Testing the Effect of Computer-Assisted Detection on Interpretive Performance in Screening Mammography

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Abstract
OBJECTIVE. The objective of our study was to test whether the use of computer-assisted detection (CAD) improves sensitivity at no cost to specificity for the detection of breast cancer and enables more accurate assessment of fatty breast tissue compared with dense breast tissue.MATERIALS AND METHODS. We created a stratified random sample of screening mammograms weighted with difficult cases split evenly among women with fatty breast tissue and those with dense breast tissue: 114 patients were cancer-free, 114 had cancer 1 year after screening, and 113 had cancer 13-24 months after screening. In test settings 6 months apart, 19 community radiologists interpreted 341 bilateral screening mammograms with and without CAD. We compared the sensitivity and specificity using regression models adjusting for repeated measures.RESULTS. CAD assistance did not affect overall sensitivity (cancer by 1 year: 63.2% without CAD and 62.0% with CAD; cancer in 13-24 months: 33.5% without CAD and 32.3% with CAD), but its effect...