Tag: breast AI

Patients Want Mammo AI, But Mostly As Backup

Posted on by Brian Casey

Patients support the idea of having AI review their screening mammograms – under certain conditions. That’s according to a new study in Radiology: Imaging Cancer that could have implications for breast imagers seeking to integrate AI into their practices.

Mammography screening has been identified as one of the most promising use cases for AI, but clinical adoption has been sluggish for reasons that range from low reimbursement to concerns about data privacy, security, algorithm bias, and transparency. 

  • Vendors and providers are working on solving many of the problems impeding greater AI use, but patient preference is an often overlooked factor – even as some providers are beginning to offer AI review services for which patients pay out of pocket.

To gain more insight into what patients want, researchers from the University of Texas Southwestern Medical Center surveyed 518 women who got screening mammography over eight months in 2023, finding …

  • 71% preferred that AI be used as a second reader along with a radiologist.
  • Only 4.4% accepted standalone AI interpretation of their images.
  • 74% wanted patient consent before AI review.
  • If AI found an abnormality, 89% wanted a radiologist to review their case, versus 51% who wanted AI to review abnormal findings by radiologists.
  • If AI missed a finding, 58% believed “everyone” should be accountable, while 15% said they would hold the AI manufacturer accountable. 

Patient preference for use of AI in collaboration with radiologists tracks with other recent research. 

  • Patients seem to want humans to retain oversight of AI, and seem to value trust, empathy, and accountability in healthcare – values associated with providers, not machines. 

The findings should also be good news for imaging services companies offering out-of-pocket AI review services. 

The Takeaway

The new findings should be encouraging not only for breast imagers and AI developers, but also for the imaging services companies that are banking on patients to shell out their own money for AI review. As insurance reimbursement for AI languishes, this may be the only way to move mammography AI forward in the short term.

Tipping Point for Breast AI?

Posted on by Brian Casey

Have we reached a tipping point when it comes to AI for breast screening? This week another study was published – this one in Radiology – demonstrating the value of AI for interpreting screening mammograms. 

Of all the medical imaging exams, breast screening probably could use the most help. Reading mammograms has been compared to looking for a needle in a haystack, with radiologists reviewing thousands of images before finding a single cancer. 

AI could help in multiple ways, either at the radiologist’s side during interpretation or by reviewing mammograms in advance, triaging the ones most likely to be normal while reserving suspicious exams for closer attention by radiologists (indeed, that was the approach used in the MASAI study in Sweden in August).

In the new study, UK researchers in the PERFORMS trial compared the performance of Lunit’s INSIGHT MMG AI algorithm to that of 552 radiologists in 240 test mammogram cases, finding that …

  • AI was comparable to radiologists for sensitivity (91% vs. 90%, P=0.26) and specificity (77% vs. 76%, P=0.85). 
  • There was no statistically significant difference in AUC (0.93 vs. 0.88, P=0.15)
  • AI and radiologists were comparable or no different with other metrics

Like the MASAI trial, the PERFORMS results show that AI could play an important role in breast screening. To that end, a new paper in European Journal of Radiology proposes a roadmap for implementing mammography AI as part of single-reader breast screening programs, offering suggestions on prospective clinical trials that should take place to prove breast AI is ready for widespread use in the NHS – and beyond. 

The Takeaway

It certainly does seem that AI for breast screening has reached a tipping point. Taken together, PERFORMS and MASAI show that mammography AI works well enough that “the days of double reading are numbered,” at least where it is practiced in Europe, as noted in an editorial by Liane Philpotts, MD. 

While double-reading isn’t practiced in the US, the PERFORMS protocol could be used to supplement non-specialized radiologists who don’t see that many mammograms, Philpotts notes. Either way, AI looks poised to make a major impact in breast screening on both sides of the Atlantic.

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