The promise of computer aided detection in digital mammography.

Computer-aided detection (CAD) is a new technology now being implemented in many clinics to reduce the false negative rate in mammography screening. A large clinical study has been completed which shows that a substantial false negative (miss) rate exists in screening mammography, a significant fraction of the missed cancers are not subtle, and CAD has high sensitivity to these missed cancers. Full field digital mammography is now coming on the scene, but has not yet been proven in clinical practice. The authors believe that full acceptance of the new digital technology depends not merely on demonstrations of 'substantial equivalence' to film-screen technology, but rather on more complete exploitation of the unique advantages of digital technology, and that CAD can play a key role. These advantages derive from CAD's ability to quickly (in near real-time) perform analytical computations on digital information that is not readily available to the radiologist until after the cost of film-processing has occurred.