Single reading with computer-aided detection for screening mammography.

Single reading with computer-aided detection for screening mammography.

MedLine Citation:	PMID: 18832239 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	BACKGROUND: 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. We 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. METHODS: The trial was designed as an equivalence trial, with matched-pair comparisons between the cancer-detection rates achieved by single reading with computer-aided detection and those achieved by double reading. We randomly assigned 31,057 women undergoing routine screening by film mammography at three centers in England to double reading, single reading with computer-aided detection, or both double reading and single reading with computer-aided detection, at a ratio of 1:1:28. The primary outcome measures were the proportion of cancers detected according to regimen and the recall rates within the group receiving both reading regimens. RESULTS: The proportion of cancers detected was 199 of 227 (87.7%) for double reading and 198 of 227 (87.2%) for single reading with computer-aided detection (P=0.89). The overall recall rates were 3.4% for double reading and 3.9% for single reading with computer-aided detection; the difference between the rates was small but significant (P<0.001). The estimated sensitivity, specificity, and positive predictive value for single reading with computer-aided detection were 87.2%, 96.9%, and 18.0%, respectively. The corresponding values for double reading were 87.7%, 97.4%, and 21.1%. There were no significant differences between the pathological attributes of tumors detected by single reading with computer-aided detection alone and those of tumors detected by double reading alone. CONCLUSIONS: 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. (ClinicalTrials.gov number, NCT00450359.)

Authors:	Fiona J Gilbert; Susan M Astley; Maureen G C Gillan; Olorunsola F Agbaje; Matthew G Wallis; Jonathan James; Caroline R M Boggis; Stephen W Duffy;
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Publication Detail:	Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2008-10-01
Journal Detail:	Title: The New England journal of medicine Volume: 359 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2008 Oct
Date Detail:	Created Date: 2008-10-16 Completed Date: 2008-10-23 Revised Date: 2009-03-02
Medline Journal Info:	Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States
Other Details:	Languages: eng Pagination: 1675-84 Citation Subset: AIM; IM
Copyright Information:	2008 Massachusetts Medical Society
Affiliation:	Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, Scotland, United Kingdom. f.j.gilbert@abdn.ac.uk
Data Bank Information
Bank Name/Acc. No.:	ClinicalTrials.gov/NCT00450359
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MeSH Terms
Descriptor/Qualifier:	Aged Breast / pathology Breast Neoplasms / pathology, radiography* Female Humans Mammography / methods* Middle Aged Predictive Value of Tests Radiographic Image Interpretation, Computer-Assisted* Radiology Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:	03/010//Cancer Research UK
Investigator
Investigator/Affiliation:	F J Gilbert / ; M G C Gillan / ; S W Duffy / ; O F Agbaje / ; S M Astley / ; M G Wallis / ; J James / ; C R M Boggis / ; H Flight / ; K Heer / ; J Cooper / ; S W Duffy / ; O F Agbaje / ; M G Wallis / ; C R M Boggis / ; J James / ; R R Ramachandra / ; M Wilson / ; H C Burrell / ; C Lewis / ; U M Beetles / ; E J Cornford / ; S Garnett / ; E Hurley / ; L J Hamilton / ; A A Duncan / ; A K Jain / ; A J Evans / ; V Gaur / ; N B Barr / ; R Wilson / ; R Walker / ; M Griffiths / ; A Luck / ; L Chapman / ; J Johnson / ; J Patel / ; J Hackney / ; R Roberts / ; S Bundred /
Comments/Corrections
Comment In:	N Engl J Med. 2009 Feb 19;360(8):836 [PMID: 19228631 ]

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