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May 23, 2023Radiology195 citationsOpen Access

Standalone AI for Breast Cancer Detection at Screening Digital Mammography and Digital Breast Tomosynthesis: A Systematic Review and Meta-Analysis

JYJung Hyun YoonFSFredrik StrandPBPascal Baltzer

Key Points

  • To evaluate the standalone performance of AI in interpreting digital mammography and digital breast tomosynthesis (DBT) images.
  • Systematic search across multiple databases for studies from January 2017 to June 2022.
  • Reviewed sensitivity, specificity, and area under the curve (AUC) values.
  • Conducted random effects meta-analysis and meta-regression for different study types and imaging techniques.
  • Pooled AUCs were significantly higher for standalone AI than radiologists in reader studies on digital mammography (0.87 vs 0.81, P=0.002).
  • No significant difference in AUC for historic cohort studies (0.89 vs 0.96, P=0.152).
  • AI showed significantly higher AUCs compared to radiologists in DBT studies (0.90 vs 0.79, P<0.001).

Abstract

Background There is considerable interest in the potential use of artificial intelligence (AI) systems in mammographic screening. However, it is essential to critically evaluate the performance of AI before it can become a modality used for independent mammographic interpretation. Purpose To evaluate the reported standalone performances of AI for interpretation of digital mammography and digital breast tomosynthesis (DBT). Materials and Methods A systematic search was conducted in PubMed, Google Scholar, Embase (Ovid), and Web of Science databases for studies published from January 2017 to June 2022. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) values were reviewed. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Comparative (QUADAS-2 and QUADAS-C, respectively). A random effects meta-analysis and meta-regression analysis were performed for overall studies and for different study types (reader studies vs historic cohort studies) and imaging techniques (digital mammography vs DBT). Results In total, 16 studies that include 1 108 328 examinations in 497 091 women were analyzed (six reader studies, seven historic cohort studies on digital mammography, and four studies on DBT). Pooled AUCs were significantly higher for standalone AI than radiologists in the six reader studies on digital mammography (0.87 vs 0.81, P = .002), but not for historic cohort studies (0.89 vs 0.96, P = .152). Four studies on DBT showed significantly higher AUCs in AI compared with radiologists (0.90 vs 0.79, P Supplemental material is available for this article. See also the editorial by Scaranelo in this issue.

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Cite This Study

Yoon et al. (2023) studied this question.

synapsesocial.com/papers/69de549dda08968cf7b0bf88https://doi.org/10.1148/radiol.222639
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