Computer-aided detection in digital mammography: comparison of craniocaudal, mediolateral oblique, and mediolateral views

PURPOSE: To retrospectively compare the sensitivity of a computer-aided detection (CAD) system for depicting breast cancer in three digital mammographic views. MATERIALS AND METHODS: This study was conducted with institutional review board approval; informed consent was waived. A commercially available CAD system was applied to the craniocaudal, mediolateral oblique, and mediolateral digital mammographic views of 83 women (mean age, 48 years; range, 30-66 years) with 83 histologically proved breast cancers. Findings were 59 masses and 41 microcalcifications (17 lesions showed both findings; 42 lesions, mass only; and 24 lesions, microcalcification only). The paired t test was used to analyze sensitivity of the CAD system for the detection of cancer in these three mammographic views and in combinations of the views. RESULTS: The sensitivities of the CAD system were 92% (76 of 83) in the craniocaudal view, 83% (69 of 83) in the mediolateral oblique view, and 86% (71 of 83) in the mediolateral view; the differences were not significant (P = .07-.62). Sensitivity increased to 96% (80 of 83) in the craniocaudal plus mediolateral oblique views and to 99% (82 of 83) in the craniocaudal plus mediolateral oblique plus mediolateral views. For masses, the sensitivity of the CAD system was 76% (45 of 59) in the craniocaudal view and 75% (44 of 59) in the mediolateral oblique view and increased to 93% (55 of 59) when mediolateral oblique and craniocaudal views were combined (P < .001). For microcalcifications, sensitivity was 98% (40 of 41) in the craniocaudal view and 95% (39 of 41) in the mediolateral oblique view, and this increased to 100% (41 of 41) when the mediolateral oblique and craniocaudal views were combined (P = .31). CONCLUSION: The sensitivities of the CAD system were not significantly different among these three digital mammographic views. Sensitivity for depicting masses was significantly increased (P < .001) when the craniocaudal view was added to the mediolateral oblique view