AUTHORS
Marthe Larsen, Camilla F. Olstad, Christoph I. Lee, Tone Hovda, Solveig R. Hoff, Marit A. Martiniussen, Karl Øyvind Mikalsen, Håkon Lund-Hanssen, Helene S. Solli, Marko Silberhorn, Åse Ø. Sulheim, Steinar Auensen, Jan F. Nygård, Solveig Hofvind
From the Section for Breast Cancer Screening (M.L., C.F.O., S.H.) and Department of Register Informatics (S.A., J.F.N.), Cancer Registry of Norway, Norwegian Institute of Public Health, PO 5313, Majorstuen, 0304 Oslo, Norway; Department of Radiology, University of Washington School of Medicine, Seattle, Wash (C.I.L.); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash (C.I.L.); Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway (T.H.); Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway (S.R.H.); Department of Circulation, Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (S.R.H.); Department of Radiology, Østfold Hospital Trust, Kalnes, Norway (M.A.M.); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (M.A.M.); SPKI–The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, Norway (K.Ø.M.); Department of Clinical Medicine, Faculty of Health Sciences (K.Ø.M.), Department of Physics and Technology, Faculty of Science and Technology (J.F.N.), and Department of Health and Care Sciences, Faculty of Health Sciences (S.H.), UiT–The Arctic University of Norway, Tromsø, Norway; Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Trondheim, Norway (H.L.H.); Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway (H.S.S.); Department of Radiology, Innlandet Hospital Trust, Hamar, Norway (M.S.); and Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway (Å.Ø.S.).
PUBLISHED
Abstract
“Just Accepted” papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.
Purpose
To explore the standalone breast cancer detection performance at different risk score thresholds of a commercially available artificial intelligence (AI) system.
Materials and Methods
This retrospective study included information from 661,695 digital mammographic examinations performed among 242,629 female individuals screened as a part of x, 2004–2018. The study sample included 3807 screen-detected cancers (SDC) and 1110 interval breast cancers (IC). A continuous examination level risk score by the AI system was used to measure performance as the area under the receiver operating characteristic curve (AUC) with 95% CIs and cancer detection at different AI risk score thresholds.
Results
The AUC of the AI system was 0.93 (95% CI: 0.92–0.93) for SDC and IC combined and 0.97 (95% CI: 0.97–0.97) for SDC. In a setting where 10% of the examinations with the highest AI risk scores were defined as positive and 90% with the lowest scores as negative, 92.0% (3502/3807) of the SDC and 44.6% (495/1100) of the IC were identified by AI. In this scenario, 68.5% (10 987/16 029) of false positive screening results (negative recall assessment) were considered negative by AI. When 50% was used as the cut-off, 99.3% (3781/3807) of the SDC and 85.2% (946/1100) of the IC were identified as positive by AI, while 17.0% (2725/16 029) of the false positives were considered as negative.
Conclusion
The AI system showed high performance in detecting breast cancers within 2 years of screening mammography and a potential for triaging low-risk mammograms to reduce radiologist workload.