Radiology · 2004
Sensitivity of noncommercial computer-aided detection system for mammographic breast cancer detection: pilot clinical trial.
Клиническое исследованиеСравнительное исследованиеСтатьяМногоцентровое исследованиеПоддержка правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод пока не подготовлен
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Helvie Mark A, Hadjiiski Lubomir, Makariou Erini, Chan Heang-Ping, Petrick Nicholas, Sahiner Berkman, Lo Shih-Chung B, Freedman Matthew, Adler Dorit, Bailey Janet, Blane Caroline, Hoff Donna, Hunt Karen, Joynt Lynn, Klein Katherine, Paramagul Chintana, Patterson Stephanie K, Roubidoux Marilyn A
Аннотация
PURPOSE: To evaluate a noncommercial computer-aided detection (CAD) program for breast cancer detection with screening mammography.
MATERIALS AND METHODS: A CAD program was developed for mammographic breast cancer detection. The program was applied to 2,389 patients' screening mammograms at two geographically remote academic institutions (institutions A and B). Thirteen radiologists who specialized in breast imaging participated in this pilot study. For each case, the individual radiologist performed a prospective Breast Imaging Reporting and Data System (BI-RADS) assessment after viewing of the screening mammogram. Subsequently, the radiologist was shown CAD results and rendered a second BI-RADS assessment by using knowledge of both mammographic appearance and CAD results. Outcome analysis of results of examination in patients recalled for a repeat examination, of biopsy, and of 1-year follow-up examination was recorded. Correct detection with CAD included a computer-generated mark indicating a possible malignancy on craniocaudal or mediolateral oblique views or both.
RESULTS: Eleven (0.46%) of 2,389 patients had mammographically detected nonpalpable breast cancers. Ten (91%) of 11 (95% CI: 74%, 100%) cancers were correctly identified with CAD. Radiologist sensitivity without CAD was 91% (10 of 11; 95% CI: 74%, 100%). In 1,077 patients, follow-up findings were documented at 1 year. Five (0.46%) patients developed cancers, which were found on subsequent screening mammograms. The area where the cancers developed in two (40%) of these five patients was marked (true-positive finding) by the computer in the preceding year. Because of CAD results, a 9.7% increase in recall rate from 14.4% (344 of 2,389) to 15.8% (378 of 2,389) occurred. Radiologists' recall rate of study patients prior to use of CAD was 31% higher than the average rate for nonstudy cases (10.3%) during the same time period at institution A.
CONCLUSION: Performance of the CAD program had a very high sensitivity of 91% (95% CI: 74%, 100%).
MATERIALS AND METHODS: A CAD program was developed for mammographic breast cancer detection. The program was applied to 2,389 patients' screening mammograms at two geographically remote academic institutions (institutions A and B). Thirteen radiologists who specialized in breast imaging participated in this pilot study. For each case, the individual radiologist performed a prospective Breast Imaging Reporting and Data System (BI-RADS) assessment after viewing of the screening mammogram. Subsequently, the radiologist was shown CAD results and rendered a second BI-RADS assessment by using knowledge of both mammographic appearance and CAD results. Outcome analysis of results of examination in patients recalled for a repeat examination, of biopsy, and of 1-year follow-up examination was recorded. Correct detection with CAD included a computer-generated mark indicating a possible malignancy on craniocaudal or mediolateral oblique views or both.
RESULTS: Eleven (0.46%) of 2,389 patients had mammographically detected nonpalpable breast cancers. Ten (91%) of 11 (95% CI: 74%, 100%) cancers were correctly identified with CAD. Radiologist sensitivity without CAD was 91% (10 of 11; 95% CI: 74%, 100%). In 1,077 patients, follow-up findings were documented at 1 year. Five (0.46%) patients developed cancers, which were found on subsequent screening mammograms. The area where the cancers developed in two (40%) of these five patients was marked (true-positive finding) by the computer in the preceding year. Because of CAD results, a 9.7% increase in recall rate from 14.4% (344 of 2,389) to 15.8% (378 of 2,389) occurred. Radiologists' recall rate of study patients prior to use of CAD was 31% higher than the average rate for nonstudy cases (10.3%) during the same time period at institution A.
CONCLUSION: Performance of the CAD program had a very high sensitivity of 91% (95% CI: 74%, 100%).
Предметные рубрики MeSH
AdultAgedAged, 80 and overBiopsy, Fine-NeedleBreast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularFalse Negative ReactionsFemaleFollow-Up StudiesHumansMammographyMiddle AgedPilot ProjectsPredictive Value of TestsProspective StudiesRadiographic Image Interpretation, Computer-AssistedRadiology, InterventionalSensitivity and SpecificityUnited StatesWomen's Health