title: Identification of Breast Cancer Using Integrated Information from MRI and Mammography.
abstract: OBJECTIVE
  Integration of information from corresponding regions between the breast MRI and an X-ray mammogram could benefit the detection of breast cancer in clinical diagnosis. We aimed to provide a framework of registration from breast MRI to mammography and to evaluate the diagnosis using the combined information.
  
  
  METHODS
  43 patients with 46 lesions underwent both MRI and mammography scans, and the interval between the two examinations was around one month. The distribution of malignant to benign lesions was 31/46 based on histological results. Maximum intensity projection and thin-plate spline methods were applied for image registration for MRI to mammography. The diagnosis using integrated information was evaluated using results of histology as the reference. The assessment of annotations and statistical analysis were performed by the two radiologists.
  
  
  RESULTS
  For the cranio-caudal view, the mean post-registration error between MRI and mammography was 2.2±1.9 mm. For the medio-lateral oblique view, the proposed approach performed even better with a mean error of 3.0±2.4 mm. In the diagnosis using MRI assessment with information of mammography, the sensitivity was 91.9±2.3% (29/31, 28/31), specificity 70.0±4.7% (11/15, 10/15), accuracy 84.8±3.1% (40/46, 38/46), positive predictive value 86.4±2.1% (29/33, 28/33) and negative predictive value 80.8±5.4% (11/13, 10/13).
  
  
  CONCLUSIONS
  MRI with the aid of mammography shows potential improvements of sensitivity, specificity, accuracy, PPV and NPV in clinical breast cancer diagnosis compared to the use of MRI alone.
authors.affiliation: Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan; Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Neng
authors.initials: SN
authors.lastname: Yang
authors.affiliation: Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan.
authors.forename: Fang-Jing
authors.initials: FJ
authors.lastname: Li
authors.affiliation: Department of Radiology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yen-Hsiu
authors.initials: YH
authors.lastname: Liao
authors.affiliation: Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan.
authors.forename: Yueh-Sheng
authors.initials: YS
authors.lastname: Chen
authors.affiliation: Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan; Department of Radiology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Wu-Chung
authors.initials: WC
authors.lastname: Shen
authors.affiliation: Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan; Department of Biomedical Informatics, Asia University, Taichung, Taiwan.
authors.forename: Tzung-Chi
authors.initials: TC
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged