Computer-aided detection in breast MRI: a systematic review and meta-analysis.

ABSTRACT

OBJECTIVES: 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.