Morton Marilyn J, Whaley Dana H, Brandt Kathleen R, Amrami Kimberly K
Divisions of Breast Imaging and Intervention and Biostatistics, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Radiology. 2006 May;239(2):375-83. doi: 10.1148/radiol.2392042121. Epub 2006 Mar 28.
To prospectively determine the effect of a commercially available computer-aided detection (CAD) system on interpretations of screening mammograms.
Institutional review board approval was granted; informed consent and HIPAA compliance were waived. A total of 21 349 screening mammograms obtained in 18 096 women were interpreted first without and then with review of CAD images to determine the effect of CAD analysis on the screening breast cancer detection rate, recall rate, and positive predictive value (PPV) for biopsy. The percentage of total cancers detected by the radiologists independent of CAD and the percentage correctly marked by the CAD system were determined.
On the basis of pre-CAD interpretations, 2101 patients were recalled for diagnostic evaluation, 256 biopsies were performed, and 105 breast cancers were diagnosed. The breast cancer detection rate per 1000 screening mammograms was 4.92 (105 of 21 349 mammograms), the recall rate was 9.84% (2101 of 21 349 mammograms), and the PPV for biopsy was 41.0% (105 of 256 biopsies). After CAD image review, 199 additional patients were recalled, 21 additional biopsies were performed, and eight additional cancers were detected. The effect was a 7.62% (eight of 105) increase in the number of breast cancers detected, an increase in the recall rate to 10.77% (2300 of 21 349 mammograms), and a slight decrease in the PPV to 40.8% (113 of 277 biopsies). Radiologists detected 92.9% (105 of 113 cancers) of the total cancers, and CAD correctly marked 76.1% (86 of 113 cancers).
The use of CAD improved the detection of breast cancer, with an acceptable increase in the recall rate and a minimal increase in the number of biopsies with benign results.
前瞻性地确定一种商用计算机辅助检测（CAD）系统对筛查乳腺X线摄影解读的影响。
获得机构审查委员会批准；豁免知情同意和符合健康保险流通与责任法案（HIPAA）的要求。对18096名女性的21349份筛查乳腺X线摄影进行解读，先在不参考CAD图像的情况下进行，然后在参考CAD图像后进行，以确定CAD分析对筛查乳腺癌检出率、召回率和活检阳性预测值（PPV）的影响。确定放射科医生独立于CAD检测出的癌症总数的百分比以及CAD系统正确标记的百分比。
基于CAD前的解读，2101名患者被召回进行诊断评估，进行了256次活检，诊断出105例乳腺癌。每1000份筛查乳腺X线摄影的乳腺癌检出率为4.92（21349份乳腺X线摄影中的105例），召回率为9.84%（21349份乳腺X线摄影中的2101例），活检的PPV为41.0%（256次活检中的105例）。在参考CAD图像后，又有199名患者被召回，进行了21次额外活检，又检测出8例癌症。结果是检测出的乳腺癌数量增加了7.62%（105例中的8例），召回率提高到10.77%（21349份乳腺X线摄影中的2300例），PPV略有下降至40.8%（277次活检中的113例）。放射科医生检测出了92.9%（113例癌症中的105例）的癌症总数，CAD正确标记了76.1%（113例癌症中的86例）。
使用CAD提高了乳腺癌的检出率，召回率有可接受的增加，良性结果的活检数量增加最少。
