Diagnostic evaluation of a PACS subsystem using mammographs. An ROC analysis

The objective of this study was to compare the diagnostic accuracy of digitized mammographs with the original conventional films. The criterion was the detectability of small calcifications in the female breast. Four skilled radiologists read 100 films, conventional as well as digitized. The results were analysed using ROC methodology, and showed much lower diagnostic accuracy of digitized images (average AUC 0.67) compared to conventional films (average AUC 0.89). One of the problems with digitized images was to recognize and ignore film artifacts, which were hard to discriminate from small calcifications. The experiment was prepared, carried out and analysed with the FEASIBLE software package.