Computer-aided detection in breast MRI: a systematic review and meta-analysis

Abstract

ObjectivesTo evaluate the additional value of computer-aided detection (CAD) in breast MRI by assessing radiologists’ accuracy in discriminating benign from malignant breast lesions.MethodsA literature search was performed with inclusion of relevant studies using a commercially available CAD system with automatic colour mapping. Two independent researchers assessed the quality of the studies. The accuracy of the radiologists’ performance with and without CAD was presented as pooled sensitivity and specificity.ResultsOf 587 articles, 10 met the inclusion criteria, all of good methodological quality. Experienced radiologists reached comparable pooled sensitivity and specificity before and after using CAD (sensitivity: without CAD: 89%; 95% CI: 78–94%, with CAD: 89%; 95%CI: 81–94%) (specificity: without CAD: 86%; 95% CI: 79–91%, with CAD: 82%; 95% CI: 76–87%). For residents the pooled sensitivity increased from 72% (95% CI: 62–81%) without CAD to 89% (95% CI: 80–94%) with CAD, however, not significantly. Concerning specificity, the results were similar (without CAD: 79%; 95% CI: 69–86%, with CAD: 78%; 95% CI: 69–84%).ConclusionsCAD in breast MRI has little influence on the sensitivity and specificity of experienced radiologists and therefore their interpretation remains essential. However, residents or inexperienced radiologists seem to benefit from CAD concerning breast MRI evaluation.

Comparison of Gadoteric Acid and Gadobutrol for Detection as Well as Morphologic and Dynamic Characterization of Lesions on Breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging

“…The size of the included masses was quite large, with mean diameter of approximately 25 mm; however, this lesion size is in the range of published studies, evaluating breast MR images by CAD systems. 15 There exists a lack of data for small lesions, as the correct detection and characterization of small breast lesions remain a specific challenge for CAD systems on breast MRI. 52 Further limitations of this investigation are that premenopausal and postmenopausal women were included; patients could not discontinue possible hormonal medication for a longer time interval, and premenopausal women did not undergo breast DCE-MRI at the exactly same time points of their menstrual cycle.…”

“…15 There is high clinical interest in incorporating also morphologic assessment into CAD systems and in linking computerextracted features to the descriptors of the BI-RADS MRI atlas. Some of the CAD systems for breast DCE-MRI combine morphologic and dynamic parameters, showing promising results, whereas different MRI contrast media have been used.…”

Correlation of Semi-Quantitative Breast-Specific Gamma Imaging Findings with Dynamic Contrast-Enhanced MRI Parameters Assessed by a Computer-Aided Evaluation Program for Breast Cancer

“…Dynamic contrast-enhanced (DCE) MRI can depict the distribution of a contrast agent within a tumor over time and can noninvasively assess the tissue vasculature (9). Computer-aided detection (CAD) programs for DCE-MRI automate kinetic assessment and provide an easier way to interpret the patterns of contrast enhancement across a series of images (10,11).…”

Digital Analysis in Breast Imaging

“…It is a component in the daily routine that serves more like a computer-assisted evaluation and visualization tool than only as a lesion detection [33]. Radiologists usually detect the lesions easily, but only the most experienced ones can safely assess the lesion [50]. MRI interpretation requires knowledge of the morphology and kinetics of the lesion as well as its enhancement patterns.…”