title: Computer-aided detection (CAD) for breast MRI: evaluation of efficacy at 3.0 T.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the accuracy of 3.0-T breast MRI interpretation using manual and fully automated kinetic analyses.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Alysis Zorggroep, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands. CMeeuwis@alysis.nl
authors.forename: Carla
authors.initials: C
authors.lastname: Meeuwis
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: van de Ven
authors.forename: Gerard
authors.initials: G
authors.lastname: Stapper
authors.forename: Arancha M
authors.initials: AM
authors.lastname: Fernandez Gallardo
authors.forename: Maurice A A J
authors.initials: MA
authors.lastname: van den Bosch
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: Wouter B
authors.initials: WB
authors.lastname: Veldhuis
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001185:Artificial Intelligence; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity