Single reading with computer-aided detection performed by selected radiologists in a breast cancer screening program

Highlights • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The cancer detection rate improved at the cost of increasing recall rate. • 3-CAD, used by breast radiologists, did not help to detect more canc...

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Published in	European journal of radiology Vol. 83; no. 11; pp. 2019 - 2023
Main Authors	Bargalló, Xavier, Santamaría, Gorane, del Amo, Montse, Arguis, Pedro, Ríos, José, Grau, Jaume, Burrel, Marta, Cores, Enrique, Velasco, Martín
Format	Journal Article
Language	English
Published	Ireland Elsevier Ireland Ltd 01.11.2014
Subjects	Aged Breast Breast neoplasms Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Breast screening Clinical Competence Computer-assisted diagnosis Female Humans Mammography Mammography - methods Mass Screening - methods Observer Variation Pattern Recognition, Automated Program Evaluation Prospective Studies Radiographic Image Interpretation, Computer-Assisted Radiology Radiology - standards Reproducibility of Results Breast Mammography Breast neoplasms Computer-assisted diagnosis Breast screening
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Abstract	Highlights • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The cancer detection rate improved at the cost of increasing recall rate. • 3-CAD, used by breast radiologists, did not help to detect more cancers.
AbstractList	Highlights • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The cancer detection rate improved at the cost of increasing recall rate. • 3-CAD, used by breast radiologists, did not help to detect more cancers. To assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by computer-aided detection (CAD) in a breast cancer screening program. This was a prospective study approved by the ethics committee. Data from 21,321 consecutive screening mammograms in incident rounds (2010-2012) were read following a single reading plus CAD protocol and compared with data from 47,462 consecutive screening mammograms in incident rounds (2004-2010) that were interpreted following a double reading plus arbitration protocol. For the single reading, radiologists were selected on the basis of the appraisement of their previous performance. Period 2010-2012 vs. period 2004-2010: Cancer detection rate (CDR): 6.1‰ (95% confidence interval: 5.1-7.2) vs. 5.25‰; Recall rate (RR): 7.02% (95% confidence interval: 6.7-7.4) vs. 7.24% (selected readers before arbitration) and vs. 3.94 (all readers after arbitration); Predictive positive value of recall: 8.69% vs. 13.32%. Average size of invasive cancers: 14.6±9.5mm vs. 14.3±9.5mm. Stage: 0 (22.3/26.1%); I (59.2/50.8%); II (19.2/17.1%); III (3.1/3.3%); IV (0/1.9%). Specialized breast radiologists performed better than general radiologists. The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration. •1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD.•2-The cancer detection rate improved at the cost of increasing recall rate.•3-CAD, used by breast radiologists, did not help to detect more cancers. To assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by computer-aided detection (CAD) in a breast cancer screening program. This was a prospective study approved by the ethics committee. Data from 21,321 consecutive screening mammograms in incident rounds (2010–2012) were read following a single reading plus CAD protocol and compared with data from 47,462 consecutive screening mammograms in incident rounds (2004–2010) that were interpreted following a double reading plus arbitration protocol. For the single reading, radiologists were selected on the basis of the appraisement of their previous performance. Period 2010–2012 vs. period 2004–2010: Cancer detection rate (CDR): 6.1‰ (95% confidence interval: 5.1–7.2) vs. 5.25‰; Recall rate (RR): 7.02% (95% confidence interval: 6.7–7.4) vs. 7.24% (selected readers before arbitration) and vs. 3.94 (all readers after arbitration); Predictive positive value of recall: 8.69% vs. 13.32%. Average size of invasive cancers: 14.6±9.5mm vs. 14.3±9.5mm. Stage: 0 (22.3/26.1%); I (59.2/50.8%); II (19.2/17.1%); III (3.1/3.3%); IV (0/1.9%). Specialized breast radiologists performed better than general radiologists. The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration. OBJECTIVESTo assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by computer-aided detection (CAD) in a breast cancer screening program.METHODSThis was a prospective study approved by the ethics committee. Data from 21,321 consecutive screening mammograms in incident rounds (2010-2012) were read following a single reading plus CAD protocol and compared with data from 47,462 consecutive screening mammograms in incident rounds (2004-2010) that were interpreted following a double reading plus arbitration protocol. For the single reading, radiologists were selected on the basis of the appraisement of their previous performance.RESULTSPeriod 2010-2012 vs. period 2004-2010: Cancer detection rate (CDR): 6.1‰ (95% confidence interval: 5.1-7.2) vs. 5.25‰; Recall rate (RR): 7.02% (95% confidence interval: 6.7-7.4) vs. 7.24% (selected readers before arbitration) and vs. 3.94 (all readers after arbitration); Predictive positive value of recall: 8.69% vs. 13.32%. Average size of invasive cancers: 14.6±9.5mm vs. 14.3±9.5mm. Stage: 0 (22.3/26.1%); I (59.2/50.8%); II (19.2/17.1%); III (3.1/3.3%); IV (0/1.9%). Specialized breast radiologists performed better than general radiologists.CONCLUSIONSThe cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration.
Author	Grau, Jaume Ríos, José Burrel, Marta del Amo, Montse Bargalló, Xavier Santamaría, Gorane Cores, Enrique Arguis, Pedro Velasco, Martín
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Snippet	Highlights • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The... •1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD.•2-The cancer... To assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by... OBJECTIVESTo assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by...
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SubjectTerms	Aged Breast Breast neoplasms Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Breast screening Clinical Competence Computer-assisted diagnosis Female Humans Mammography Mammography - methods Mass Screening - methods Observer Variation Pattern Recognition, Automated Program Evaluation Prospective Studies Radiographic Image Interpretation, Computer-Assisted Radiology Radiology - standards Reproducibility of Results
Title	Single reading with computer-aided detection performed by selected radiologists in a breast cancer screening program
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