The Use of Computer-aided Detection in Mammographic Interpretation: Detection versus Distraction

摘要

This is a synopsis of my personal perspectives on the present and future clinical roles of computer-aided detection (CAD), based on current state-of-the-art technology. Rapid progress has been made in clinical research involving this modality during the past few years, which is likely to continue apace. Therefore, some of what is written here probably will have advanced from speculation to reality in the few months between the writing and the presentation of the material in lecture format. This chapter concentrates on the current benefits and limitations of CAD from a clinical perspective. Evidence is mounting that CAD can be used to improve the performance of singlereader mammographic interpretation, functioning as an adjunct to, rather than a replacement for, physician interpretation. The rationale behind this adjunctive role is straightforward. Although CAD is capable of clinically acceptable performance in marking several common mammographic findings that indicate the presence of breast cancer, CAD performance is still clearly inferior to human interpretation for several types of activities (eg, marking "focal asymmetries" and "developing asymmetries," comparing the images of one breast with the other, and comparing a current mammographic examination with those done previously). Until CAD is shown to depict almost all of the potentially important lesions that now are frequently detected in clinical practice, it is reasonable that physician interpretation will retain its primary role.