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Eur Radiol. 2018 Jul;28(7):2996-3006. doi: 10.1007/s00330-017-5280-3. Epub 2018 Feb 7.

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

Author information

1
Department of Radiology and Nuclear Medicine, Radboud University Medical Centre Nijmegen (NL), Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. jan.vanzelst@radboudumc.nl.
2
Department of Radiology and Nuclear Medicine, Radboud University Medical Centre Nijmegen (NL), Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
3
Department of Biomedical Imaging and Image Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna/Vienna General Hospital (A), Vienna, Austria.
4
Department of Radiology, Centre Diagnosi per la Imatge Tarragona (E), Tarragona, Spain.
5
Center for Medical Imaging and Department of Radiology, University Medical Centre Groningen (NL), Groningen, Netherlands.
6
MeVis Medical Solutions, Bremen (DE), Bremen, Germany.
7
Department of Gynaecology and Obstetrics, Universitäts-Frauenklinik Heidelberg (D), Heidelberg, Germany.
8
Department of Radiology, Jeroen Bosch Hospital, s-Hertogenbosch (NL), s-Hertogenbosch, Netherlands.
9
Department of Radiology, University Medical Centre Utrecht (NL), Utrecht, Netherlands.

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.

KEYWORDS:

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

PMID:
29417251
PMCID:
PMC5986849
DOI:
10.1007/s00330-017-5280-3
[Indexed for MEDLINE]
Free PMC Article

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