Diagnostic performance of radiologists with and without different CAD systems for mammography

The purpose of this study is the evaluation of the variation of performance in terms of sensitivity and specificity of two radiologists with different experience in mammography, with and without the assistance of two different CAD systems. The CAD considered are SecondLookTM (CADx Medical Systems, Canada), and CALMA (Computer Assisted Library in MAmmography). The first is a commercial system, the other is the result of a research project, supported by INFN (Istituto Nazionale di Fisica Nucleare, Italy); their characteristics have already been reported in literature. To compare the results with and without these tools, a dataset composed by 70 images of patients with cancer (biopsy proven) and 120 images of healthy breasts (with a three years follow up) has been collected. All the images have been digitized and analysed by two CAD, then two radiologists with respectively 6 and 2 years of experience in mammography indipendently made their diagnosis without and with, the support of the two CAD systems. In this work sensitivity and specificity variation, the Az area under the ROC curve, are reported. The results show that the use of a CAD allows for a substantial increment in sensitivity and a less pronounced decrement in specificity. The extent of these effects depends on the experience of the readers and is comparable for the two CAD considered.