title: Computer-aided detection (CAD) system for breast MRI in assessment of local tumor extent, nodal status, and multifocality of invasive breast cancers: preliminary study.
abstract: BACKGROUND
  We aimed to investigate the efficacy of computer-aided detection (CAD) for MRI in the assessment of tumor extent, lymph node status, and multifocality in invasive breast cancers in comparison with other breast imaging modalities.
  
  
  METHODS
  Two radiologists measured the maximum tumor size, as well as, analyzed lymph node status and multifocality in 86 patients with invasive breast cancers using mammography, ultrasound, CT, MRI with and without CAD, and 18-fludeoxyglucose positron emission tomography (FDG-PET). The assessed data were compared with pathology.
  
  
  RESULTS
  For tumor extent, there were no significant differences between pathological size and measured size using mammography, ultrasound, CT, or MRI with and without CAD (P>0.05). For evaluation of lymph node status, ultrasound had the best kappa coefficients (0.522) for agreement between imaging and pathology, and diagnostic performance with 92.1% specificity and 90.0% positive predictive value. For multifocality, MRI with CAD had the highest area under the receiver operating characteristic curve (AUC=0.888).
  
  
  CONCLUSIONS
  CAD for MRI is feasible to assess tumor extent and multifocality in invasive breast cancer patients. However, CAD is not effective in evaluation of nodal status.
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan city, Gyeonggi-do, 425-707, Korea. akaeuny@hanmail.net.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Song
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan city, Gyeonggi-do, 425-707, Korea. seoboky@korea.ac.kr.
authors.forename: Bo Kyoung
authors.initials: BK
authors.lastname: Seo
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, Korea. krcho@korea.ac.kr.
authors.forename: Kyu Ran
authors.initials: KR
authors.lastname: Cho
authors.affiliation: Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, Korea. wokhee@korea.ac.kr.
authors.forename: Ok Hee
authors.initials: OH
authors.lastname: Woo
authors.affiliation: Department of Surgery, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan city, Gyeonggi-do, 425-707, Korea. gsson@korea.ac.kr.
authors.forename: Gil Soo
authors.initials: GS
authors.lastname: Son
authors.affiliation: Department of Nuclear Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan city, Gyeonggi-do, 425-707, Korea. snuhnm2009@naver.com.
authors.forename: Chulhan
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, Korea. anglercho@gmail.com.
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Cho
authors.affiliation: Department of Biostatistics, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Seongnam-si, Gyeonggi-do, 463-707, Korea. qrio1010@gmail.com.
authors.forename: Soon-Sun
authors.initials: SS
authors.lastname: Kwon
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D017076:Computer-Aided Design; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve