2003 Computer-Aided Detection Versus Independent Double Reading of Masses on Mammograms Authors: Karssemeijer N, Otten JDM, Verbeek ALM et al Published: Radiology 2003; 227: 192-200. PURPOSE: To evaluate the use of a computer-aided detection (CAD) system (designed for mammographic mass detection) to help improve mass interpretation and to compare CAD results with independent double-reading results. CONCLUSION: For prior mammograms that depicted masses, the mean sensitivity of the radiologists, as averaged among the false-positive rates lower than 10%, was 39.4%; this increased by 7.0% with CAD and by 10.5% with double reading. Differences among single, double, and CAD readings were statistically significant (P < .001). Although independent double reading yields the best detection performance, the presence and probability of CAD mass markers can improve mammogram interpretation.   Analysis of 172 Subtle Findings on Prior Normal Mammograms in Women with Breast Cancer Detected at Follow-up Screening Authors: Ikeda DM, Birdwell RL, O’Shaughnessy KF, Brenner RJ, and Sickles EA Published: Radiology 2003; 226: 494-503. PURPOSE:To retrospectively review nonspecific findings on prior screening mammograms to determine what features were most often deemed normal or benign despite the development of breast cancer in the same location detected at follow-up screening. CONCLUSION: There were 110 patients with 115 cancers. On the prior mammograms with missed cancers, 35 (30%) of the 115 lesions were calcifications, with 17 of 35 (49%) clustered or pleomorphic. Eighty of the 115 (70%) were mass lesions, with 32 of 80 (40%) spiculated or irregular. For calcifications and masses, the most frequently suggested reasons for possible miss were dense breasts (12 of 35; 34%) and distracting lesions (35 of 80; 44%), respectively. CAD marked 30 (86%) of 35 missed calcifications and 58 (73%) of 80 missed masses. Detection errors affected cases with calcifications and masses. CAD marked most (77%; 88 of 115) cancers missed at screening mammography that radiologists retrospectively judged to merit recall.   Computer-Aided Detection (CAD) in Screening Mammography: Sensitivity of Commercial CAD Systems for Detecting Architectural Distortion Authors: Baker JA, Rosen EL, Lo JY, Gimenez EI, Walsh R, and Soo MS. Published: AJR 2003; 181: 1083-1088. PURPOSE: To evaluate the sensitivity of commercially available CAD systems for revealing architectural distortion, the third most common appearance of breast cancer. CONCLUSION: The more sensitive of the two CAD systems, the R2 ImageChecker, also had a significantly lower number of false-positive marks per image. Systems that generate many false-positive marks may result in a true positive mark being ignored by a radiologist overwhelmed by distracting prompts. Therefore, the false-positive rate of a CAD system must be considered along with its sensitivity.” This modified abstract is displayed and reprinted here with permission from the American Roentgen Ray Society. www.ajronline.org   Mammography with Computer-Aided Detection: Reproducibility Assessment – Initial Experience Authors: Zheng B, Hardesty LA, Poller WR, Sumkin JH, and Golla S. Published: Radiology 2003; 228: 58-62. OBJECTIVE: To examine the performance and reproducibility of a commercially available computer-aided detection (CAD) system with a set of mammograms obtained in 100 patients who had undergone biopsy after positive findings at mammography. RESULTS: Forty-eight (96.0%) of 50 microcalcification clusters were marked on all three images in the abnormality-based analysis. Of the remaining two clusters, one was marked in two images and one was marked in only one. The abnormality-based sensitivity for mass detection ranged from 66.7% (64 of 96) to 70.8% (68 of 96). Reproducibility of marked regions generated by the CAD system is improved from that reported previously, largely as a result of the substantial reduction in the false-positive detection rates. Reproducibility of true-positive identification of masses remains an important issue that may have methodologic and clinical practice implications.