13 Imaging Med. (2014) 6(1), 13–20 ISSN 1755-5191
Aim: Within this work, a comparative analysis of two commercial computer-aided
detection or diagnosis (CAD) systems, CyclopusCAD
®
mammo (v. 6.0) produced by
CyclopusCAD Ltd (Palermo, Italy) and SecondLook
®
(v. 6.1C) produced by iCAD Inc.
(OH, USA) is performed by evaluating the results of both systems application on an
unique set of mammographic digital images routinely acquired in a hospital structure.
Materials & methods: The two CAD systems have been separately applied on a sample
set of 126 mammographic digital cases, having been independently diagnosed by two
senior radiologists. According to the human diagnosis, the cases in the sample reference
set are divided into 61 negatives and 65 pathological cases (21 cases displaying both
mass lesions and microcalcifications and 44 cases characterized only by mass lesions).
The images in the pathological subset contain 123 human diagnosed mass lesions
and 37 human diagnosed microcalcifications clusters. In the case of CyclopusCAD,
the system offered the possibility to evaluate sensitivity at several threshold levels
(working points); five different setting levels (high sensitivity, normal sensitivity,
standard, normal specificity and high specificity) have been used. Results: At the
standard threshold level, CyclopusCAD exhibits an overall sensitivity of 83.1 versus
66.2% for iCAD (p = 0.04) and an average number of false positives per image (FP/im)
of 1.38 against 0.47 for iCAD (p < 0.01). Specifically, for the mass lesions, CyclopusCAD
exhibits a sensitivity of 76.9% at a rate of 0.73 FP/im, while iCAD displays a sensitivity
of 61.5% at 0.28 FP/im. For the microcalcifications, CyclopusCAD exhibits a sensitivity
of 76.2% at a rate of 0.64 FP/image, while iCAD displays a sensitivity of 61.9% at
0.19 FP/im. The reported results have also been expressed in terms of free-response
receiver operating characteristic curves, corresponding to five different thresholds in
the case of CyclopusCAD and to one single threshold value for iCAD. Conclusion: The
overall accuracies of the two systems are fairly comparable up to the uncertainty level
of this analysis. CyclopusCAD may reach a higher sensitivity level for both masses and
microcalcifications owing to the flexibility in the working point choice, with the price
of a major number of FP/im.
Keywords:BREASTCANCERsCLUSTERSsCOMPUTERASSISTEDDIAGNOSISs&&$-s&2/#CURVE
sMAMMOGRAPHYsMASSLESIONSsMICROCALCIlCATIONSsPERFORMANCE
Breast tumors constitute the second most im-
portant cause of cancer mortality in women
[1] . Current screening programs have proven
themselves as valuable auxiliary instruments
that lead to noticeable decreases in mortality
incidence. One may safely assert that a further
reduction of the mortality incidence could be
reached through significant improvement of
the screening sensitivity. Several methods for
reducing the probability of error have been
considered; first is the double reading, which
consists of either acquiring a double percep-
tion of the lesion or a double interpretation
of the latter. The most accurate (lesion) inter-
pretation method is the supervised double lec-
ture, in which a third reader revisits the cases
part of
Research Article
Imaging in Medicine
10.2217/IIM.13.68 © 2014 Future Medicine Ltd
tal
wo
Computer-aided diagnosis in digital
mammography: comparison of two
commercial systems
Donato Cascio*
,1
,
Francesco Fauci
1
, Marius
Iacomi
1,2
, Giuseppe Raso
1
,
Rosario Magro
1
, Debora
Castrogiovanni
3
, Guido
Filosto
3
, Raffaele Ienzi
4
& Maria Simone Vasile
5
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