{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:49:22Z","timestamp":1787165362347,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Artificial intelligence (AI)-based systems have the potential to increase the efficiency and effectiveness of breast cancer screening programs but need to be carefully validated before clinical implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To retrospectively evaluate an AI system to safely reduce the workload of a double-reading breast cancer screening program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>All digital mammography (DM) screening examinations of women aged 40\u201374 years between August 2021 and January 2022 in \u00d6sterg\u00f6tland, Sweden were included. Analysis of the interval cancers (ICs) was performed in 2024. Each examination was double-read by two breast radiologists and processed by the AI system, which assigned a score of 1\u201310 to each examination based on increasing likelihood of cancer. In a retrospective simulation, the AI system was used for triaging; low-risk examinations (score 1\u20137) were selected for single reading and high-risk examinations (score 8\u201310) for double reading.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15,468 DMs were included. Using an AI triaging strategy, 10,473 (67.7%) examinations received scores of 1\u20137, resulting in a 34% workload reduction. Overall, 52\/53 screen-detected cancers were assigned a score of 8\u201310 by the AI system. One cancer was missed by the AI system (score 4) but was detected by the radiologists. In total, 11 cases of IC were found in the 2024 analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Replacing one reader in breast cancer screening with an AI system for low-risk cases could safely reduce workload by 34%. In total, 11 cases of IC were found in the 2024 analysis; of them, three were identified correctly by the AI system at the 2021\u20132022 examination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02841851251356176","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T05:31:43Z","timestamp":1755495103000},"page":"1165-1173","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The use of artificial intelligence (AI) to safely reduce the workload of breast cancer screening: a retrospective simulation study"],"prefix":"10.1177","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2054-8729","authenticated-orcid":false,"given":"Pantelis","family":"Gialias","sequence":"first","affiliation":[{"name":"Department of Radiology in Link\u00f6ping, and Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Centre for Medical Image Science and Visualization (CMIV), Link\u00f6ping University, Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Kristoffersen","family":"Wiberg","sequence":"additional","affiliation":[{"name":"Department of Radiology in Link\u00f6ping, and Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Kathrin","family":"Brehl","sequence":"additional","affiliation":[{"name":"ScreenPoint Medical BV, Toernooiveld 300, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9548-4842","authenticated-orcid":false,"given":"Tomas","family":"Bjerner","sequence":"additional","affiliation":[{"name":"Department of Radiology in Link\u00f6ping, and Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Centre for Medical Image Science and Visualization (CMIV), Link\u00f6ping University, Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6148-1053","authenticated-orcid":false,"given":"H\u00e5kan","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Centre for Medical Image Science and Visualization (CMIV), Link\u00f6ping University, Link\u00f6ping Sweden"},{"name":"Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/M19-2125"},{"key":"e_1_3_2_4_2","unstructured":"Socialstyrelsen Nationell utv\u00e4rdering \u2013 br\u00f6stcancerscreening med mammografi in: Socialstyrelsen (Ed.) 2022."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32859"},{"key":"e_1_3_2_6_2","first-page":"74","article-title":"European guidelines for quality assurance in breast cancer screening and diagnosis. -summary document","volume":"4","author":"Perry N","year":"2008","unstructured":"Perry N, Broeders M, de Wolf C, et al. European guidelines for quality assurance in breast cancer screening and diagnosis. -summary document. Oncol Clin Pract 2008;4:74\u201386.","journal-title":"Oncol Clin Pract"},{"key":"e_1_3_2_7_2","article-title":"Staff shortages are putting UK breast cancer screening \u201cat risk,\u201d survey finds","volume":"353","author":"Gulland A","year":"2016","unstructured":"Gulland A. Staff shortages are putting UK breast cancer screening \u201cat risk,\u201d survey finds. BMJ 2016;353:i2350.","journal-title":"BMJ"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.18179"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2021.03.022"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1799-6"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy222"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018181371"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2019.1610387"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00298-X"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.212381"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-07686-3"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07165-1"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1117\/1.JMI.10.6.061404"},{"key":"e_1_3_2_19_2","article-title":"Artificial intelligence for breast cancer detection in screening mammography in Sweden: a prospective, population-based, paired-reader, non-inferiority study","volume":"5","author":"Dembrower K","year":"2023","unstructured":"Dembrower K, Crippa A, Col\u00f3n E, et al. Artificial intelligence for breast cancer detection in screening mammography in Sweden: a prospective, population-based, paired-reader, non-inferiority study. Lancet Digit Health 2023;5:e703\u2013e711.","journal-title":"Lancet Digit Health"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.3321"},{"key":"e_1_3_2_21_2","article-title":"Effect of artificial intelligence-based triaging of breast cancer screening mammograms on cancer detection and radiologist workload: a retrospective simulation study","volume":"2","author":"Dembrower K","year":"2020","unstructured":"Dembrower K, W\u00e5hlin E, Liu Y, et al. Effect of artificial intelligence-based triaging of breast cancer screening mammograms on cancer detection and radiologist workload: a retrospective simulation study. Lancet Digit Health 2020;2:e468\u2013e474.","journal-title":"Lancet Digit Health"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","unstructured":"Sechopoulos I Teuwen J Mann R. Artificial intelligence for breast cancer detection in mammography and digital breast tomosynthesis: State of the art. Semin Cancer Biol 2021;72:214\u2013225.","DOI":"10.1016\/j.semcancer.2020.06.002"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-07992-w"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204432"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.210948"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203555"},{"key":"e_1_3_2_27_2","first-page":"3958","article-title":"Impact of real-life use of artificial intelligence as support for human reading in a population-based breast cancer screening program with mammography and tomosynthesis","author":"El\u00edas-Cabot E","year":"2024","unstructured":"El\u00edas-Cabot E, Romero-Mart\u00edn S, Raya-Povedano JL, et al. Impact of real-life use of artificial intelligence as support for human reading in a population-based breast cancer screening program with mammography and tomosynthesis. Eur Radiol 2024;34:3958\u20133966.","journal-title":"Eur Radiol"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-09461-y"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203555"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.230989"},{"key":"e_1_3_2_31_2","volume-title":"Going from double to single Reading for screening exams labeled as likely normal by AI: what is the impact?15th International Workshop on Breast Imaging (IWBI2020)","author":"Balta C","unstructured":"Balta C, Rodriguez-Ruiz A, Mieskes C, et al. Going from double to single Reading for screening exams labeled as likely normal by AI: what is the impact? In: 15th International Workshop on Breast Imaging (IWBI2020), 2020, SPIE:94-101."},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2019180068"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.211590"}],"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02841851251356176","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02841851251356176","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02841851251356176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:34:45Z","timestamp":1777390485000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02841851251356176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,17]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/02841851251356176"],"URL":"https:\/\/doi.org\/10.1177\/02841851251356176","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,17]]}}}