title: Computer-aided detection in breast MRI: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the additional value of computer-aided detection (CAD) in breast MRI by assessing radiologists' accuracy in discriminating benign from malignant breast lesions.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Of 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%).
  
  
  CONCLUSIONS
  CAD 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.
authors.affiliation: Department of Radiology, Center for Medical Imaging, University Medical Center Groningen, Hanzeplein 1, PO box 30.001, 9700 RB Groningen, the Netherlands. m.d.dorrius@rad.umcg.nl
authors.forename: Monique D
authors.initials: MD
authors.lastname: Dorrius
authors.forename: Marijke C
authors.initials: MC
authors.lastname: Jansen-van der Weide
authors.forename: Peter M A
authors.initials: PM
authors.lastname: van Ooijen
authors.forename: Ruud M
authors.initials: RM
authors.lastname: Pijnappel
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D002983:Clinical Competence; D003287:Contrast Media; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media