scholarly journals Can artificial intelligence reduce the interval cancer rate in mammography screening?

2021 ◽  
Author(s):  
Kristina Lång ◽  
Solveig Hofvind ◽  
Alejandro Rodríguez-Ruiz ◽  
Ingvar Andersson
Keyword(s):  
Artificial Intelligence ◽  
Risk Score ◽  
Mammography Screening ◽  
False Negative ◽  
Interval Cancer ◽  
Stage Iv ◽  
True Negative ◽  
Stage Iv Disease ◽  
Interval Cancer Rate ◽  
Screening Mammograms

Abstract Objectives To investigate whether artificial intelligence (AI) can reduce interval cancer in mammography screening. Materials and methods Preceding screening mammograms of 429 consecutive women diagnosed with interval cancer in Southern Sweden between 2013 and 2017 were analysed with a deep learning–based AI system. The system assigns a risk score from 1 to 10. Two experienced breast radiologists reviewed and classified the cases in consensus as true negative, minimal signs or false negative and assessed whether the AI system correctly localised the cancer. The potential reduction of interval cancer was calculated at different risk score thresholds corresponding to approximately 10%, 4% and 1% recall rates. Results A statistically significant correlation between interval cancer classification groups and AI risk score was observed (p < .0001). AI scored one in three (143/429) interval cancer with risk score 10, of which 67% (96/143) were either classified as minimal signs or false negative. Of these, 58% (83/143) were correctly located by AI, and could therefore potentially be detected at screening with the aid of AI, resulting in a 19.3% (95% CI 15.9–23.4) reduction of interval cancer. At 4% and 1% recall thresholds, the reduction of interval cancer was 11.2% (95% CI 8.5–14.5) and 4.7% (95% CI 3.0–7.1). The corresponding reduction of interval cancer with grave outcome (women who died or with stage IV disease) at risk score 10 was 23% (8/35; 95% CI 12–39). Conclusion The use of AI in screen reading has the potential to reduce the rate of interval cancer without supplementary screening modalities. Key Points • Retrospective study showed that AI detected 19% of interval cancer at the preceding screening exam that in addition showed at least minimal signs of malignancy. Importantly, these were correctly localised by AI, thus obviating supplementary screening modalities. • AI could potentially reduce a proportion of particularly aggressive interval cancers. • There was a correlation between AI risk score and interval cancer classified as true negative, minimal signs or false negative.

Retrospective analysis of the effect on interval cancer rate of adding an artificial intelligence algorithm to the reading process for two-dimensional full-field digital mammography

2021 ◽  
pp. 096914132098804
Author(s):  
Axel Graewingholt ◽  
Paolo Giorgi Rossi
Keyword(s):  
Breast Cancer ◽  
Artificial Intelligence ◽  
Cancer Screening ◽  
Confidence Interval ◽  
Digital Mammography ◽  
Interval Cancer ◽  
Interval Cancers ◽  
Cancer Rate ◽  
Interval Cancer Rate ◽  
Artificial Intelligence Algorithm

Interval cancers are a commonly seen problem in organized breast cancer screening programs and their rate is measured for quality assurance. Artificial intelligence algorithms have been proposed to improve mammography sensitivity, in which case it is likely that the interval cancer rate would decrease and the quality of the screening system could be improved. Interval cancers from negative screening in 2011 and 2012 of one regional unit of the national German breast cancer screening program were classified by a group of radiologists, categorizing the screening digital mammography with diagnostic images as true interval, minimal signs, false negative and occult cancer. Screening mammograms were processed using a detection algorithm based on deep learning. Of the 29 cancer cases available, artificial intelligence identified eight out of nine of those classified as minimal signs, all six false negatives and none of the true interval and occult cancers. Sensitivity for lesions judged to be already present in screening mammogram was 93% (95% confidence interval 68–100) and sensitivity for any interval cancer was 48% (95% confidence interval 29–67). Using an artificial intelligence algorithm as an additional reading tool has the potential to reduce interval cancers. How and if this theoretical advantage can be reached without a negative effect on recall rate is a challenge for future research.

scholarly journals Reader characteristics and mammogram features associated with breast imaging reporting scores

2020 ◽  
Vol 93 (1114) ◽  
pp. 20200363
Author(s):  
Phuong Dung(Yun) Trieu ◽  
Sarah J Lewis ◽  
Tong Li ◽  
Karen Ho ◽  
Kriscia A Tapia ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Performance Metrics ◽  
Recall Performance ◽  
False Negative ◽  
True Negative ◽  
Screen Readers ◽  
Factors Associated ◽  
Breast Screen ◽  
Screening Mammograms ◽  
Discrete Mass

