Should CAD be used as a second reader? - Exploring two alternative reading modes for CAD in screening mammography

Abstract

16963 FFDM cases (280 cancers), were culled retrospectively and run with a CAD algorithm. Instead of using CAD as a "second reader", the study investigates the feasibility of using CAD for prescreening, allowing cases with no CAD prompts to bypass review, thereby decreasing the workload. The study also investigates the outcome of presorting all cases with matching CAD marks of the same type in both views, to enrich the case mix, thereby enhancing the reader's willingness to accept true CAD prompts. The sensitivity of the CAD algorithm was 83.4% and the mean false mark rate generated by CAD per case was 1.15. It was found that prescreening decreases the workload by about 42%, but is not feasible since 6.4% of the cancers would be missed. Using presorting, 73.2 % of the cancers and only 14.2% of the normals would be prioritized for interpretation, enriching the case mix by 5 times. © 2010 Springer-Verlag.