A Pilot Study in the Analysis of Digitized Mammograms: Combining Academic and Commercial Results on a Public Database

This article explores the development and utility of computer-assisted interpretation of mammograms with use of an academically developed mass enhancement system and the R2 ImageChecker M1000 System, a commercial mass detector system. This exploratory pilot study examines five mammogram views, three with abnormalities and two without, that were extracted from the public database known as the Digital Database for Screening Mammography. Digitized images were analyzed by an academic system (producing 25 different enhancement images) and original films were analyzed by the commercial R2 system (producing a set of five output views with region-of-interest prompts). Quantitative assessment was derived from radiologist-marked database ground truth information, whereas qualitative evaluation relied on a 210-question survey presented to two radiologists active in a breast cancer screening program. Academically developed segmentation-based enhancements appeared useful in aiding interpretation for the mass-prompting system by enhancing medically relevant features in prompt areas. Dual feature–based enhancements were preferred to single feature enhancements. Edge-based features appeared useful for facilitating clinical interpretation of possible spicules and for differentiating abnormal and normal tissues. This provisional study does not allow direct comparisons of the R2 system to other commercial or academic systems. However, this research does help to provide a framework for presenting medically relevant issues that can impact the development of digital mass-prompting systems and suggest alternative visualization techniques.