Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. ORIGINAL RESEARCH n BREAST IMAGING 40 radiology.rsna.org n Radiology: Volume 257: Number 1—October 2010 Interpretation Time of Computer- aided Detection at Screening Mammography 1 Philip M. Tchou, PhD Tamara Miner Haygood, PhD, MD E. Neely Atkinson, PhD Tanya W. Stephens, MD Paul L. Davis, MD Elsa M. Arribas, MD William R. Geiser, MS Gary J. Whitman, MD Purpose: To prospectively determine the interpretation time associ- ated with computer-aided detection (CAD) and to analyze how CAD affected radiologists’ decisions and their level of confidence in their interpretations of digital screening mammograms. Materials and Methods: An Institutional Review Board exemption was obtained, and patient consent was waived in this HIPAA compliant study . The participating radiologists gave informed con- sent. Five radiologists were prospectively studied as they interpreted 267 clinical digital screening mammograms. Interpretation times, recall decisions, and confidence levels were recorded without CAD and then with CAD. Software was used for linear regression fitting of inter- pretation times. P values less than .05 were considered to indicate statistically significant differences. Results: Mean interpretation time without CAD was 118 seconds 6 4.2 (standard error of the mean). Mean time for reviewing CAD images was 23 seconds 6 1.5. CAD identified additional findings in five cases, increased confidence in 38 cases, and decreased confidence in 21 cases. Interpretation time without CAD increased with the number of mammographic views ( P , .0001). Mean times for interpretation without CAD and review of the CAD images both increased with the number of CAD marks ( P , .0001). The interpreting radiologist was a significant variable for all interpretation times ( P , .0001). Interpretation time with CAD increased by 3.2 seconds (95% confidence interval: 1.8, 4.6) for each calcification cluster marked and by 7.3 seconds (95% confi- dence interval: 4.7, 9.9) for each mass marked. Conclusion: The additional time required to review CAD images rep- resented a 19% increase in the mean interpretation time without CAD. CAD requires a considerable time invest- ment for digital screening mammography but may provide less measureable benefits in terms of confidence of the radiologists. q RSNA, 2010 1 From the Departments of Imaging Physics (P.M.T., W.R.G.), Diagnostic Radiology (T.M.H., T.W.S., P.L.D., E.M.A., G.J.W.), and Biostatistics and Applied Mathematics (E.N.A.), University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. From the 2009 RSNA Annual Meeting. Received November 18, 2009; revision requested December 18; revision received March 10, 2010; accepted April 6; final version accepted April 21. Address correspondence to P.M.T. (e-mail: pmtchou@gmail.com). q RSNA, 2010