Abstract
Diagnostic performance and reading speed for conventional mammography film reading is compared to reading digitized mammograms on a dedicated workstation. A series of mammograms judged negative at screening and corresponding priors were collected. Half were diagnosed as cancer at the next screening, or earlier for interval cancers. The others were normal. Original films were read by fifteen experienced screening radiologists. The readers annotated potential abnormalities and estimated their likelihood of malignancy. More than 1 year later, five radiologists reread a subset of 271 cases (88 cancer cases having visible signs in retrospect and 183 normals) on a mammography workstation after film digitization. Markers from a computer-aided detection (CAD) system for microcalcifications were available to the readers. Performance was evaluated by comparison of Az-scores based on ROC and multiple-Reader multiple-case (MRMC) analysis, and localized receiver operating characteristic (LROC) analysis for the 271 cases. Reading speed was also determined. No significant difference in diagnostic performance was observed between conventional and soft-copy reading. Average Az-scores were 0.83 and 0.84 respectively. Soft-copy reading was only slightly slower than conventional reading. Using a mammography workstation including CAD for detection of microcalcifications, soft-copy reading is possible without loss of quality or efficiency.
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References
Pisano ED, Cole EB, Major S et al (2000) Radiologists’ preferences for digital mammographic display. Radiology 216:820–830
Pisano ED, Cole EB, Kistner EO et al (2002) Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display. Radiology 223:483–488
van Engeland S, Snoeren PR, Karssemeijer N, Hendriks JHCL (2003) Optimized perception of lesion growth in mammograms using digital display. In: Chakraborty DP, Krupinski EA (eds) Proceedings of SPIE, Medical Imaging 2003, Image perception, observer performance, and technology assessment, vol. 5034, SPIE, Bellingham, WA, pp 25–31
van Engeland S, Snoeren PR, Hendriks JHCL, Karssemeijer N (2003) A comparison of methods for mammogram registration. In: Pluim JPW and Fitzpatrick JM (eds) Special issue on image registration. IEEE Trans Med Imag 22(11):1436–1444
Snoeren PR, Karssemeijer N (2003) Gray scale registration of mammograms using a model of image acquisition. In: Taylor C and Noble J (eds) Lect Notes Comp Sc 2732 pp 401–412
Laming D, Warren R (2000) Improving the detection of cancer in the screening of mammograms. J Med Screen 7:24–30
Evertsz CJG, Karssemeijer N, Bödicker A et al (2003) SCREEN-TRIAL: softcopy reading in European screening mammography. In: Peitgen H-O (ed) Digital mammography, IWDM 2002, 6th International workshop on digital mammography. Springer, Berlin Heidelberg New York, pp 423–427
Skaane P, Young K, Skjennald A (2003) Population-based mammography screening: comparison of screen-film and full-field digital mammography with soft-copy reading—Oslo I study. Radiology 229:877–884
Fracheboud J, Otto SJ, Groenewoud JH et al (2003) National Evaluation of Breast Cancer Screening in the Netherlands, 10th evaluation report, Rotterdam
Evertsz CJG, Bödicker A, Roelofs AAJ et al (2002) Softcopy reading in screening mammography: European projects SCREEN and SCREEN-TRIAL. Electromedica 70:157–164
NEMA (1998) Digital imaging and communications in medicine (DICOM) supplement 28: grayscale standard display function. National Electrical Manufacturers Association, Rosslyn, VA, USA
Roelofs AAJ, van Woudenberg S, Hendriks JHCL, Karssemeijer N (2003) Optimized soft-copy display of digitized mammograms. In: Chakraborty DP, Krupinski EA (eds) Proceedings of SPIE, Medical Imaging 2003, Image perception, observer performance, and technology assessment, vol. 5034. SPIE, Bellingham, WA, USA, pp 10–19
Swensson RG (1996) Unified measurement of observer performance in detecting and localizing target objects on images. Med Phys 23:1709–1725
Karssemeijer N, Otten JDM, Verbeek ALM et al (2003) Computer-aided detection versus independent double reading of masses on mammograms. Radiology 227:192–200
Burhenne LJW, Wood SA, D’Orsi CJ et al (2000) Potential contribution of computer-aided detection to the sensitivity of screening mammography. Radiology 215:554–562
Dorfman DD, Berbaum KS, Metz CE (1992) ROC rating analysis: generalization to the population of readers and cases with the jackknife method. Invest Radiol 27:723–731
Roe CA, Metz CE (1997) The Dorfman–Berbaum–Metz method for statistical analysis of multi-reader, multi-modality ROC data: validation by computer simulation. Acad Radiol 4:298–303
Roe CA, Metz CE (1997) Variance-component modeling in the analysis of receiver operating characteristic index estimates. Acad Radiol 4:587–600
Quenouille MH (1949) Approximate tests of correlation in time series. J Royal Stat Soc Ser B 11:68–84
Tukey JW (1958) Bias and confidence in not quite large samples. Ann Math Stat 29:614. Abstract
http://www-radiology.uchicago.edu/krl/KRL_ROC/software_index.htm. Charles E. Metz, University of Chicago, version 1.3 beta 1
Karssemeijer N, Frieling JT, Hendriks JHCL (1993) Spatial resolution in digital mammography. Invest Radiol 28:413–419
Freedman MT, Steller DE, Jafroudi H et al (1995) Digital mammography: tradeoffs between 50- and 100-micron pixel size. In: van Metter RL, Beutel J (eds) Proceedings of SPIE, Medical imaging 1995, Physics of medical imaging, vol. 2432. SPIE, San Diego, CA, pp 114–125
Vedantham S, Karellas A, Suryanarayanan S et al (2000) Full breast digital mammography with an amorphous silicon-based flat panel detector: physical characteristics of a clinical prototype. Med Phys 27:558–567
Noel A, Thibault F (2004) Digital detectors for mammography: the technical challenges. Eur Radiol 14(11):1990–1998
Gennaro G, Baldelli P, Taibi A, Di Maggio C, Gambaccini M (2004) Patient dose in full-field digital mammography: an Italian survey. Eur Radiol 14(4):645–652
Acknowledgements
This work was supported by a grant from the European Community in the 5th Framework of the Information Society Technologies program IST as part of the SCREEN-TRIAL project. The authors wish to thank the participants of the observer study: D. Beijerinck, MD, and J.J.M. Deurenberg, MD, from Stichting Preventicon, Utrecht, The Netherlands, P.A.M. Bun-Sevenstern, MD, from BoBWest and the LUMC, Leiden, The Netherlands, A.C.W. Borstlap, MD, from the Department of Radiology, VieCuri, Medical Centre, Venlo, The Netherlands, and F.H. Jansen, MD, from the Catharina Hospital in Eindhoven, The Netherlands. They would also like to thank L. Pesce, PhD, from the Kurt Rossmann Laboratories, University of Chicago, USA, for his valuable comments regarding MRMC analysis.
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Roelofs, A.A.J., van Woudenberg, S., Otten, J.D.M. et al. Effect of soft-copy display supported by CAD on mammography screening performance. Eur Radiol 16, 45–52 (2006). https://doi.org/10.1007/s00330-005-2878-7
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DOI: https://doi.org/10.1007/s00330-005-2878-7