Automated computerized classification of malignant and benign masses on digitized mammograms.

Rationale and Objectives: To develop a method for differentiating malignant from benign masses in which a computer automatically extracts lesion features and merges them into an estimated likelihood of malignancy.
Materials and Methods: Ninety-five mammograms depicting masses in 65 patients were digitized. Various features related to the margin and density of each mass were extracted automatically from the neighborhoods of the computer-identified mass regions. Selected features were merged into an estimated likelihood of malignancy by, using three different automated classifiers. The performance of the three classifiers in distinguishing between benign and malignant masses was evaluated by receiver operating characteristic analysis and compared with the performance of an experienced mammographer and that of five less experienced mammographers.
Results: Our computer classification scheme yielded an area under the receiver operating characteristic curve (Az) value of 0.94, which was similar to that for an experienced mammographer (Az = 0.91) and was statistically significantly higher than the average performance of the radiologists with less mammographic experience (Az = 0.81) (P = .013). With the database used, the computer scheme achieved, at 100% sensitivity, a positive predictive value of 83%, which was 12% higher than that for the performance of the experienced mammographer and 21% higher than that for the average performance of the less experienced mammographers (P < .0001).
Conclusion: Automated computerized classification schemes may be useful in helping radiologists distinguish between benign and malignant masses and thus reducing the number of unnecessary biopsies.