Improved cancer detection in automated breast ultrasound by radiologists using Computer Aided Detection

Eur J Radiol. 2017 Apr:89:54-59. doi: 10.1016/j.ejrad.2017.01.021. Epub 2017 Jan 22.

Abstract

Objective: To investigate the effect of dedicated Computer Aided Detection (CAD) software for automated breast ultrasound (ABUS) on the performance of radiologists screening for breast cancer.

Methods: 90 ABUS views of 90 patients were randomly selected from a multi-institutional archive of cases collected between 2010 and 2013. This dataset included normal cases (n=40) with >1year of follow up, benign (n=30) lesions that were either biopsied or remained stable, and malignant lesions (n=20). Six readers evaluated all cases with and without CAD in two sessions. CAD-software included conventional CAD-marks and an intelligent minimum intensity projection of the breast tissue. Readers reported using a likelihood-of-malignancy scale from 0 to 100. Alternative free-response ROC analysis was used to measure the performance.

Results: Without CAD, the average area-under-the-curve (AUC) of the readers was 0.77 and significantly improved with CAD to 0.84 (p=0.001). Sensitivity of all readers improved (range 5.2-10.6%) by using CAD but specificity decreased in four out of six readers (range 1.4-5.7%). No significant difference was observed in the AUC between experienced radiologists and residents both with and without CAD.

Conclusions: Dedicated CAD-software for ABUS has the potential to improve the cancer detection rates of radiologists screening for breast cancer.

Keywords: Automated breast ultrasound; Breast cancer; Computer Aided Detection; Detection; Screening; Ultrasound.

MeSH terms

  • Adult
  • Area Under Curve
  • Breast / diagnostic imaging
  • Breast Neoplasms / diagnostic imaging*
  • Diagnosis, Computer-Assisted / methods*
  • Female
  • Humans
  • Middle Aged
  • Observer Variation
  • Probability
  • ROC Curve
  • Radiologists
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ultrasonography, Mammary / methods*