Dedicated computer-aided detection software for automated 3D breast ultrasound; an efficient tool for the radiologist in supplemental screening of women with dense breasts
van Zelst, Jan C M; Tan, Tao; Clauser, Paola; Domingo, Angels; Dorrius, Monique D; Drieling, Daniel; Golatta, Michael; Gras, Francisca; de Jong, Mathijn; Pijnappel, Ruud; Rutten, Matthieu J C M; Karssemeijer, Nico; Mann, Ritse M
(2018) European Radiology, volume 28, issue 7, pp. 2996 - 3006
(Article)
Abstract
Objectives: To determine the effect of computer-aided-detection (CAD) software for automated breast ultrasound (ABUS) on reading time (RT) and performance in screening for breast cancer. Material and methods: Unilateral ABUS examinations of 120 women with dense breasts were randomly selected from a multi-institutional archive of cases including 30 malignant (20/30
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mammography-occult), 30 benign, and 60 normal cases with histopathological verification or ≥ 2 years of negative follow-up. Eight radiologists read once with (CAD-ABUS) and once without CAD (ABUS) with > 8 weeks between reading sessions. Readers provided a BI-RADS score and a level of suspiciousness (0-100). RT, sensitivity, specificity, PPV and area under the curve (AUC) were compared. Results: Average RT was significantly shorter using CAD-ABUS (133.4 s/case, 95% CI 129.2-137.6) compared with ABUS (158.3 s/case, 95% CI 153.0-163.3) (p < 0.001). Sensitivity was 0.84 for CAD-ABUS (95% CI 0.79-0.89) and ABUS (95% CI 0.78-0.88) (p = 0.90). Three out of eight readers showed significantly higher specificity using CAD. Pooled specificity (0.71, 95% CI 0.68-0.75 vs. 0.67, 95% CI 0.64-0.70, p = 0.08) and PPV (0.50, 95% CI 0.45-0.55 vs. 0.44, 95% CI 0.39-0.49, p = 0.07) were higher in CAD-ABUS vs. ABUS, respectively, albeit not significantly. Pooled AUC for CAD-ABUS was comparable with ABUS (0.82 vs. 0.83, p = 0.53, respectively). Conclusion: CAD software for ABUS may decrease the time needed to screen for breast cancer without compromising the screening performance of radiologists. Key Points: • ABUS with CAD software may speed up reading time without compromising radiologists’ accuracy. • CAD software for ABUS might prevent non-detection of malignant breast lesions by radiologists. • Radiologists reading ABUS with CAD software might improve their specificity without losing sensitivity.
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Keywords: Ultrasonography, Breast neoplasms, Diagnosis, Computer-assisted, Mammography, Early detection of cancer, Breast Neoplasms/diagnostic imaging, Area Under Curve, Imaging, Three-Dimensional/methods, Humans, Middle Aged, Ultrasonography, Mammary/methods, Random Allocation, Mammography/methods, Multimodal Imaging/methods, Early Detection of Cancer/methods, Time Factors, Sensitivity and Specificity, Adult, Female, Aged, Image Interpretation, Computer-Assisted/methods, Software, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 0938-7994
Publisher: Springer-Verlag
Note: Funding Information: The authors of this manuscript declare relationships with the following companies: Dr. N. Karssemeijer is CEO of Screenpoint Medical Inc. and a shareholder in Qview Medical Inc. and Matakina Ltd. Dr. R. Mann is speaker for Siemens Healthcare. Funding Information: Funding This study has received funding by European Union's Seventh Framework programme FP7 under grant agreement no. 306088. Publisher Copyright: © 2018, The Author(s).
(Peer reviewed)
