title: Contralateral lesions detected by preoperative MRI in patients with recently diagnosed breast cancer: application of MR CAD in differentiation of benign and malignant lesions.
abstract: OBJECTIVE
  To retrospectively investigate the added value of kinetic features measured by computer-aided diagnosis (CAD) for differentiating benign and malignant contralateral breast lesions detected by preoperative MRI in breast cancer patients.
  
  
  METHODS
  This study was approved by our institutional review board, and the requirement for informed consent was waived. Fifty-two breast MR images and their CAD kinetic features were obtained for 52 consecutive breast cancer patients with contralateral breast lesions detected by preoperative MRI and confirmed by excision (23 cancers and 29 benign lesions). Three experienced radiologists independently reviewed the MR images without CAD information and assessed probabilities of malignancy. Four weeks later, these probabilities were reanalyzed using stored CAD data. Diagnostic performances and detection rates of delayed washout components were compared between interpretations without and with CAD for each reader.
  
  
  RESULTS
  Use of MR CAD increased detection of washout component by 2.4- to 3.7-fold than visual assessment for enhancing contralateral lesions, which increased sensitivity (91% vs. 87% in reader 1; 96% vs. 74% in reader 2; 91% vs. 70% in reader 3) and decreased specificity, but statistical significance was only found for decreased specificity in one reader (52% vs. 28%, P = 0.039), and overall performance (areas under ROC curves 0.672 vs. 0.616 in reader 1; 0.624 vs. 0.603 in reader 2; 0.706 vs. 0.590 in reader 3) remained unimproved.
  
  
  CONCLUSIONS
  Addition of MR CAD increased sensitivity and decreased specificity than radiologist's assessment alone for differentiating benign and malignant contralateral lesions in breast cancer patients and overall performance remained unimproved.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, and Institute of Radiation Medicine, 101 Daehangno, Jongno-gu, Seoul, Republic of Korea.
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Jeong Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Mijung
authors.initials: M
authors.lastname: Jang
authors.forename: Soo-Yeon
authors.initials: SY
authors.lastname: Kim
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D011300:Preoperative Care; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine