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AI Helps General Radiologists Achieve Specialist-Level Performance in Interpreting Mammograms

By MedImaging International staff writers
Posted on 16 Feb 2024

Image: Saige-DX is a custom-built categorical AI system designed to assist in breast cancer screening (Photo courtesy of DeepHealth)

Breast cancer, affecting one in eight women during their lifetimes, becomes far more treatable when detected early. The five-year relative survival rate for stage 1 breast cancer is an encouraging 99%, highlighting the importance of early detection. Now, groundbreaking research reveals that an advanced artificial intelligence (AI) technology, designed for mammography, can significantly enhance the early detection and diagnosis of breast cancer by enabling general radiologists to perform at the level of specialists.

DeepHealth’s (Los Angeles, CA, USA) Saige-Dx is a custom-built categorical AI system that automatically spots suspicious lesions in mammograms, assigning a level of suspicion to each finding and the entire case. In a pivotal study conducted by DeepHealth, the interpretative skills of 18 physicians, including both breast specialists and general radiologists, were evaluated. The researchers analyzed 240 retrospectively gathered digital breast tomosynthesis scans for cancer indicators. Utilizing Saige-DX, each radiologist demonstrated an enhanced ability to interpret mammograms. Their average diagnostic accuracy, measured by the area under the receiver operating characteristic curve, improved from 0.87 to 0.93 with the aid of AI.

The improvement was significant in both groups of radiologists, with generalists adding 0.08 to their accuracy score and specialists improving by 0.05. This enhanced performance was consistent across various cancer characteristics, such as lesion type and size, and across patient subgroups, including different races and ethnicities, ages, and breast densities. The researchers attribute this success to the AI system's design, which specifically addresses challenging cases. The algorithm was trained using a dataset that included cancers previously missed in clinical settings by radiologists. Furthermore, Saige-Dx's minimal use of “bounding boxes” for marking breast images likely prevented radiologists from being overwhelmed by excessive markings, a common issue with less precise computer-aided diagnostic tools.

“The mean performance of general radiologists with AI exceeded that of breast imaging specialists unaided by AI, suggesting that the AI software could help patients receive specialist-level interpretations for their screening mammogram even if interpreted by a general radiologist,” the researchers noted. “The benefits of using AI are not limited to generalists, as specialists also showed improved performance.”

“In conclusion, our results show that general radiologists may achieve specialist-level performance when interpreting screening DBT mammograms with the aid of AI and that specialists can achieve even higher performance (increased sensitivity and specificity) in a diverse population across multiple cancer types,” stated Jiye G. Kim, PhD, DeepHealth’s director of clinical studies.

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92 (761.03210449219): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294800287 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

93 (!!!!! 1847.0287322998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

94 (690.93704223633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

95 (942.94548034668): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294800287 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

96 (592.94700622559): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

97 (328.06396484375): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

98 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

99 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

100 (149.96528625488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

101 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

102 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

103 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

104 (299.93057250977): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

105 (!!!!! 101708.88900757): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

106 (!!!!! 12166.976928711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

107 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

108 (!!!!! 2124.0711212158): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800287 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800287 AND type='deeppockets_item' AND published='1' LIMIT 1

109 (!!!!! 1128365.9934998): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

110 (!!!!! 2549.8867034912): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

111 (288.00964355469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

112 (87.976455688477): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

113 (697.13592529297): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

114 (184.05914306641): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

115 (332.11708068848): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

116 (415.08674621582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

117 (!!!!! 1382.1125030518): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

118 (!!!!! 1636.9819641113): SELECT name FROM jos_deeppockets WHERE id=211

119 (447.03483581543): SELECT name FROM jos_deeppockets WHERE id=211

120 (851.86958312988): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

121 (540.97175598145): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

122 (994.92073059082): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

123 (609.15946960449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

124 (!!!!! 12076.139450073): TRUNCATE TABLE jos_trademed_module

125 (!!!!! 2254.0092468262): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294800287 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

126 (410.07995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

127 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

128 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

129 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

130 (!!!!! 1129.8656463623): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

131 (463.00888061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

132 (202.89421081543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

133 (647.06802368164): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800287 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800287 AND type='deeppockets_item' AND published='1' LIMIT 1

134 (!!!!! 1307.9643249512): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

135 (464.91622924805): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

136 (298.02322387695): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

137 (!!!!! 2475.0232696533): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

138 (998.97384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800287 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800287 AND published='1' LIMIT 1

139 (167.1314239502): select jos_twitters.link from jos_twitters where cat=10

140 (241.04118347168): select jos_facebook.link from jos_facebook where cat=10

141 (171.89979553223): select jos_google_plus.link from jos_google_plus where cat=10

142 (!!!!! 1307.0106506348): select jos_linkedin.link from jos_linkedin where cat=10

143 (844.00177001953): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

144 (!!!!! 1570.9400177002): insert into jos_banners_delta values (14615,'2025-04-29 10:34:18','3.14.247.147','view'),(14202,'2025-04-29 10:34:18','3.14.247.147','view'),(14203,'2025-04-29 10:34:18','3.14.247.147','view')

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