Potential of computer-aided diagnosis to reduce variability in radiologists' interpretations of mammograms depicting microcalcifications

Radiology. 2001 Sep;220(3):787-94. doi: 10.1148/radiol.220001257.


Purpose: To evaluate whether computer-aided diagnosis can reduce interobserver variability in the interpretation of mammograms.

Materials and methods: Ten radiologists interpreted mammograms showing clustered microcalcifications in 104 patients. Decisions for biopsy or follow-up were made with and without a computer aid, and these decisions were compared. The computer was used to estimate the likelihood that a microcalcification cluster was due to a malignancy. Variability in the radiologists' recommendations for biopsy versus follow-up was then analyzed.

Results: Variation in the radiologists' accuracy, as measured with the SD of the area under the receiver operating characteristic curve, was reduced by 46% with computer aid. Access to the computer aid increased the agreement among all observers from 13% to 32% of the total cases (P <.001), while the kappa value increased from 0.19 to 0.41 (P <.05). Use of computer aid eliminated two-thirds of the substantial disagreements in which two radiologists recommended biopsy and routine screening in the same patient (P <.05).

Conclusion: In addition to its demonstrated potential to improve diagnostic accuracy, computer-aided diagnosis has the potential to reduce the variability among radiologists in the interpretation of mammograms.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Biopsy
  • Breast Diseases / diagnostic imaging*
  • Calcinosis / diagnostic imaging
  • Diagnosis, Computer-Assisted*
  • Female
  • Follow-Up Studies
  • Humans
  • Mammography*
  • Observer Variation*
  • ROC Curve
  • Sensitivity and Specificity