Decrease in interpretation time for both novice and experienced readers using a concurrent computer-aided detection system for digital breast tomosynthesis

Objectives To compare the diagnostic performance and interpretation time of digital breast tomosynthesis (DBT) for both novice and experienced readers with and without using a computer-aided detection (CAD) system for concurrent read. Methods CAD system was developed for concurrent read in DBT interpretation. In this observer performance study, we used an enriched sample of 100 DBT cases including 70 with and 30 without breast cancers. Image interpretation was performed by four radiologists with different experience levels (two experienced and two novice). Each reader completed two reading sessions (at a minimum 2-month interval), once with and once without CAD. Three different rating scales were used to record each reader’s interpretation. Reader performance with and without CAD was reported and compared for each radiologist. Reading time for each case was also recorded. Results Average area under the receiver operating characteristic curve values for BI-RADS scale on using CAD were 0.778 and 0.776 without using CAD, demonstrating no statistically significant differences. Results were consistent when the probability of malignancy and percentage probability of malignancy scales were used. Reading times per case were 72.07 s and 62.03 s (SD, 37.54 s vs 34.38 s) without and with CAD, respectively. The average difference in reading time on using CAD was a statistically significant decrease of 10.04 ± 1.85 s, providing 14% decrease in time. The time-reducing effect was consistently observed in both novice and experienced readers. Conclusion DBT combined with CAD reduced interpretation time without diagnostic performance loss to novice and experienced readers. Key Points • The use of a concurrent DBT-CAD system shortened interpretation time. • The shortened interpretation time with DBT-CAD did not come at a cost to diagnostic performance to novice or experienced readers. • The concurrent DBT-CAD system improved the efficiency of DBT interpretation.