Influence of breast lesion size and histologic findings on tumor detection rate of a computer-aided detection system

PURPOSE: To evaluate associations between histopathologic findings, tumor size, and detection rate of malignant mammographic findings by using a computer-aided detection (CAD) system. MATERIALS AND METHODS: The study included 208 mammographically detected histologically proven malignant breast lesions in 208 women. Findings were 150 masses and 114 microcalcifications; 56 lesions showed both findings; 94 lesions, mass only; and 58 lesions, microcalcification only. CAD was used to evaluate mammograms in two views retrospectively. Also, corresponding histopathologic findings and lesion size were evaluated. CAD marks were considered positive if, on at least one view, they correctly identified the corresponding mammographic lesion location. RESULTS: Ninety percent (135 of 150) of masses and 93.0% (106 of 114) of microcalcifications were marked correctly by the CAD system. Overall tumor detection rate was 93.8% (195 of 208). Size-related detection rate for masses was 83.3% (25 of 30) for lesions up to 10 mm, 100% (45 of 45) for lesions 11-20 mm, 100% (46 of 46) for lesions 21-30 mm, 83.3% (10 of 12) for lesions 31-40 mm, and 52.9% (nine of 17) for lesions larger than 40 mm. Size-related tumor detection rate for microcalcifications was 92.5% (37 of 40) for microcalcifications up to 10 mm, 93.1% (27 of 29) for lesions 11-20 mm, 100% (20 of 20) for lesions 21-30 mm, 87.5% (seven of eight) for lesions 31-40 mm, and 88.2% (15 of 17) for larger microcalcifications. Detection rates for mammographically visible masses (invasive ductal carcinoma, invasive lobular carcinoma, invasive tubular carcinoma, noninvasive cancers, mucinoid cancers, and others) were 92.3% (84 of 91), 89.3% (25 of 28), 75.0% (six of eight), 100% (15 of 15), 33.3% (one of three), and 80.0% (four of five), respectively. Detectability rates for mammographically visible areas suspicious for microcalcifications (invasive ductal carcinoma, invasive lobular carcinoma, invasive tubular carcinoma, and noninvasive cancers) were 92.3% (60 of 65), 100% (eight of eight), 100% (five of five), and 91.9% (31 of 34), respectively. Highest overall detection rates were observed for invasive ductal carcinomas (96.6% [112 of 116]) and noninvasive cancers (92.9% [39 of 42]). CONCLUSION: Highest detection rates were observed for 10-30-mm tumor masses and for invasive ductal carcinomas and noninvasive cancers.