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Invasive breast cancers detected by screening mammography: A detailed comparison of computer‐aided detection‐assisted single reading and double reading
Author(s) -
Cawson JN,
Nickson C,
Amos A,
Hill G,
Whan AB,
Kavanagh AM
Publication year - 2009
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2009.02100.x
Subject(s) - medicine , cad , mammography , breast cancer , cancer , oncology , nuclear medicine , engineering drawing , engineering
Summary To compare double reading plus arbitration for discordance, (currently best practice, (BP)) with computer‐aided‐detection (CAD)‐assisted single reading (CAD‐R) for detection of invasive cancers detected within BreastScreen Australia. Secondarily, to examine characteristics of cancers detected/rejected using each method. Mammograms of 157 randomly selected double‐read invasive cancers were mixed 1:9 with normal cancers (total 1569), all detected in a BreastScreen service. Cancers were detected by two readers or one reader (C2 and C1 cancers, ratio 70:30%) in the program. The 1569 film‐screen mammograms were read by two radiologists (reader A (RA) and reader B(RB)), with findings recorded before and after CAD. Discordant findings with BP were resolved by arbitration. We compared CAD‐assisted reading (CAD‐RA, CAD‐RB) with BP, and CAD and arbitration contribution to findings. We correlated cancer size, sensitivity and mammographic density with detection methods. BP sensitivity 90.4% compared with CAD‐RA sensitivity 86.6% ( P = 0.12) and CAD‐RB 94.3% ( P = 0.14). CAD‐RB specificity was less than BP ( P = 0.01). CAD sensitivity was 93%, but readers rejected most positive CAD prompts. After CAD, reader's sensitivity increased 1.9% and specificity dropped 0.2% and 0.8%. Arbitration decreased specificity 4.7%. Receiving operator curves analysis demonstrated BP accuracy better than CAD‐RA, borderline significance ( P = 0.07), but not CAD‐RB. Secondarily, cancer size was similar for BP and CAD‐R. Cancers recalled after arbitration ( P = 0.01) and CAD‐R ( P = 0.10) were smaller. No difference in cancer size or sensitivity between reading methods was found with increasing breast density. CAD‐R and BP sensitivity and cancer detection size were not significantly different. CAD‐R specificity was significantly lower for one reader.