Improving Breast Cancer Detection Accuracy of Mammography with the Concurrent Use of an Artificial Intelligence Tool

Abstract

Purpose To evaluate the benefits of an artificial intelligence (AI)–based tool for two-dimensional mammography in the breast cancer detection process. Materials and Methods In this multireader, multicase retrospective study, 14 radiologists assessed a dataset of 240 digital mammography images, acquired between 2013 and 2016, using a counterbalance design in which half of the dataset was read without AI and the other half with the help of AI during a first session and vice versa during a second session, which was separated from the first by a washout period. Area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and reading time were assessed as endpoints. Results The average AUC across readers was 0.769 (95% CI: 0.724, 0.814) without AI and 0.797 (95% CI: 0.754, 0.840) with AI. The average difference in AUC was 0.028 (95% CI: 0.002, 0.055, P = .035). Average sensitivity was increased by 0.033 when using AI support (P = .021). Reading time changed dependently to the AI-tool score. For low likelihood of malignancy (< 2.5%), the time was about the same in the first reading session and slightly decreased in the second reading session. For higher likelihood of malignancy, the reading time was on average increased with the use of AI. Conclusion This clinical investigation demonstrated that the concurrent use of this AI tool improved the diagnostic performance of radiologists in the detection of breast cancer without prolonging their workflow. Supplemental material is available for this article. Keywords: Breast, Convolutional Neural Network (CNN), Diagnosis, Mammography © RSNA, 2020

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