Breast Ultrasound Computer-Aided Diagnosis: Analysis of Types of Errors

Abstract

Purpose: The aim of this study was to evaluate the diagnostic performance of breast ultrasound (US) computer-aided diagnosis (CAD) to distinguish between benign and malignant lesions and analyze features of lesions interpreted with errors retrospectively. Materials and Methods: Three hundred and sixteen women with 375 breast lesions were enrolled. We assessed the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Additionally, we evaluated the causes and patterns of the misinterpretation in the false positive and negative groups. Results: The accuracy, sensitivity, specificity, PPV, and NPV of breast US-CAD were 80.3%, 83.3%, 79.8%, 37.7%, and 97.0%, respectively. There were 8 false negative lesions that were oval in shape and in parallel orientation. There were 66 false positive lesions. The greatest number of errors entailed inappropriate demarcation due to heterogeneous echogenicity, etc. The second exhibited suspicious features with good demarcation and description but were confirmed as benign histologically. The third entailed a benign lesion with suspicious features, such as abscesses. The smallest portion with good demarcations and descriptions indicating benign status exhibited possible malignancy as a final conclusion. Conclusion: Breast US-CAD is expected to be helpful in avoiding unnecessary biopsies due to its high NPV. Therefore, operators need to know the characteristics of lesions prone to misinterpretation.

Keywords

• ultrasonography
• breast neoplasm
• diagnosis
• computer-assisted