A real-world study of AI for DBT screening found that AI-assisted mammogram interpretation nearly doubled the breast cancer detection rate. Radiologists using iCAD’s ProFound AI software saw sharp improvements across multiple metrics.
Mammography screening has quickly become one of the most promising use cases for AI.
- Multiple large-scale studies published in 2024 and 2025 have documented improved radiologist performance when using AI for mammogram interpretation, with the largest studies performed in Europe.
Another new technology changing mammography screening is digital breast tomosynthesis, which is being rapidly adopted in the U.S.
- DBT use in Europe is occurring more slowly, so questions have arisen about whether AI’s benefits for 2D mammography would also be found with 3D systems.
To investigate this question, researchers writing in Clinical Breast Cancer tested radiologist performance for DBT screening before and after implementation of iCAD’s ProFound V2.1 AI algorithm in 2020 at Indiana University.
- Interestingly, the pre-AI period included use of iCAD’s older PowerLook CAD software.
Across the 16.7k DBT cases studied, those with AI saw …
- A sharp improvement in cancer detection rate per 1k exams (6.1 vs. 3.7).
- A decline in the abnormal interpretation rate (6.5% vs. 8.2%).
- Higher PPV1 (rate that abnormal mammograms would be positive) (8.8% vs. 4.2%).
- Higher PPV3 (rate that biopsies would be positive) (57% vs. 32%).
- Higher specificity (94% vs. 92%).
- No statistically significant change in sensitivity.
The findings on sensitivity are curious given AI’s positive impact on other interpretation metrics.
- Researchers postulated that there was higher breast cancer incidence in the post-AI implementation period, which could have been caused by AI finding cancers that were missed in the period without AI.
The Takeaway
The radiology world has seen multiple positive studies on AI for mammography, but most of these have come from Europe and involved 2D mammography not DBT. The new results suggest that AI’s benefits will also transfer to DBT, the technology that’s becoming the standard of care for breast screening in the U.S.
