CAD usage in screening, diagnostic mammography increases: Study

The use of computer-aided detection (CAD) is increasing, in both screening and diagnostic mammography, according to a study in the October issue of the Journal of the American College of Radiology (www.jacr.org). CAD software systems highlight and alert the radiologist of abnormal areas of density, mass or calcification on a digitized mammographic image (of the breast) that may indicate the presence of cancer.

Screening mammography is an X-ray exam of the breast that is used as a screening tool to detect early breast cancer in women experiencing no symptoms. Diagnostic mammography is an X-ray exam of the breast that is performed in order to evaluate a breast complaint of abnormality detected by physical exam or routine screening mammography.

Researchers at Thomas Jefferson University Hospital in Philadelphia, PA, reviewed codes for screening and diagnostic mammography (both screen-film and digital) as well as codes for screening and diagnostic CAD from the Medicare Part B Physician/Supplier Procedure Summary Master Files for 2004 - 2008.

In 2004, a total of 5,728,419 screening mammograms were performed, and CAD was used in 2,257,434 (39 percent) of them. In 2008, a total of 5,827,326 screening mammograms were performed, and CAD was used in 4,305,595 (74 percent) of them. In 2004, a total of 1,835,700 diagnostic mammograms were performed, and CAD was used in 360,483 (20 percent) of them. In 2008, a total of 1,682,026 diagnostic mammograms were performed, and CAD was used in 845,461 (50 percent) of them. "By 2008, CAD was used in about three quarters of all screening exams and half of all diagnostic exams," said Vijay M. Rao, MD, lead author of the study.

"The use of CAD is controversial, while some support it and others are critical of it. Nonetheless, while there remains debate over the efficacy of CAD, it is apparent that radiologists are increasingly utilizing this technology and that it is becoming standard practice in breast diagnosis," said Rao.