Investig Magn Reson Imaging.  2019 Mar;23(1):46-54. 10.13104/imri.2019.23.1.46.

Computer-Aided Detection with Automated Breast Ultrasonography for Suspicious Lesions Detected on Breast MRI

• Kim S
• Kang BJ
• Kim SH
• Lee J
• Park GE

• KMID: 2442233
• DOI: http://doi.org/10.13104/imri.2019.23.1.46

Abstract

PURPOSE
The aim of this study was to evaluate the diagnostic performance of a computer-aided detection (CAD) system used with automated breast ultrasonography (ABUS) for suspicious lesions detected on breast MRI, and CAD-false lesions.
MATERIALS AND METHODS
We included a total of 40 patients diagnosed with breast cancer who underwent ABUS (ACUSON S2000) to evaluate multiple suspicious lesions found on MRI. We used CAD (QVCADâ„¢) in all the ABUS examinations. We evaluated the diagnostic accuracy of CAD and analyzed the characteristics of CAD-detected lesions and the factors underlying false-positive and false-negative cases. We also analyzed false-positive lesions with CAD on ABUS.
RESULTS
Of a total of 122 suspicious lesions detected on MRI in 40 patients, we excluded 51 daughter nodules near the main breast cancer within the same quadrant and included 71 lesions. We also analyzed 23 false-positive lesions using CAD with ABUS. The sensitivity, specificity, positive predictive value, and negative predictive value of CAD (for 94 lesions) with ABUS were 75.5%, 44.4%, 59.7%, and 62.5%, respectively. CAD facilitated the detection of 81.4% (35/43) of the invasive ductal cancer and 84.9% (28/33) of the invasive ductal cancer that showed a mass (excluding non-mass). CAD also revealed 90.3% (28/31) of the invasive ductal cancers measuring larger than 1 cm (excluding non-mass and those less than 1 cm). The mean sizes of the true-positive versus false-negative mass lesions were 2.08 ± 0.85 cm versus 1.6 ± 1.28 cm (P < 0.05). False-positive lesions included sclerosing adenosis and usual ductal hyperplasia. In a total of 23 false cases of CAD, the most common (18/23) cause was marginal or subareolar shadowing, followed by three simple cysts, a hematoma, and a skin wart.
CONCLUSION
CAD with ABUS showed promising sensitivity for the detection of invasive ductal cancer showing masses larger than 1 cm on MRI.

Keyword

Breast cancer; Magnetic resonance imaging; Computer-aided detection; Automated breast ultrasonography

MeSH Terms

Breast Neoplasms
Breast*
Hematoma
Humans
Hyperplasia
Magnetic Resonance Imaging*
Nuclear Family
Sensitivity and Specificity
Shadowing (Histology)
Skin
Ultrasonography, Mammary*
Warts