# Using automated software evaluation to improve the performance of breast radiographers in tomosynthesis screening

## TL;DR

A software tool helps breast radiographers improve their performance in positioning and compression during cancer screening.

## Contribution

A novel software tool is introduced to automatically evaluate and improve radiographers' performance in tomosynthesis screening.

## Key findings

- All radiographers increased the percentage of high-quality images after using the software.
- Improvements in compression performance were observed, with some up to 16%.
- Better radiographer performance is expected to lead to improved screening outcomes.

## Abstract

To improve breast radiographers’ individual performance by using automated software to assess the correctness of breast positioning and compression in tomosynthesis screening.

In this retrospective longitudinal analysis of prospective cohorts, six breast radiographers with varying experience in the field were asked to use automated software to improve their performance in breast compression and positioning. The software tool automatically analyzes craniocaudal (CC) and mediolateral oblique (MLO) views for their positioning quality by scoring them according to PGMI classifications (perfect, good, moderate, inadequate) and checking whether the compression pressure is within the target range. The positioning and compression data from the studies acquired before the start of the project were used as individual baselines, while the data obtained after the training were used to test whether conscious use of the software could help the radiographers improve their performance. The percentage of views rated perfect or good and the percentage of views in target compression were used as overall metrics to assess changes in performance.

Following the use of the software, all radiographers significantly increased the percentage of images rated as perfect or good in both CCs and MLOs. Individual improvements ranged from 7 to 14% for CC and 10 to 16% for MLO views. Moreover, most radiographers exhibited improved compression performance in CCs, with improvements up to 16%.

Active use of a software tool to automatically assess the correctness of breast compression and positioning in breast cancer screening can improve the performance of radiographers.

This study suggests that the use of a software tool for automatically evaluating correctness of breast compression and positioning in breast cancer screening can improve the performance of radiographers on these metrics, which may ultimately lead to improved screening outcomes.

• Proper breast positioning and compression are critical in breast cancer screening to ensure accurate diagnosis.

• Active use of the software increased the quality of craniocaudal and mediolateral oblique views acquired by all radiographers.

• Improved performance of radiographers is expected to improve screening outcomes.