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Published online before print June 28, 2002, 10.1148/radiol.2242010703
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(Radiology 2002;224:560-568.)
© RSNA, 2002


Breast Imaging

Breast Cancer: Effectiveness of Computer-aided Diagnosis—Observer Study with Independent Database of Mammograms1

Zhimin Huo, PhD2, Maryellen L. Giger, PhD, Carl J. Vyborny, MD, PhD and Charles E. Metz, PhD

1 From the Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC2026, Chicago, IL 60637. From the 1999 RSNA scientific assembly. Received March 29, 2001; revision requested May 21; final revision received January 14, 2002; accepted February 6. Supported in part by U.S. Army Medical Research and Materiel Command grant DAMD 17-96-1-6058. Address correspondence to M.L.G. (e-mail: m-giger@uchicago.edu).

PURPOSE: To evaluate the effectiveness of a computerized classification method as an aid to radiologists reviewing clinical mammograms for which the diagnoses were unknown to both the radiologists and the computer.

MATERIALS AND METHODS: Six mammographers and six community radiologists participated in an observer study. These 12 radiologists interpreted, with and without the computer aid, 110 cases that were unknown to both the 12 radiologist observers and the trained computer classification scheme. The radiologists’ performances in differentiating between benign and malignant masses without and with the computer aid were evaluated with receiver operating characteristic (ROC) analysis. Two-tailed P values were calculated for the Student t test to indicate the statistical significance of the differences in performances with and without the computer aid.

RESULTS: When the computer aid was used, the average performance of the 12 radiologists improved, as indicated by an increase in the area under the ROC curve (Az) from 0.93 to 0.96 (P < .001), by an increase in partial area under the ROC curve (0.90A'z) from 0.56 to 0.72 (P < .001), and by an increase in sensitivity from 94% to 98% (P = .022). No statistically significant difference in specificity was found between readings with and those without computer aid ({Delta} = -0.014; P = .46; 95% CI: -0.054, 0.026), where {Delta} is difference in specificity. When we analyzed results from the mammographers and community radiologists as separate groups, a larger improvement was demonstrated for the community radiologists.

CONCLUSION: Computer-aided diagnosis can potentially help radiologists improve their diagnostic accuracy in the task of differentiating between benign and malignant masses seen on mammograms.

© RSNA, 2002

Index terms: Breast neoplasms, 00.31, 00.32 • Breast neoplasms, radiography, 00.111, 00.119 • Breast radiography, 00.111, 00.119 • Computers, diagnostic aid • Receiver operating characteristic curve (ROC)




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