Impact of Artificial Intelligence on Mammography Interpretation by Breast Radiologists, Non-Breast Radiologists, and Senior Residents

Abstract

Background: Artificial intelligence (AI) is recognized to have tremendous potential to revolutionize breast cancer management through mammography. However, the extent of its impact on radiologists with different levels of experience remains largely unexplored. Therefore, this study aimed to comprehensively show how AI could assist radiologists of varying expertise including breast and non-breast radiologists, as well as senior residents, in performing mammogram interpretation.Methods: This retrospective study analyzed eligible mammograms from Cipto Mangunkusumo Hospital between January 2017 and March 2021. Mammographic readings were conducted independently by two breast radiologists, two from other subspecialties, and three senior residents, all blinded to clinical information. AI standalone performance, as well as radiologists with and without AI assistance, was measured. Results: The results showed that a total of 886 eligible mammograms were analyzed. AI standalone performance, assessed using ROC curve analysis, yielded an AUC of 0.946 (95% CI, 0.925–0.967) with sensitivity and specificity of 90.1% and 93.6%, respectively. AI assistance significantly improved the sensitivity and specificity of all radiologists, regardless of experience level, with a median increase of 19.4% (IQR, 10.4–33.5%) and 12.1% (IQR, 5.2–16.2%), respectively. Moreover, there was a trend toward a higher increase with AI assistance in dense compared to fatty breasts.Conclusions: AI proved to be a highly effective diagnostic supplement for radiologists across varying experience levels, specifically in non-breast radiologists, offering the potential to add even greater value in cases of dense breast tissue. The results were derived from a national referral tertiary hospital that generally received many breast cancer cases referred from other hospitals for further treatment. Therefore, further studies incorporating different levels of hospitals were needed.