Optimizing mammography interpretation education: leveraging deep learning for cohort-specific error detection to enhance radiologist training.

Purpose: Accurate interpretation of mammograms presents challenges. Tailoring mammography training to reader profiles holds the promise of an effective strategy to reduce these errors. This proof-of-concept study investigated the feasibility of employing convolutional neural networks (CNNs) with transfer learning to categorize regions associated with false-positive (FP) errors within screening mammograms into categories of "low" or "high" likelihood of being a false-positive detection for radiologists sharing similar geographic characteristics.

Approach: Mammography test sets assessed by two geographically distant cohorts of radiologists (cohorts A and B) were collected. FP patches within these mammograms were segmented and categorized as "difficult" or "easy" based on the number of readers committing FP errors. Patches outside 1.5 times the interquartile range above the upper quartile were labeled as difficult, whereas the remaining patches were labeled as easy. Using transfer learning, a patch-wise CNN model for binary patch classification was developed utilizing ResNet as the feature extractor, with modified fully connected layers for the target task. Model performance was assessed using 10-fold cross-validation.

Results: Compared with other architectures, the transferred ResNet-50 achieved the highest performance, obtaining receiver operating characteristics area under the curve values of 0.933 ( $\pm 0.012$ ) and 0.975 ( $\pm 0.011$ ) on the validation sets for cohorts A and B, respectively.

Conclusions: The findings highlight the feasibility of employing CNN-based transfer learning to predict the difficulty levels of local FP patches in screening mammograms for specific radiologist cohort with similar geographic characteristics.