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Cross-Institutional Evaluation of BI-RADS Predictive Model for Mammographic Diagnosis of Breast Cancer

¹ Department of Radiology, Duke University Medical Center, DUMC-3302, Bryan Research Bldg., Rm. 161G, Durham, NC 27710.
² Department of Biomedical Engineering, Duke University, Durham, NC 27710.

View larger version (16K): [in a new window]   Fig. 1. —Graph shows receiver operating characteristic (ROC) curves for three trials, which differ according to whether each was trained or tested on Duke or Penn data sets. Partial ROC plot corresponding to top 10% of this plot is shown in Figure 2. Top line=trial A (Duke/Duke), middle line=trial C (Penn/Penn), bottom line=trial B (Duke/Penn).

View larger version (16K): [in a new window]   Fig. 2. —Graph shows partial receiver operating characteristic (ROC) curves (sensitivity 90%) for three trials. Letters A, B, and C in this plot mark actual operating points used for those trials. Trial A (Duke/Duke) was best performer, followed by closely intertwined curves for trials C (Penn/Penn) and B (Duke/Penn).

View larger version (19K): [in a new window]   Fig. 3. —Partial histogram of model outputs for Duke-only trial A. This model was trained and tested on Duke set. This histogram spans only output range 0-0.284, corresponding to 90% sensitivity or better. Threshold of 0.10 yields 98% sensitivity and 36% specificity as reported in Table 2. White bar = benign, black bar = malignant.

View larger version (16K): [in a new window]   Fig. 4. —Partial histogram of model outputs for cross-institutional trial B. This model was trained on the Duke set and tested using the Penn set. Histogram spans only output range 0-0.176, corresponding to 90% sensitivity or better. Applying trial A's threshold of 0.10 resulted in 96% sensitivity and 28% specificity. White bar = benign, black bar = malignant.

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