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Is there a safety-net effect with computer-aided detection?

Ethan Du-Crow1, Susan M Astley1, Johan Hulleman2

  • 1Division of Informatics, Imaging and Data Sciences, University of Manchester, Faculty of Biology, Medicine and Health, Manchester, United Kingdom.

Journal of Medical Imaging (Bellingham, Wash.)
|January 7, 2020
PubMed
Summary
This summary is machine-generated.

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Computer-aided detection (CAD) systems may reduce thoroughness in initial mammogram searches. While CAD improves detection of its own marked targets, it might negatively impact the preliminary unaided search for microcalcification clusters.

Area of Science:

  • Medical Imaging
  • Radiology
  • Human Factors in Medicine

Background:

  • Computer-aided detection (CAD) systems assist in interpreting screening mammograms by highlighting suspicious regions.
  • A potential 'safety-net' effect exists where the preliminary unaided search may be less thorough due to the subsequent CAD review.

Purpose of the Study:

  • To investigate the 'safety-net' effect in computer-aided detection (CAD) during mammogram interpretation.
  • To assess how the availability of CAD prompts influences the initial visual search for microcalcification clusters.

Main Methods:

  • A visual search experiment was conducted with 52 nonexpert observers simulating breast screening with CAD.
  • Participants searched 100 synthetic images for microcalcification clusters under both prompted (CAD) and unprompted (no-CAD) conditions.
Keywords:
breast cancercomputer-aided detectioneye-trackingimage perceptionmammographyvisual search

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  • Eye-tracking data and behavioral sensitivity were collected to analyze image coverage and detection accuracy.

    • Main Results:

    • Image coverage was significantly lower in the initial search phase when CAD prompts were available compared to the no-CAD condition.
    • Observer sensitivity was significantly higher for targets identified by CAD compared to the same targets in the no-CAD condition.
    • No significant difference in sensitivity was observed for targets *not* marked by CAD between the CAD and no-CAD conditions.

    Conclusions:

    • The availability of CAD may influence the thoroughness of the initial unaided search, potentially reducing overall image coverage.
    • CAD systems enhance sensitivity for their detected targets but may not improve detection of unprompted targets.
    • Future CAD efficacy studies should consider and account for this potential 'safety-net' effect on initial search behavior.