Using computer-aided detection in mammography as a decision support

Maurice Samulski*, Rianne Hupse, Carla Boetes, Roel D. M. Mus, Gerard J. den Heeten, Nico Karssemeijer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


To evaluate an interactive computer-aided detection (CAD) system for reading mammograms to improve decision making. A dedicated mammographic workstation has been developed in which readers can probe image locations for the presence of CAD information. If present, CAD findings are displayed with the computed malignancy rating. A reader study was conducted in which four screening radiologists and five non-radiologists participated to study the effect of this system on detection performance. The participants read 120 cases of which 40 cases had a malignant mass that was missed at the original screening. The readers read each mammogram both with and without CAD in separate sessions. Each reader reported localized findings and assigned a malignancy score per finding. Mean sensitivity was computed in an interval of false-positive fractions less than 10%. Mean sensitivity was 25.1% in the sessions without CAD and 34.8% in the CAD-assisted sessions. The increase in detection performance was significant (p = 0.012). Average reading time was 84.7 +/- 61.5 s/case in the unaided sessions and was not significantly higher when interactive CAD was used (85.9 +/- 57.8 s/case). Interactive use of CAD in mammography may be more effective than traditional CAD for improving mass detection without affecting reading time.
Original languageEnglish
Pages (from-to)2323-2330
JournalEuropean Radiology
Issue number10
Publication statusPublished - Oct 2010


  • Mammography
  • Breast
  • Early detection of cancer
  • Decision making
  • Computer-assisted
  • Radiographic image interpretation

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