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Computer-aided detection may improve accuracy of single-reading mammography
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Single-reading mammography with computer-aided detection may be an accurate alternative to using two readers.
Researchers from various U.K. sites randomly assigned patients (n=31,057) undergoing routine screening by film mammography to double reading, single reading with computer-aided detection or both double and single reading with computer-aided detection.
The double-reading approach detected 199 of 227 cancers (87.7%) and was associated with a 3.4% recall rate. Single reading with computer-aided detection found 198 of 227 cancers (87.2%; P=.89) and was associated with a 3.9% recall rate (P<.001).
Both the double-reading strategy and single reading with computer-aided detection were similar in terms of sensitivity, specificity and positive predictive value. There were no significant differences between the pathology of the tumors detected by single reading with computer-aided detection and those tumors detected by two readers. – by Rebekah Cintolo
N Engl J Med. 2008;359:1675-1684.
In many aspects of life, computer-assisted technology has improved our ability to find things. For example, does anyone think that finding an address on a paper map is superior to finding an address with Google maps? A similar argument is made here: Finding a breast lesion on a mammogram can be enhanced by using computer-assisted detection. In this case, software can substitute for a second human reader. A very important message from this study is that the human reader cannot be excluded from the interpretation of the mammogram. Although computers can objectively analyze large amounts of data, humans bring experience and interpretive skills to the process.
– Doug Yee, MD
HemOnc Today Editorial Board member
Gilbert et al. have published results that support those of other investigators demonstrating that two sets of eyes, whether human or electronic, are better than one set when reading mammograms. When the second set of "eyes" is that of a computer, the benefit results in even greater callback rates than when two radiologists interpret the images. The benefit of double reading must be weighed against the increased number of women being told that they may have a significant abnormality and the increased cost associated with double reading. It should be remembered that however good the first reader, studies show a benefit from a second reading, and a good first reader is better than two mediocre readings.
– D. David Dershaw, MD
Director, Breast Imaging Section, Department of Radiology
Memorial Sloan-Kettering Cancer Center