve: 0.62 for interactive CAD and 0.57 for prompt-based CAD; p 5 0.009 with a 95% confidence level). 153 Overcoming tissue superimposition The 2D depiction of a three-dimensional breast is one of the major limitations inherent to mammography.…”

Section: Breast Screeningmentioning

confidence: 99%

“…153 Initial testing of interactive CAD has demonstrated a statistically significant improvement in detection sensitivity concurrent with a reduction in the FP rate when compared with prompt-based CAD (receiver-operating characteristic area under curve: 0.62 for interactive CAD and 0.57 for prompt-based CAD; p 5 0.009 with a 95% confidence level). 153 Overcoming tissue superimposition The 2D depiction of a three-dimensional breast is one of the major limitations inherent to mammography. As previously discussed, this can lead to the false representation of a benign mass as having malignant characteristics.…”

Section: Breast Screeningmentioning

confidence: 99%

“…For mammographic CAD, developers trained ANN using sets of 100-10,000 images containing numerous biopsy-proven malignant and benign cases. 152,153 The function of ANN is to take input data such as border continuity, spiculation and contrast measures to produce an output which estimates the degree of malignancy associated with a given case. 154 As a result of this development, CAD does not simply identify all incidences of abnormality on a radiograph; rather its scope now extends to interpreting the classification of a lesion.…”

Section: Breast Screeningmentioning

confidence: 99%

“…154 A further effort to limit the FP rate manifests as a shift in the manner in which CAD cues are presented to the end-user. Hupse et al 153 hypothesized that an interactive decision support system would be more effective than the traditional prompt system that is currently used in clinical practice. The interactive approach is based on the premise that a CAD cue will not be presented to the reader unless a region of suspicion is queried by a mouse click.…”

Section: Breast Screeningmentioning

confidence: 99%

See 3 more Smart Citations

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.

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Section: Breast Screeningmentioning

confidence: 99%

Section: Breast Screeningmentioning

confidence: 99%

Section: Breast Screeningmentioning

confidence: 99%

Section: Breast Screeningmentioning

confidence: 99%

See 2 more Smart Citations

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…Before a technology breakthrough happens, which enables to reduce case-based false-positive detection rates to a level that is comparable or lower than the false-positive recall rates of radiologists, alternative approaches in both CAD development and cueing methods should be investigated and tested. For example, one research group demonstrated that using an interactive CAD cueing method, in which CAD marks and their associated detection scores remain hidden unless their locations are queried by a radiologist, could help in significantly improving the radiologists' performance compared to the use of traditional CAD cueing method [19]. However, hiding false-positive cues may still be unable to increase CAD sensitivity in detecting subtle cancers due to the limitation of CAD training datasets and have limited impact in helping radiologists significantly reduce false-positive recalls.…”

mentioning

confidence: 99%