CAD boosts single readers

Double reading is better than single reading - at least for the detection of small breast cancer. But a software could boost one readers functionality. UK-researchers found out that performance of a single reader using a computer-aided detection system may match the performance achieved by two readers.

Photo: CAD boosts single readers

The sensitivity of screening mammography for the detection of small breast cancers is higher when the mammogram is read by two readers rather than by a single reader. Fiona Gilbert from the University of Aberdeen and her colleagues  conducted a trial to determine whether the performance of a single reader using a computer-aided detection system would match the performance achieved by two readers.

In a prospective, multi-center trial, the researchers compared the cancer detection rate for a single reading of screening mammograms with R2 Computer-Aided Detection (CAD ) system by Hologic versus double reading without CAD support. The study was published in the online version of the New England Journal of Medicine.

In the study, lead author Dr. Fiona Gilbert and her colleagues in the United Kingdom analyzed the screening results from 31,057 women undergoing routine screening by film mammography and found that a single reader with Hologic’s R2 CAD system produced comparable cancer detection rates (87.2%) to double reading (87.7%) without CAD. Although single reading with CAD produced a higher recall rate (3.9%) than double reading (3.4%), they concluded that despite this difference, “Single reading with computer-aided detection could be an alternative to double reading and could improve the rate of detection of cancer from screening mammograms read by a single reader.”

“Double reading is a method for increasing cancer detection commonly used in European screening programs. However, it is used by few practices in the United States because it is time-consuming and because of a shortage of radiologists focused on breast imaging,” said Ronald A. Castellino, MD, FACR, Chief Medical Officer for Hologic. “These results indicate that in the United States, where single reading of mammograms is most common, Hologic’s R2 CAD system can provide an improvement in cancer detection rates comparable to those achieved with double reading. This important study, combined with prior published research studies, further supports the use of the R2 CAD system to increase cancer detection. ”

The strengths of this study are that it was a multicenter, prospective trial involving more than 30,000 women and that the high volume readers (reading more than 5,000 mammograms per year) were unaware of their reading assignments.



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