Objectives: This study aims to explore the reading performances of radiologists in detecting cancers on mammograms using Tabar Breast Imaging Reporting and Data System (BIRADS) classification and identify factors related to breast imaging reporting scores. Methods: 117 readings of five different mammogram test sets with each set containing 20 cancer and 40 normal cases were performed by Australian radiologists. Each radiologist evaluated the mammograms using the BIRADS lexicon with category 1 - negative, category 2 - benign findings, category 3 - equivocal findings (Recall), category 4 - suspicious findings (Recall), and category 5 - highly suggestive of malignant findings (Recall). Performance metrics (true positive, false positive, true negative, and false negative) were calculated for each radiologist and the distribution of reporting categories was analyzed in reader-based and case-based groups. The association of reader characteristics and case features among categories was examined using Mann-Whitney U and Kruskal-Wallis tests. Results: 38% of cancer-containing mammograms were reported with category 3 which decreased to 32.3% with category 4 and 16.2% with category 5 while 16.6 and 10.3% of cancer cases were marked with categories 1 and 2. Female readers had less false-negative rates when using categories 1 and 2 for cancer cases than male readers (p < 0.01). A similar pattern as gender category was also found in Breast Screen readers and readers completed breast reading fellowships compared with non-Breast Screen and non-fellowship readers (p < 0.05). Radiologists with low number of cases read per week were more likely to record the cancer cases with category 4 while the ones with high number of cases were with category 3 (p < 0.01). Discrete mass and asymmetric density were the two types of abnormalities reported mostly as equivocal findings with category 3 (47–50%; p = 0.005) while spiculated mass or stellate lesions were mostly selected as highly suggestive of malignancy with category 5 (26%, p = 0.001). Conclusions: Most radiologists used category 3 when reporting cancer mammograms. Gender, working for BreastScreen, fellowship completion, and number of cases read per week were factors associated with scoring selection. Radiologists reported higher Tabar BIRADS category for specific types of abnormalities on mammograms than others. Advances in knowledge: The study identified factors associated with the decision of radiologists in assigning a BIRADS Tabar score for mammograms with abnormality. These findings will be useful for individual training programs to improve the confidence of radiologists in recognizing abnormal lesions on screening mammograms.

Utility of Positron Emission Tomography for the Staging of Patients With Potentially Operable Esophageal Carcinoma

2000 ◽  
Vol 18 (18) ◽  
pp. 3202-3210 ◽  
Author(s):  
P. Flamen ◽  
A. Lerut ◽  
E. Van Cutsem ◽  
W. De Wever ◽  
M. Peeters ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Gastroesophageal Junction ◽  
False Negative ◽  
Stage Iv ◽  
Diagnostic Value ◽  
Emission Tomography ◽  
Positron Emission ◽  
Stage Iv Disease ◽  
A Prospective Study

PURPOSE: A prospective study of preoperative tumor-node-metastasis staging of patients with esophageal cancer (EC) was designed to compare the accuracy of 18-F-fluoro-deoxy-d-glucose (FDG) positron emission tomography (PET) with conventional noninvasive modalities.PATIENTS AND METHODS: Seventy-four patients with carcinomas of the esophagus (n = 43) or gastroesophageal junction (n = 31) were studied. All patients underwent attenuation-corrected FDG-PET imaging, a spiral computed tomography (CT) scan, and an endoscopic ultrasound (EUS).RESULTS: FDG-PET demonstrated increased activity in the primary tumor in 70 of 74 patients (sensitivity: 95%). False-negative PET images were found in four patients with T1 lesions. Thirty-four patients (46%) had stage IV disease. FDG-PET had a higher accuracy for diagnosing stage IV disease compared with the combination of CT and EUS (82% v 64%, respectively; P = .004). FDG-PET had additional diagnostic value in 16 (22%) of 74 patients by upstaging 11 (15%) and downstaging five (7%) patients. Thirty-nine (53%) of the 74 patients underwent a 2- or 3-field lymphadenectomy in conjunction with primary curative esophagectomy. In these patients, tumoral involvement was found in 21 local and 35 regional or distant lymph nodes (LN). For local LN, the sensitivity of FDG-PET was lower than EUS (33% v 81%, respectively; P = .027), but the specificity may have been higher (89% v 67%, respectively; P = not significant [NS]). For the assessment of regional and distant LN involvement, compared with the combined use of CT and EUS, FDG-PET had a higher specificity (90% v 98%, respectively; P = .025) and a similar sensitivity (46% v 43%, respectively; P = NS).CONCLUSION: PET significantly improves the detection of stage IV disease in EC compared with the conventional staging modalities. PET improves diagnostic specificity for LN staging.

Performance of Computer-aided Detection in False-Negative Screening Mammograms of Breast Cancers

2004 ◽  
Vol 51 (4) ◽  
pp. 465 ◽  
Author(s):  
Boo Kyung Han ◽  
Ji Young Kim ◽  
Jung Hee Shin ◽  
Yeon Hyeon Choe
Keyword(s):  
False Negative ◽  
Breast Cancers ◽  
Computer Aided Detection ◽  
Computer Aided ◽  
Screening Mammograms

Performance of Computer-aided Detection in False-Negative Screening Mammograms of Breast Cancers

2004 ◽  
Vol 51 (4) ◽  
pp. 465
Author(s):  
Boo Kyung Han ◽  
Ji Young Kim ◽  
Jung Hee Shin ◽  
Yeon Hyeon Choe
Keyword(s):  
False Negative ◽  
Breast Cancers ◽  
Computer Aided Detection ◽  
Computer Aided ◽  
Screening Mammograms

