Potential of Computer-aided Diagnosis to Reduce Variability in Radiologists’ Interpretations of Mammograms Depicting Microcalcifications

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Abstract
PURPOSE: To evaluate whether computer-aided diagnosis can reduce interobserver variability in the interpretation of mammograms. MATERIALS AND METHODS: Ten radiologists interpreted mammograms showing clustered microcalcifications in 104 patients. Decisions for biopsy or follow-up were made with and without a computer aid, and these decisions were compared. The computer was used to estimate the likelihood that a microcalcification cluster was due to a malignancy. Variability in the radiologists’ recommendations for biopsy versus follow-up was then analyzed. RESULTS: Variation in the radiologists’ accuracy, as measured with the SD of the area under the receiver operating characteristic curve, was reduced by 46% with computer aid. Access to the computer aid increased the agreement among all observers from 13% to 32% of the total cases (P < .001), while the κ value increased from 0.19 to 0.41 (P < .05). Use of computer aid eliminated two-thirds of the substantial disagreements in which two radiologists recomme...

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