Effect of Computer-Aided Detection on Independent Double Reading of Paired Screen-Film and Full-Field Digital Screening Mammograms

Abstract

CAD showed the potential to increase the cancer detection rate for FFDM and for screen-film mammography in breast cancer screening performed with independent double reading.

Computer aids and human second reading as interventions in screening mammography: Two systematic reviews to compare effects on cancer detection and recall rate

“…Of the retrieved papers not included, four were excluded since the results they reported were contained in other papers that were included,(32-35) three described studies comparing CAD to double reading rather than single reading, (36)(37)(38) and four were on selected cases not an unselected sequence of screening cases. (39)(40)(41)(42) Two of the included papers were published after the initial search and identified when the searches were repeated immediately prior to publication. (14;15) Table 1 summarises the ten included studies: six matched and four unmatched.…”

False Positive Marks on Unsuspicious Screening Mammography with Computer-Aided Detection

“…Their results showed that a CAD system with 90% sensitivity and two false positives per case improved radiologist performance, a CAD system with 90% sensitivity and eight false positives per case or a CAD system with 50% sensitivity and two false positives per case had no significant impact on radiologist performance, while a CAD system with 50% sensitivity and eight false positives per case was detrimental to radiologist performance. Since CAD sensitivity is about 90% or higher [22][23][24][25][26][27]], Zheng's results are another indicator that distracting/relevant marks ratio of the CAD systems reported in our study and other studies with current CAD that have about two false positives per case [25][26][27][28][29] should improve radiologist performance [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Although both versions of the CAD system in our study did not have statistically different specificities when considering all marks, v5.0 had higher specificity in terms of only masses than v7.2, and v7.2 had higher specificity in terms of only calcifications than v5.0.…”

“…False positive rate is commonly reported in the CAD literature, with earlier studies reporting means of 3-5 false positives per four-image case [3][4][5][22][23][24][25] and more recent studies reporting means of 2-3 false positives per fourimage case [26][27][28][29][30]. Recent studies estimate a range of 0.45 to 0.55 false positive marks per image from digital mammograms [26,30], indicating that the false positive rate is comparable between film screen and digital mammograms with a mean of 2-3 marks per four-image mammogram.…”

“…More recent CAD studies, some of which involved digital mammograms, have reported a mean of two false positive CAD marks per four-image mammogram [26][27][28][29][30]. In addition to retrospectively assessing the specificity and rate of false positive marks in two versions of CAD in screening mammography among unsuspicious cases in a university clinic setting, the purpose of this article is to assess the reviewing radiologist's ease of dismissing CAD false positives.…”

Presenting a Simplified Assistant Tool for Breast Cancer Diagnosis in Mammography to Radiologists

“…The effect of CAD on double reading of paired screen-film and full field digital screening mammograms was evaluated by Skaane et al [10]. The CAD (Image Checker, version 8.0 R2 Technology) showed the potential to increase the cancer detection rate for both FFDM (full field digital mammography) and screen-film mammography in breast cancer screen performed with independent double reading.…”