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

scholarly journals Laparoscopic Revisional Surgery After Failed Heller Myotomy for Esophageal Achalasia: Long-Term Outcome at a Single Tertiary Center

2021 ◽  
Author(s):  
Giovanni Capovilla ◽  
Renato Salvador ◽  
Luca Provenzano ◽  
Michele Valmasoni ◽  
Lucia Moletta ◽  
...  
Keyword(s):  
Heller Myotomy ◽  
Revisional Surgery ◽  
Stage Iv ◽  
Postoperative Outcomes ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Eckardt Score ◽  
Stage Iv Disease

Abstract Background Laparoscopic Heller myotomy (HM) has gained acceptance as the gold standard of treatment for achalasia. However, 10–20% of the patients will experience symptom recurrence, thus requiring further treatment including pneumodilations (PD) or revisional surgery. The aim of our study was to assess the long-term outcome of laparoscopic redo HM. Methods Patients who underwent redo HM at our center between 2000 and 2019 were enrolled. Postoperative outcomes of redo HM patients (redo group) were compared with that of patients who underwent primary laparoscopic HM in the same time span (control group). For the control group, we randomly selected patients matched for age, sex, FU time, Eckardt score (ES), previous PD, and radiological stage. Failure was defined as an Eckardt score > 3 or the need for re-treatment. Results Forty-nine patients underwent laparoscopic redo HM after failed primary HM. A new myotomy on the right lateral wall of the EGJ was the procedure of choice in the majority of patients (83.7%). In 36 patients (73.5%) an anti-reflux procedure was deemed necessary. Postoperative outcomes were somewhat less satisfactory, albeit comparable to the control group; the incidence of postoperative GERD was higher in the redo group (p < 0.01). At a median 5-year FU time, a good outcome was obtained in 71.4% of patients in the redo group; further 5 patients (10.2%) obtained a long-term symptom control after complementary PD, thus bringing the overall success rate to 81.6%. Stage IV disease at presentation was independently associated with a poor outcome of revisional LHD (p = 0.003). Conclusions This study reports the largest case series of laparoscopic redo HM to date. The procedure, albeit difficult, is safe and effective in relieving symptoms in this group of patients with a highly refractory disease. The failure rate, albeit not significantly, and the post-operative reflux are higher than after primary HM. Patients with stage IV disease are at high risk of esophagectomy.

scholarly journals A multicenter, hospital-based and non-inferiority study for diagnostic efficacy of automated whole breast ultrasound for breast cancer in China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yujing Xin ◽  
Xinyuan Zhang ◽  
Yi Yang ◽  
Yi Chen ◽  
Yanan Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
False Negative ◽  
Final Analysis ◽  
Age Group ◽  
Surgical Biopsy ◽  
True Negative ◽  
Diagnostic Efficacy ◽  
Negative Results ◽  
Informed Consent Form ◽  
Magnetic Resonance Imaging Mri

AbstractThis study is the first multi-center non-inferiority study that aims to critically evaluate the effectiveness of HHUS/ABUS in China breast cancer detection. This was a multicenter hospital-based study. Five hospitals participated in this study. Women (30–69 years old) with defined criteria were invited for breast examination by HHUS, ABUS or/and mammography. For BI-RADS category 3, an additional magnetic resonance imaging (MRI) test was provided to distinguish the true negative results from false negative results. For women classified as BI-RADS category 4 or 5, either core aspiration biopsy or surgical biopsy was done to confirm the diagnosis. Between February 2016 and March 2017, 2844 women signed the informed consent form, and 1947 of them involved in final analysis (680 were 30 to 39 years old, 1267 were 40 to 69 years old).For all participants, ABUS sensitivity (91.81%) compared with HHUS sensitivity (94.70%) with non-inferior Z tests, P = 0.015. In the 40–69 age group, non-inferior Z tests showed that ABUS sensitivity (93.01%) was non-inferior to MG sensitivity (86.02%) with P < 0.001 and HHUS sensitivity (95.44%) was non-inferior to MG sensitivity (86.02%) with P < 0.001. Sensitivity of ABUS and HHUS are all superior to that of MG with P < 0.001 by superior test.For all participants, ABUS specificity (92.89%) was non-inferior to HHUS specificity (89.36%) with P < 0.001. Superiority test show that specificity of ABUS was superior to that of HHUS with P < 0.001. In the 40–69 age group, ABUS specificity (92.86%) was non-inferior to MG specificity (91.68%) with P < 0.001 and HHUS specificity (89.55%) was non-inferior to MG specificity (91.68%) with P < 0.001. ABUS is not superior to MG with P = 0.114 by superior test. The sensitivity of ABUS/HHUS is superior to that of MG. The specificity of ABUS/HHUS is non-inferior to that of MG. In China, for an experienced US radiologist, both HHUS and ABUS have better diagnostic efficacy than MG in symptomatic individuals.

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