Dedicated computer-aided detection software for automated 3D breast ultrasound; an efficient tool for the radiologist in supplemental screening of women with dense breasts

Jan C.M. van Zelst, Tao Tan, Paola Clauser, Angels Domingo, Monique D. Dorrius, Daniel Drieling, Michael Golatta, Francisca Gras, Mathijn de Jong, Ruud Pijnappel, Matthieu J.C.M. Rutten, Nico Karssemeijer, Ritse M. Mann

Research output: Contribution to journalArticlepeer-review

50 Citations (Scopus)

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 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.

Original languageEnglish
Pages (from-to)2996-3006
Number of pages11
JournalEuropean Radiology
Volume28
Issue number7
DOIs
Publication statusPublished - 1 Jul 2018
Externally publishedYes

Keywords

  • Breast neoplasms
  • Diagnosis, Computer-assisted
  • Early detection of cancer
  • Mammography
  • Ultrasonography

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