How widely is computer-aided detection used in screening and diagnostic mammography?

Abstract

Purpose: The aim of this study was to determine how widely computer-aided detection (CAD) is used in screening and diagnostic mammography and to see if there are differences between hospital facilities and private offices.

Methods: The nationwide Medicare Part B fee-for-service databases for 2004 to 2008 were used. The Current Procedural Terminology(®) codes for screening and diagnostic mammography (both digital and screen film) and the CAD add-on codes were selected. Procedure volume was compared for screening vs diagnostic mammography and for hospital facilities vs private offices.

Results: From 2004 to 2008, Medicare screening mammography volume increased slightly from 5,728,419 to 5,827,326 (+2%), but the use of screening CAD increased from 2,257,434 to 4,305,595 (+91%). By 2008, CAD was used in 74% of all screening mammographic studies. During this same time period, the Medicare volume of diagnostic mammography declined slightly from 1,835,700 to 1,682,026 (-8%), but the use of diagnostic CAD increased from 360,483 to 845,461 (+135%). By 2008, CAD was used in 50% of all diagnostic mammographic studies. In hospital facilities in 2008, CAD was used in 70% of all screening mammographic studies, compared with 81% in private offices. For diagnostic mammography in 2008, CAD was used in 48% in hospitals, compared with 55% in private offices.

Conclusion: Despite some operational drawbacks to using CAD, radiologists have embraced it in an effort to improve cancer detection. Its use has grown rapidly, and in 2008, it was used in three-quarters of all screening mammographic studies and half of all diagnostic mammographic studies. Women undergoing either screening or diagnostic mammography are more likely to receive CAD if they go to a private office than if they go to a hospital facility, although the differences are not great.