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Impact of Artificial Intelligence Decision Support Using Deep Learning on Breast Cancer Screening Interpretation with Single-View Wide-Angle Digital Breast Tomosynthesis
- Source :
- Radiology, 300, 529-536, Radiology, 300, 3, pp. 529-536
- Publication Year :
- 2021
-
Abstract
- Background The high volume of data in digital breast tomosynthesis (DBT) and the lack of agreement on how to best implement it in screening programs makes its use challenging. Purpose To compare radiologist performance when reading single-view wide-angle DBT images with and without an artificial intelligence (AI) system for decision and navigation support. Materials and Methods A retrospective observer study was performed with bilateral mediolateral oblique examinations and corresponding synthetic two-dimensional images acquired between June 2016 and February 2018 with a wide-angle DBT system. Fourteen breast screening radiologists interpreted 190 DBT examinations (90 normal, 26 with benign findings, and 74 with malignant findings), with the reference standard being verified by using histopathologic analysis or at least 1 year of follow-up. Reading was performed in two sessions, separated by at least 4 weeks, with a random mix of examinations being read with and without AI decision and navigation support. Forced Breast Imaging Reporting and Data System (categories 1-5) and level of suspicion (1-100) scores were given per breast by each reader. The area under the receiver operating characteristic curve (AUC) and the sensitivity and specificity were compared between conditions by using the public-domain iMRMC software. The average reading times were compared by using the Wilcoxon signed rank test. Results The 190 women had a median age of 54 years (range, 48-63 years). The examination-based reader-averaged AUC was higher when interpreting results with AI support than when reading unaided (0.88 [95% CI: 0.84, 0.92] vs 0.85 [95% CI: 0.80, 0.89], respectively; P = .01). The average sensitivity increased with AI support (64 of 74, 86% [95% CI: 80%, 92%] vs 60 of 74, 81% [95% CI: 74%, 88%]; P = .006), whereas no differences in the specificity (85 of 116, 73.3% [95% CI: 65%, 81%] vs 83 of 116, 71.6% [95% CI: 65%, 78%]; P = .48) or reading time (48 seconds vs 45 seconds; P = .35) were detected. Conclusion Using a single-view digital breast tomosynthesis (DBT) and artificial intelligence setup could allow for a more effective screening program with higher performance, especially in terms of an increase in cancers detected, than using single-view DBT alone. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Chan and Helvie in this issue.
- Subjects :
- Wilcoxon signed-rank test
Breast imaging
Breast Neoplasms
Sensitivity and Specificity
Decision Support Techniques
Breast cancer screening
Deep Learning
All institutes and research themes of the Radboud University Medical Center
Artificial Intelligence
Image Interpretation, Computer-Assisted
medicine
Screening programs
Humans
Mass Screening
Breast screening
Radiology, Nuclear Medicine and imaging
Early Detection of Cancer
Retrospective Studies
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Digital Breast Tomosynthesis
Middle Aged
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
Single view
Female
Clinical Competence
Artificial intelligence
business
Mammography
Subjects
Details
- ISSN :
- 00338419
- Database :
- OpenAIRE
- Journal :
- Radiology, 300, 529-536, Radiology, 300, 3, pp. 529-536
- Accession number :
- edsair.doi.dedup.....b3150a9f13191cd6dd4a3b6bcd063759