Influence of Mammography Acquisition Parameters on AI and Radiologist Interpretive Performance.
Authors
Affiliations (11)
Affiliations (11)
- Department of Data Science, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215.
- Department of Pathology, Brigham and Women's Hospital, Boston, Mass.
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Wash.
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
- Department of Radiology, University of Washington School of Medicine, Seattle, Wash.
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Wash.
- Department of Public Health Sciences, University of California Davis, Davis, Calif.
- Kaiser Permanente Washington Health Research Institute, Seattle, Wash.
- Department of Medicine, UCLA National Clinician Scholar Program, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Wash.
- Department of Bioengineering, University of California, Los Angeles, Samueli School of Engineering, Los Angeles, Calif.
Abstract
<i>"Just Accepted" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content</i>. Purpose To evaluate the impact of screening mammography acquisition parameters on the interpretive performance of AI and radiologists. Materials and Methods The associations between seven mammogram acquisition parameters-mammography machine version, kVp, x-ray exposure delivered, relative x-ray exposure, paddle size, compression force, and breast thickness-and AI and radiologist performance in interpreting two-dimensional screening mammograms acquired by a diverse health system between December 2010 and 2019 were retrospectively evaluated. The top 11 AI models and the ensemble model from the Digital Mammography DREAM Challenge were assessed. The associations between each acquisition parameter and the sensitivity and specificity of the AI models and the radiologists' interpretations were separately evaluated using generalized estimating equations-based models at the examination level, adjusted for several clinical factors. Results The dataset included 28,278 screening two-dimensional mammograms from 22,626 women (mean age 58.5 years ± 11.5 [SD]; 4913 women had multiple mammograms). Of these, 324 examinations resulted in breast cancer diagnosis within 1 year. The acquisition parameters were significantly associated with the performance of both AI and radiologists, with absolute effect sizes reaching 10% for sensitivity and 5% for specificity; however, the associations differed between AI and radiologists for several parameters. Increased exposure delivered reduced the specificity for the ensemble AI (-4.5% per 1 SD increase; <i>P</i> < .001) but not radiologists (<i>P</i> = .44). Increased compression force reduced the specificity for radiologists (-1.3% per 1 SD increase; <i>P</i> < .001) but not for AI (<i>P</i> = .60). Conclusion Screening mammography acquisition parameters impacted the performance of both AI and radiologists, with some parameters impacting performance differently. ©RSNA, 2025.