Mammographic Features of Breast Cancers at Single Reading with Computer-aided Detection and at Double Reading in a Large Multicenter Prospective Trial of Computer-aided Detection: CADET II
Jonathan J. James, Fiona J. Gilbert, Matthew G. Wallis, Maureen G. C. Gillan, Susan M. Astley, Caroline R. M. Boggis, Olorunsola F. Agbaje, Adam R. Brentnall, and Stephen W. Duffy
Radiology 2010;256 379-386
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Purpose: To evaluate the mammographic features of breast cancer that favor lesion detection with single reading and computer-aided detection (CAD) or with double reading
Results: A total of 227 cancers were detected in 28 204 women. A total of 170 cases were recalled with both reading regimens. Lesion types were masses (66%), microcalcifications (25%), parenchymal deformities (6%), and asymmetric densities (3%). The ability of the reading regimens to correctly prompt the reader to recall cases varied significantly by lesion type (P < .001). More parenchymal deformities were recalled with double reading, whereas more asymmetric densities were recalled with single reading with CAD. There was no difference in the ability of either reading regimen to prompt the reader to correctly recall masses or microcalcifications. CAD correctly prompted 100% of microcalcifications, 87% of mass lesions, 80% of asymmetric densities, and 50% of parenchymal deformities. CAD correctly marked 93% of spiculated masses compared with 80% of ill-defined masses (P = .054). There was a significant trend for cancers detected with double reading to occur only in women with a denser mammographic background pattern (P = .02). Size had no effect on lesion detection.
Conclusion: Readers using either single reading with CAD or double reading need to be aware of the strengths and weaknesses of reading regimens to avoid missing the more challenging cancer cases
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