[Retrospective analysis of a computer-aided detection (CAD) system in full-field digital mammography in correlation to tumor histology].

Purpose: To evaluate the usefulness of a computer-aided detection (CAD) system in full-field digital mammography in correlation to tumor histology.

Material And Methods: A total of 476 patients (226 patients with histologically proven malignant tumors, 250 healthy women) took part in this study. The mammograms were studied retrospectively, using the CAD system Image Checker. For 226 patients digital mammograms in MLO-projection were available. For 186 of these patients the CC-projection was also available. CAD markers that correlated with histologically proven carcinomas were considered to be true-positive markers. All other CAD markers were considered to be false-positive. Histologically proven carcinomas without markers were false-negative results. The dependence of the CAD markers placement upon the different carcinoma histologies was studied using the Chi-square test.

Results: No significant difference could be proven for the detectability of malignant breast lesions of different histologic types. For the detectability of ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), lobular carcinoma in situ (LCIS), tubular carcinoma and ductulo-lobular carcinoma, the true positives were 71.1 %, 75 %, 70.7 %, 70 %, 60 % and 80 %, respectively, in the MLO projection and 83.9 %, 75.9 %, 81.8 %, 77.8 %, 87.5 % and 33.3 %, respectively, in the CC projection. There was an average of 0.5 false-positive markers per mammographic image.

Conclusion: The histologic type of carcinoma seems to have no influence on detectability when using the CAD system. The high rate of false-positive markers shows, however, the limited specificity of the CAD system and that improvements are necessary.