Computer-aided detection (CAD) for breast MRI: Evaluation of efficacy at 3.0 T

Department of Radiology, Alysis Zorggroep, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
European Radiology (Impact Factor: 4.01). 09/2009; 20(3). DOI: 10.1007/s00330-009-1573-5
Source: OAI


The purpose of the study was to evaluate the accuracy of 3.0-T breast MRI interpretation using manual and fully automated kinetic analyses.
Manual MRI interpretation was done on an Advantage Workstation. Retrospectively, all examinations were processed with a computer-aided detection (CAD) system. CAD data sets were interpreted by two experienced breast radiologists and two residents. For each lesion automated analysis of enhancement kinetics was evaluated at 50% and 100% thresholds. Forty-nine malignant and 22 benign lesions were evaluated.
Using threshold enhancement alone, the sensitivity and specificity of CAD were 97.9% and 86.4%, respectively, for the 50% threshold, and 97.9% and 90%, respectively, for the 100% threshold. Manual interpretation by two breast radiologists showed a sensitivity of 84.6% and a specificity of 68.8%. For the same two radiologists the mean sensitivity and specificity for CAD-based interpretation was 90.4% (not significant) and 81.3% (significant at p < 0.05), respectively. With one-way ANOVA no significant differences were found between the two breast radiologists and the two residents together, or between any two readers separately.
CAD-based analysis improved the specificity compared with manual analysis of enhancement. Automated analysis at 50% and 100% thresholds showed a high sensitivity and specificity for readers with varying levels of experience.

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    • "All rights reserved. doi:10.1016/j.ejrad.2011.03.060 above a certain threshold level, and have been shown to improve specificity compared to radiologist's assessments alone by better demonstrating the presence of enhancement and delayed enhancement features [7] [8] [9]. As the kinetic curve type determined by the most suspicious kinetic feature, i.e., any presence of washout is considered to be more suspicious than plateau which in turn is considered to be more suspicious than persistence, is known to be significantly different between benign and malignant lesions, whole lesion assessment by CAD could be expected to improve diagnostic performance in differentiation of benign and malignant lesions [10] [11] [12] [13]. "
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