de Vries, C. F. et al. (2023) Impact of different mammography systems on artificial intelligence performance in breast cancer screening. Radiology: Artificial Intelligence, 5(3), e220146. (doi: 10.1148/ryai.220146)
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Abstract
Artificial intelligence (AI) tools may assist breast screening mammography programs, but limited evidence supports their generalizability to new settings. This retrospective study used a 3-year dataset (April 1, 2016–March 31, 2019) from a U.K. regional screening program. The performance of a commercially available breast screening AI algorithm was assessed with a prespecified and site-specific decision threshold to evaluate whether its performance was transferable to a new clinical site. The dataset consisted of women (aged approximately 50–70 years) who attended routine screening, excluding self-referrals, those with complex physical requirements, those who had undergone a previous mastectomy, and those who underwent screening that had technical recalls or did not have the four standard image views. In total, 55 916 screening attendees (mean age, 60 years ± 6 [SD]) met the inclusion criteria. The prespecified threshold resulted in high recall rates (48.3%, 21 929 of 45 444), which reduced to 13.0% (5896 of 45 444) following threshold calibration, closer to the observed service level (5.0%, 2774 of 55 916). Recall rates also increased approximately threefold following a software upgrade on the mammography equipment, requiring per–software version thresholds. Using software-specific thresholds, the AI algorithm would have recalled 277 of 303 (91.4%) screen-detected cancers and 47 of 138 (34.1%) interval cancers. AI performance and thresholds should be validated for new clinical settings before deployment, while quality assurance systems should monitor AI performance for consistency.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Zurowski, Mr John |
Authors: | de Vries, C. F., Colosimo, S. J., Staff, R. T., Dymiter, J. A., Yearsley, J., Dinneen, D., Boyle, M., Harrison, D. J., Anderson, L. A., Lip, G., Black, C., Murray, A. D., Wilde, K., Blackwood, J. D., Butterly, C., Zurowski, J., Eilbeck, J., and McSkimming, C. |
College/School: | College of Medical Veterinary and Life Sciences |
Journal Name: | Radiology: Artificial Intelligence |
Publisher: | Radiological Society of North America |
ISSN: | 2638-6100 |
ISSN (Online): | 2638-6100 |
Published Online: | 22 March 2023 |
Copyright Holders: | Copyright © 2023 RSNA |
First Published: | First published in Radiology: Artificial Intelligence 5(3): e220146 |
Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
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