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Application of artificial intelligence–based computer-assisted diagnosis on synthetic mammograms from breast tomosynthesis: comparison with digital mammograms

Si Eun Lee et al. — European Radiology (2021)

Abstract



To compare the diagnostic agreement and performances of synthetic and conventional mammograms when artificial intelligence–based computer-assisted diagnosis (AI-CAD) is applied.








Materiel and method



From January 2017 to April 2017, 192 patients (mean age 53.7 ± 11.7 years) diagnosed with 203 breast cancers were enrolled in this retrospective study. All patients underwent digital breast tomosynthesis (DBT) with digital mammograms (DM) simultaneously. Commercial AI-CAD was applied to the reconstructed synthetic mammograms (SM) from DBT and DM respectively and abnormality scores were calculated. We compared the median abnormality scores between DM and SM with the Wilcoxon signed-rank test and used the Bland-Altman analysis to evaluate agreements between the two mammograms and to investigate clinicopathological factors which might affect agreement. Diagnostic performances were compared using an area under the receiver operating characteristic curve (AUC).








Result



The abnormality scores showed a mean difference (bias) of - 3.26 (95% limits of agreement: - 32.69, 26.18) between the two mammograms by the Bland-Altman analysis. The concordance correlation coefficient was 0.934 (95% CI: 0.92, 0.946), suggesting high reproducibility. SM showed higher abnormality scores in cancer with distortion and occult findings, T1 and N0 cancer, and luminal type cancer than DM (all p ≤ 0.001). Diagnostic performance did not differ between the mammograms (AUC 0.945 for conventional mammograms, 0.938 for synthetic mammograms, p = 0.499).








Conclusion



AI-CAD can also work well on synthetic mammograms, showing good agreement and comparable diagnostic performance compared to its application to DM.








Key Points


• AI-CAD which was developed based on imaging findings of digital mammograms can also be applied to synthetic mammograms.

• AI-CAD showed good agreement and similar diagnostic performance when applied to both synthetic and digital mammograms.

• With AI-CAD, synthetic mammograms showed relatively higher abnormality scores in cancer with distortion and occult findings, T1 and N0 cancer, and luminal type cancer than digital mammograms.


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AUTHORS

Si Eun Lee1 ; Kyunghwa Han2 ; Eun-Kyung Kim3

1Department of Radiology, Yongin Severance Hospital, 2Department of Radiology, Severance Hospital, 3Department of Radiology, Yongin Severance Hospital

PUBLISHED
European Radiology (2021)

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