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RISK MANAGEMENT - OFFICE SYSTEM IMPROVEMENTS
Computer-Aided Detection Technology for Breast Imaging
(Radiologist Only)
Studies have shown that 20% to 40% of breast cancers go undetected at the screening stage and that half of the undetected cancers are missed due to observational oversights by radiologists. The oversights can be a result of radiologist fatigue, the complex image structure of the breast on a mammogram, and the subtle nature of certain observable characteristics of the disease that can result in false negative mammogram readings. The persistence of observational oversights is not strongly related to the experience of the radiologist, but may be inevitable with human observers. Although double readings may improve radiologist's performance, these strategies do not eliminate lapses and have not been readily adopted into the routine examination process in the United States.
In June 1998, the FDA approved Computer Aided Detection (CAD) as an aid to the radiologist in screening mammography as it has the ability to prompt a radiologist to both obvious and subtle signs of breast cancer on mammograms. CAD technology is being used by an increasing number of radiologists to assist in the early detection of breast cancer. This technology has the potential to detect findings that might otherwise be overlooked during the interpretation process, thus increasing cancer detection rates. It is particularly effective in identifying microcalcifications related to breast cancer. After a radiologist reviews the mammogram and decides whether there are any findings to recall, the CAD system is engaged. After noting the CAD prompts, the mammogram is reviewed again to see if any of the prompts add to the opinion that has already been formed about the mammogram. CAD, as it currently applies to screening mammography, should not be used to make diagnostic decisions as only the original mammograms may be used for interpretation by a qualified radiologist.
If you are a radiologist and have implemented a Computer-Aided Detection Unit (e.g., R2 Technology) in your practice, please click here to complete an Office System Questionnaire.
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