Differing benefits of artificial intelligence-based computer-aided diagnosis for breast US according to workflow and experience level

Si Eun Lee, Kyunghwa Han, Ji Hyun Youk, Jee Eun Lee, Ji Young Hwang, Miribi Rho, Jiyoung Yoon, Eun Kyung Kim, Jung Hyun Yoon

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Purpose: This study evaluated how artificial intelligence-based computer-assisted diagnosis (AI-CAD) for breast ultrasonography (US) influences diagnostic performance and agreement between radiologists with varying experience levels in different workflows. Methods: Images of 492 breast lesions (200 malignant and 292 benign masses) in 472 women taken from April 2017 to June 2018 were included. Six radiologists (three inexperienced [<1 year of experience] and three experienced [10-15 years of experience]) individually reviewed US images with and without the aid of AI-CAD, first sequentially and then simultaneously. Diagnostic performance and interobserver agreement were calculated and compared between radiologists and AI-CAD. Results: After implementing AI-CAD, the specificity, positive predictive value (PPV), and accuracy significantly improved, regardless of experience and workflow (all P<0.001, respectively). The overall area under the receiver operating characteristic curve significantly increased in simultaneous reading, but only for inexperienced radiologists. The agreement for Breast Imaging Reporting and Database System (BI-RADS) descriptors generally increased when AI-CAD was used (κ=0.29-0.63 to 0.35-0.73). Inexperienced radiologists tended to concede to AI-CAD results more easily than experienced radiologists, especially in simultaneous reading (P<0.001). The conversion rates for final assessment changes from BI-RADS 2 or 3 to BI-RADS higher than 4a or vice versa were also significantly higher in simultaneous reading than sequential reading (overall, 15.8% and 6.2%, respectively; P<0.001) for both inexperienced and experienced radiologists. Conclusion: Using AI-CAD to interpret breast US improved the specificity, PPV, and accuracy of radiologists regardless of experience level. AI-CAD may work better in simultaneous reading to improve diagnostic performance and agreement between radiologists, especially for inexperienced radiologists.

Original languageEnglish
Pages (from-to)718-727
Number of pages10
JournalUltrasonography
Volume41
Issue number4
DOIs
Publication statusPublished - 2022 Oct

Bibliographical note

Publisher Copyright:
© 2022 Korean Society of Ultrasound in Medicine (KSUM).

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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