The present study evaluated the diagnostic performance of artificial intelligence-based computer-aided diagnosis (AI-CAD) compared to that of dedicated breast radiologists in characterizing suspicious microcalcification on mammography. We retrospectively analyzed 435 unilateral mammographies from 420 patients (286 benign; 149 malignant) undergoing biopsy for suspicious microcalcification from June 2003 to November 2019. Commercial AI-CAD was applied to the mammography images, and malignancy scores were calculated. Diagnostic performance was compared between radiologists and AI-CAD using the area under the receiving operator characteristics curve (AUC). The AUCs of radiologists and AI-CAD were not significantly different (0.722 vs. 0.745, p = 0.393). The AUCs of the adjusted category were 0.726, 0.744, and 0.756 with cutoffs of 2%, 10%, and 38.03% for AI-CAD, respectively, which were all significantly higher than those for radiologists alone (all p < 0.05). None of the 27 cases downgraded to category 3 with a cutoff of 2% were confirmed as malignant on pathological analysis, suggesting that unnecessary biopsies could be avoided. Our findings suggest that the diagnostic performance of AI-CAD in characterizing suspicious microcalcification on mammography was similar to that of the radiologists, indicating that it may aid in making clinical decisions regarding the treatment of breast microcalcification.
Keywords: artificial intelligence; breast cancer; computer-aided diagnosis; diagnosis; mammography; radiology.