Computer Technology Helps Radiologists Spot Overlooked Small

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U.S. Army Medical Research and Materiel Command

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July 20, 2000
For Immediate Release:

Computer Technology Helps Radiologists Spot Overlooked Small Breast Cancers

Research Results from "Era of Hope" Department of Defense Breast Cancer Research Program Meeting

ATLANTA, June 9, 2000 - Computer-aided diagnosis (CAD) can help radiologists find early-stage breast cancers that might otherwise be missed, according to findings from a retrospective study presented at the "Era of Hope" Department of Defense Breast Cancer Research Program meeting.

"CAD cannot pick up lesions that are invisible at mammography, but it can compensate for some cases of radiologist oversight," said principal investigator Kunio Doi, Ph.D. professor of radiology at The University of Chicago, IL. "We believe the increasingly positive results with CAD demonstrate it can serve as a 'second opinion' for traditional screening mammograms."

Breast cancer is most curable in its early stages, and for now, mammography is the only known method for reliably identifying breast cancer early, before it can be felt by a woman or her doctor. Despite mammography's proven value, many small cancers are barely evident on mammograms and can elude detection by tired or less experienced radiologists. CAD provides a measure of insurance against human error by graphically drawing radiologists' attention to masses and microcalcifications - potentially cancerous anomalies that may be overlooked.

In this study, a CAD Prototype Intelligent Workstation, developed by Dr. Doi and colleagues at The University of Chicago, was used to review the mammograms of more than 22,000 women who had routine screenings in the past five years. Among the first 12,670 women whose charts have been analyzed, 79 developed breast cancer. Although many of these cancers were eventually found through screening mammography, 23 women had had an earlier screening mammogram that was interpreted as negative on which the cancer was visible in retrospect. The CAD workstation identified 52% of these missed cancers roughly a year before they were actually detected.

Under subcontract from the University's Department of Defense grant, radiologists are now using CAD as a concurrent second opinion for all screening mammograms at Grant Square Imaging in Hinsdale, IL. Data analysis from that study will begin in about two years.

With a CAD workstation, a laser scanner first transforms the mammography film into a detailed matrix of digital data. Microcalcifications appear as tiny white spots, and masses appear as round or irregular shapes. Guided by complex programming refined over many years, the system's computer vision and artificial intelligence algorithms scan the digital matrix, sift out background findings and normal soft tissue, then highlight patterns that are likely to represent lesions. Areas interpreted as suspicious are flagged on the digital mammogram with arrows. After reviewing the mammograms and the computer output, a radiologist prepares a negative or positive report based on experienced judgment.

"The next challenge for CAD is diagnosis," said Dr. Doi. "We have already developed algorithms that guide our system in distinguishing benign from malignant lesions. I believe that in time, as we fine-tune those algorithms, CAD will also become an important tool in helping women avoid unnecessary biopsies in addition to diagnosing more cancers."

"Era of Hope" is a forum for the presentation of research supported by the U.S. Department of Defense's Breast Cancer Research Program (BCRP), an unprecedented partnership between the military, scientists, clinicians, and breast cancer survivors. Since 1992, the BCRP has been working to prevent and cure breast cancer by fostering new directions in research, addressing underserved populations and issues, encouraging the work of new and young scientists and inviting the voice of breast cancer survivors to be heard in all aspects of the program. One of 53 congressional research programs managed by the U.S. Army Medical Research and Materiel Command, the BCRP has received more than $1 billion to date from Congress for innovative breast cancer research.

"Mammographic Computer-Aided Diagnosis for Breast Cancer Detection"
Kunio Doi, Maryellen L. Giger, Robert M. Nishikawa, Carl J. Vyborny, Yulei Jiang, Zhimin Huo, Robert A. Schmidt
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