Potential of computer-aided diagnosis to reduce variability in radiologists' interpretations of mammograms depicting microcalcifications

PURPOSE: To evaluate whether computer-aided diagnosis can reduce interobser ver variability in the interpretation of mammograms. MATERIALS AND METHODS: Ten radiologists interpreted mammograms showing clus tered microcalcifications in 104 patients. Decisions for biopsy or follow-u p were made with and without a computer aid, and these decisions were compa red. The computer was used to estimate the likelihood that a microcalcifica tion cluster was due to a malignancy. Variability in the radiologists' reco mmendations for biopsy versus follow-up was then analyzed. RESULTS: Variation in the radiologists' accuracy, as measured with the SD o f the area under the receiver operating characteristic curve, was reduced b y 46% with computer aid, Access to the computer aid increased the agreement among all observers from 13% to 32% of the total cases (P < .001), while t he <kappa> value increased from 0.19 to 0.41 (P < .05). Use of computer aid eliminated two-thirds of the substantial disagreements in which two radiol ogists recommended biopsy and routine screening in the same patient (P < .0 5). CONCLUSION: In addition to its demonstrated potential to improve diagnostic accuracy, computer-aided diagnosis has the potential to reduce the variabi lity among radiologists in the interpretation of mammograms.