The development and evaluation of CADMIUM: a prototype system to assist in the interpretation of mammograms

We have developed CADMIUM, a novel approach for the design of systems to assist in the interpretation of medical images. CADMIUM uses symbolic reasoning to relate information obtained from image processing to the decisions radiologists take. The approach is based on a symbolic decision procedure which has already been used successfully in a variety of nonimaging clinical decision systems. In CADMIUM this decision procedure is extended with models of three generic image interpretation tasks: detection, measurement and classification of image features. The extended procedure is used to construct the lines of reasoning needed in each task and to control the acquisition of information by image processing. CADMIUM has been evaluated as an aid to the differential diagnosis of microcalcifications on mammographic images. Radiographers who had been trained to interpret images performed better when using the advice provided by the system.