PURPOSE: To prospectively assess the effect of computer-aided detection (CAD) on the interpretation of screening mammograms in a community breast center. MATERIALS AND METHODS: Over a 12-month period, 12,860 screening mammograms were interpreted with the assistance of a CAD system. Each mammogram was initially interpreted without the assistance of CAD, followed immediately by a reevaluation of areas marked by the CAD system. Data were recorded to measure the effect of CAD on the recall rate, positive predictive value for biopsy, cancer detection rate, and stage of malignancies at detection. RESULTS: When comparing the radiologist’s performance without CAD with that when CAD was used, the authors observed the following: (a) an increase in recall rate from 6.5% to 7.7%, (b) no change in the positive predictive value for biopsy at 38%, (c) a 19.5% increase in the number of cancers detected, and (d) an increase in the proportion of early-stage (0 and I) malignancies detected from 73% to 78%. CONCLUSION: The u...

Screening mammography with computer-aided detection: prospective study of 12,860 patients in a community breast center.

Breast cancer is the second-most common and leading cause of cancer death among women. It has become a major health issue in the world over the past 50 years, and its incidence has increased in recent years. Early detection is an effective way to diagnose and manage breast cancer. Computer-aided detection or diagnosis (CAD) systems can play a key role in the early detection of breast cancer and can reduce the death rate among women with breast cancer. The purpose of this paper is to provide an overview of recent advances in the development of CAD systems and related techniques. We begin with a brief introduction to some basic concepts related to breast cancer detection and diagnosis. We then focus on key CAD techniques developed recently for breast cancer, including detection of calcifications, detection of masses, detection of architectural distortion, detection of bilateral asymmetry, image enhancement, and image retrieval.

Computer-Aided Detection and Diagnosis of Breast Cancer With Mammography: Recent Advances

PURPOSE: To retrospectively determine the mammographic characteristics of cancers missed at screening mammography and assess the ability of computer-aided detection (CAD) to mark the missed cancers. MATERIALS AND METHODS: A multicenter retrospective study accrued 1,083 consecutive cases of breast cancer detected at screening mammography. Prior mammograms were available in 427 cases. Of these, 286 had lesions visible in retrospect. The 286 cases underwent blinded review by panels of radiologists; a majority recommended recall for 112 cases. Two experienced radiologists compared prior mammograms in 110 of these cases with the subsequent screening mammograms (when cancer was detected), noting mammographic characteristics of breast density, lesion type, size, morphology, and subjective reasons for possible miss. The prior mammograms were then analyzed with a CAD program. RESULTS: There were 110 patients with 115 cancers. On the prior mammograms with missed cancers, 35 (30%) of the 115 lesions were calcificati...

Mammographic Characteristics of 115 Missed Cancers Later Detected with Screening Mammography and the Potential Utility of Computer-aided Detection

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. The basic concept of CAD is to provide a computer output as a second opinion to assist radiologists' image interpretation by improving the accuracy and consistency of radiological diagnosis and also by reducing the image reading time. In this article, a number of CAD schemes are presented, with emphasis on potential clinical applications. These schemes include: (1) detection and classification of lung nodules on digital chest radiographs; (2) detection of nodules in low dose CT; (3) distinction between benign and malignant nodules on high resolution CT; (4) usefulness of similar images for distinction between benign and malignant lesions; (5) quantitative analysis of diffuse lung diseases on high resolution CT; and (6) detection of intracranial aneurysms in magnetic resonance angiography. Because CAD can be applied to all imaging modalities, all body parts and all kinds of examinations, it is likely that CAD will have a major impact on medical imaging and diagnostic radiology in the 21st century.

Current status and future potential of computer-aided diagnosis in medical imaging.

The authors investigated the classification of regions of interest (ROI's) on mammograms as either mass or normal tissue using a convolution neural network (CNN). A CNN is a backpropagation neural network with two-dimensional (2-D) weight kernels that operate on images. A generalized, fast and stable implementation of the CNN was developed. The input images to the CNN were obtained from the ROI's using two techniques. The first technique employed averaging and subsampling. The second technique employed texture feature extraction methods applied to small subregions inside the ROI. Features computed over different subregions were arranged as texture images, which were subsequently used as CNN inputs. The effects of CNN architecture and texture feature parameters on classification accuracy were studied. Receiver operating characteristic (ROC) methodology was used to evaluate the classification accuracy. A data set consisting of 168 ROIs containing biopsy-proven masses and 504 ROI's containing normal breast tissue was extracted from 168 mammograms by radiologists experienced in mammography. This data set was used for training and testing the CNN. With the best combination of CNN architecture and texture feature parameters, the area under the test ROC curve reached 0.87, which corresponded to a true-positive fraction of 90% at a false positive fraction of 31%. The authors' results demonstrate the feasibility of using a CNN for classification of masses and normal tissue on mammograms.

Classification of mass and normal breast tissue: a convolution neural network classifier with spatial domain and texture images

PURPOSE: To study the use of a computer vision method as a second reader for the detection of spiculated lesions on screening mammograms. MATERIALS AND METHODS: An algorithmic computer process for the detection of spiculated lesions on digitized screen-film mammograms was applied to 85 four-view clinical cases: 36 cases with cancer proved by means of biopsy and 49 cases with negative findings at examination and follow-up. The computer detections were printed as film with added outlines that indicated the suspected cancers. Four radiologists screened the 85 cases twice, once without and once with the computer reports as ancillary films. RESULTS: The algorithm alone achieved 100% sensitivity, with a specificity of 82%. The computer reports increased the average radiologist sensitivity by 9.7% (P = .005), moving from 80.6% to 90.3%, with no decrease in average specificity. CONCLUSION: The study demonstrated that computer analysis of mammograms can provide a substantial and statistically significant increase ...

W P Kegelmeyer

Papers

Computer-aided mammographic screening for spiculated lesions.