European Radiology

, Volume 29, Issue 5, pp 2518–2525 | Cite as

Decrease in interpretation time for both novice and experienced readers using a concurrent computer-aided detection system for digital breast tomosynthesis

  • Eun Young Chae
  • Hak Hee KimEmail author
  • Ji-wook Jeong
  • Seung-Hoon Chae
  • Sooyeul Lee
  • Young-Wook Choi



To compare the diagnostic performance and interpretation time of digital breast tomosynthesis (DBT) for both novice and experienced readers with and without using a computer-aided detection (CAD) system for concurrent read.


CAD system was developed for concurrent read in DBT interpretation. In this observer performance study, we used an enriched sample of 100 DBT cases including 70 with and 30 without breast cancers. Image interpretation was performed by four radiologists with different experience levels (two experienced and two novice). Each reader completed two reading sessions (at a minimum 2-month interval), once with and once without CAD. Three different rating scales were used to record each reader’s interpretation. Reader performance with and without CAD was reported and compared for each radiologist. Reading time for each case was also recorded.


Average area under the receiver operating characteristic curve values for BI-RADS scale on using CAD were 0.778 and 0.776 without using CAD, demonstrating no statistically significant differences. Results were consistent when the probability of malignancy and percentage probability of malignancy scales were used. Reading times per case were 72.07 s and 62.03 s (SD, 37.54 s vs 34.38 s) without and with CAD, respectively. The average difference in reading time on using CAD was a statistically significant decrease of 10.04 ± 1.85 s, providing 14% decrease in time. The time-reducing effect was consistently observed in both novice and experienced readers.


DBT combined with CAD reduced interpretation time without diagnostic performance loss to novice and experienced readers.

Key Points

• The use of a concurrent DBT-CAD system shortened interpretation time.

• The shortened interpretation time with DBT-CAD did not come at a cost to diagnostic performance to novice or experienced readers.

• The concurrent DBT-CAD system improved the efficiency of DBT interpretation.


Digital breast tomosynthesis Computer-assisted diagnosis Breast cancer 



Computer-aided detection


Digital breast tomosynthesis


Full-field digital mammography



This study has received funding by the R&D Convergence Program (Grant Number: CAP-13-3-KERI) of the National Research Council of Science & Technology (NST) of the Republic of Korea.

Compliance with ethical standards


The scientific guarantor of this publication is Hak Hee Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Mingyu Han kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• experimental

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Eun Young Chae
    • 1
  • Hak Hee Kim
    • 1
    Email author
  • Ji-wook Jeong
    • 2
  • Seung-Hoon Chae
    • 2
  • Sooyeul Lee
    • 2
  • Young-Wook Choi
    • 3
  1. 1.Department of Radiology, Research Institute of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Medical Imaging Research SectionElectronics & Telecommunications Research InstituteDaejeonRepublic of Korea
  3. 3.Advanced Medical Device Research DivisionKorea Electrotechnology Research InstituteAnsan-siRepublic of Korea

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