Computer aided evaluation (CAE/CAD) has helped most radiologists to interpret the hundreds of images associated with breast MRI. Our purpose is to advance your MRI reading skills by discussing and illustrating:
(1) The pitfalls of using CAE/CAD - don't just "hit the button" and believe all those colors
(2) Imaging techniques, anatomic and contrast enhancement patterns that contribute to diagnosis, but are not currently included in the BI-RADS lexicon.
A. Proper use of CAD/CAE - illustrating:
1. Incorrect setup can result in missing peak enhancement
2. Check for patient motion first, before trusting the color assignment!
3. Motion compensation can lead you astray - use cine mode to visually check for software induced artifacts
3. Threshold properly to achieve balance of sensitivity and specificity
B. Review of MRI findings not yet in BI-RADS
1. T2 signal intensity
2. Blooming sign (not just a sign of Spring)
3. Hook sign
4. Edema sign
5. Diffusion properties
After viewing this exhibit the viewer will:
1. Approach CAE/CAD software with healthy skepticism, knowing how to set it up, use it properly and what to do when things seem wrong.
2. Go beyond the BI-RADS descriptors and be able to incorporate additional subtle information to improve accuracy of diagnosis.
Kelcz, F,
It's Not All in the CAD or BI-RADS: Optimizing Your Interpretation of Breast MRI by Avoiding the Perils of CAD and Including Diagnostic Imaging Data Not Yet Included in BI-RADS. Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL.
http://archive.rsna.org/2013/13022780.html
