Computer-assisted reading of mammograms.

Techniques developed in computer vision and automated pattern recognition can be applied to assist radiologists in reading mammograms. With the introduction of direct digital mammography this will become a feasible approach. A radiologist in breast cancer screening can use findings of the computer as a second opinion, or as a pointer to suspicious regions. This may increase the sensitivity and specificity of screening programs, and it may avoid the need for double reading. In this paper methods which have been developed for automated detection of mammographic abnormalities are reviewed. Programs for detecting microcalcification clusters and stellate lesions have reached a level of performance which makes application in practice viable. Current programs for recognition of masses and asymmetry perform less well. Large-scale studies still have to demonstrate if radiologists in a screening situation can deal with the relatively large number of false positives which are marked by computer programs, where the number of normal cases is much higher than in observer experiments conducted thus far.