Improving Accuracy and Efficiency with Concurrent Use of Artificial Intelligence for Digital Breast Tomosynthesis

To evaluate the use of artificial intelligence (AI) to shorten digital breast tomosynthesis (DBT) reading time while maintaining or improving accuracy. A deep learning AI system was developed to identify suspicious soft-tissue and calcified lesions in DBT images. A reader study compared the performance of 24 radiologists (13 of whom were breast subspecialists) reading 260 DBT examinations (including 65 cancer cases) both with and without AI. Readings occurred in two sessions separated by at least 4 weeks. Area under the receiver operating characteristic curve (AUC), reading time, sensitivity, specificity, and recall rate were evaluated with statistical methods for multireader, multicase studies. Radiologist performance for the detection of malignant lesions, measured by mean AUC, increased 0.057 with the use of AI (95% confidence interval [CI]: 0.028, 0.087; P .01), Reading time decreased 52.7% (95% CI: 41.8%, 61.5%; P .01), Sensitivity increased from 77.0% without AI to 85.0% with AI (8.0%; 95% CI: 2.6%, 13.4%; P .01), The concurrent use of an accurate DBT AI system was found to improve cancer detection efficacy in a reader study that demonstrated increases in AUC, sensitivity, and specificity and a reduction in recall rate and reading time. See also the commentary by Hsu and Hoyt in this issue. Reading times were significantly reduced, and sensitivity, specificity, and recall rate improved in a nonclinical reader study when an artificial intelligence system was utilized concurrently with image interpretation for digital breast tomosynthesis.